Independent origin of mono-rifampin-resistant Mycobacterium tuberculosis in patients with AIDS

M. Lutfey, P. Della-Latta, V. Kapur, L. A. Palumbo, D. Gurner, G. Stotzky, K. Brudney, J. Dobkin, A. Moss, J. M. Musser, B. N. Kreiswirth

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Historically, infections caused by Mycobacterium tuberculosis have been treated simultaneously with isoniazid and rifampin. As a consequence of this combined therapy, strains resistant only to rifampin were rarely recovered. However, recently there has been an increasing number of reports describing HIV-positive patients infected with mono-rifampin-resistant M. tuberculosis strains. Organisms cultured from seven patients (including six with AIDS) with infections caused by mono-rifampin-resistant M. tuberculosis, and seen at one New York City hospital, were analyzed by molecular techniques to test the hypothesis that dissemination of a single clone had occurred. IS6110 DNA fingerprinting and automated DNA sequencing of a region of the RNA polymerase beta subunit structural gene (rpoB) containing mutations that confer rifampin resistance showed that all organisms independently acquired the mono- rifampin-resistant phenotype. Molecular analysis of mono-rifampin-resistant organisms cultured from 13 additional patients in New York City confirmed independent strain origin. The data rule out the possibility of person-to- person strain transmission among these patients, and they suggest that host factors such as poor compliance with antituberculosis medications or decreased absorption of rifampin have been a driving force in the origin of these strains.

Original languageEnglish (US)
Pages (from-to)837-840
Number of pages4
JournalAmerican journal of respiratory and critical care medicine
Volume153
Issue number2
DOIs
StatePublished - 1996

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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