Undetected Multidrug-Resistant Tuberculosis Amplified by First-line Therapy in Mixed Infection

• DOI: 10.3201/1907.130313
• Publication Date: 2013-05-24T15:32:47Z
• Authors: Suzanne M. Hingle...; Rosalyn Casey; David Connell; Samuel Bremang; Jason T. Evans; Peter M. Hawkey; Grace E. Smith; Annette Jepson; Stuart Philip; Onn Min Kon; Ajit Lalvani
• Keywords: Multidrug-Resistant/diagnosis; Male; Delayed Diagnosis; Drug Resistance; Antitubercular Agents; Infectious and parasitic diseases; RC109-216; Minisatellite Repeats; treatment resistance; Pulmonary/diagnosis; co-infection; Drug Therapy; Culture Techniques; Drug Resistance, Multiple, Bacterial; Ethambutol/pharmacology; 616; Tuberculosis, Multidrug-Resistant; Isoniazid; Tuberculosis; Humans; Coinfection/diagnosis; Isoniazid/pharmacology; Tuberculosis, Pulmonary; Antitubercular Agents/pharmacology; Aged; Coinfection; multidrug resistant; Bacterial; R; Dispatch; Mycobacterium tuberculosis; tuberculosis and other mycobacteria; 3. Good health; drug sensitive; Treatment Outcome; Mycobacterium tuberculosis/genetics; Molecular Diagnostic Techniques; Combination; Medicine; Drug Therapy, Combination; Multiple; Ethambutol; Multilocus Sequence Typing

Abstract Infections with >1 Mycobacterium tuberculosis strain(s) are underrecognized. We show, in vitro and vivo, how first-line treatment conferred a competitive growth advantage to amplify multidrug-resistant M. strain patient mixed infection. Diagnostic techniques that identify tubercle bacilli populations needed curb the spread of multidrug resistance.