BACKGROUND: Many studies using DNA fingerprinting to differentiate Mycobacterium tuberculosis (MTB) strains reveal single strains in cultures, suggesting that most disease is caused by infection with a single strain. However, recent studies using molecular epidemiological tools that amplify multiple targets have demonstrated simultaneous infection with multiple strains of MTB. We aimed to determine the prevalence of MTB multiple strain infections in Kampala, and the impact of these infections on clinical presentation of tuberculosis (TB) and response to treatment. METHODS: A total of 113 consecutive smear and culture positive patients who previously enrolled in a house-hold contact study were included in this study. To determine whether infection with multiple MTB strains has a clinical impact on the initial presentation of patients, retrospective patient data (baseline clinical, radiological and drug susceptibility profiles) was obtained. To determine presence of infections with multiple MTB strains, MIRU-VNTR (Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeats) -PCR was performed on genomic DNA extracted from MTB cultures of smear positive sputum samples at baseline, second and fifth months. RESULTS: Of 113 patients, eight (7.1%) had infection with multiple MTB strains, coupled with a high rate of HIV infection (37.5% versus 12.6%, p = 0.049). The remaining patients (105) were infected with single MTB strains. The proportions of patients with MTB smear positive cultures after two and five months of treatment were similar. There was no difference between the two groups for other variables. CONCLUSION: Infection with multiple MTB strains occurs among patients with first episode of pulmonary tuberculosis in Kampala, in a setting with high TB incidence. Infection with multiple MTB strains had little impact on the clinical course for individual patients. This is the first MIRU-VNTR-based study from in an East African country.
BACKGROUND: Many studies using DNA fingerprinting to differentiate Mycobacterium tuberculosis (MTB) strains reveal single strains in cultures, suggesting that most disease is caused by infection with a single strain. However, recent studies using molecular epidemiological tools that amplify multiple targets have demonstrated simultaneous infection with multiple strains of MTB. We aimed to determine the prevalence of MTB multiple strain infections in Kampala, and the impact of these infections on clinical presentation of tuberculosis (TB) and response to treatment. METHODS: A total of 113 consecutive smear and culture positive patients who previously enrolled in a house-hold contact study were included in this study. To determine whether infection with multiple MTB strains has a clinical impact on the initial presentation of patients, retrospective patient data (baseline clinical, radiological and drug susceptibility profiles) was obtained. To determine presence of infections with multiple MTB strains, MIRU-VNTR (Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeats) -PCR was performed on genomic DNA extracted from MTB cultures of smear positive sputum samples at baseline, second and fifth months. RESULTS: Of 113 patients, eight (7.1%) had infection with multiple MTB strains, coupled with a high rate of HIV infection (37.5% versus 12.6%, p = 0.049). The remaining patients (105) were infected with single MTB strains. The proportions of patients with MTB smear positive cultures after two and five months of treatment were similar. There was no difference between the two groups for other variables. CONCLUSION:Infection with multiple MTB strains occurs among patients with first episode of pulmonary tuberculosis in Kampala, in a setting with high TB incidence. Infection with multiple MTB strains had little impact on the clinical course for individual patients. This is the first MIRU-VNTR-based study from in an East African country.
Authors: Philip Supply; Caroline Allix; Sarah Lesjean; Mara Cardoso-Oelemann; Sabine Rüsch-Gerdes; Eve Willery; Evgueni Savine; Petra de Haas; Henk van Deutekom; Solvig Roring; Pablo Bifani; Natalia Kurepina; Barry Kreiswirth; Christophe Sola; Nalin Rastogi; Vincent Vatin; Maria Cristina Gutierrez; Maryse Fauville; Stefan Niemann; Robin Skuce; Kristin Kremer; Camille Locht; Dick van Soolingen Journal: J Clin Microbiol Date: 2006-09-27 Impact factor: 5.948
Authors: Isdore C Shamputa; Levan Jugheli; Nikoloz Sadradze; Eve Willery; Françoise Portaels; Philip Supply; Leen Rigouts Journal: Respir Res Date: 2006-07-17
Authors: Yurena Navarro; Marta Herranz; Laura Pérez-Lago; Miguel Martínez Lirola; Maria Jesús Ruiz-Serrano; Emilio Bouza; Darío García de Viedma Journal: J Clin Microbiol Date: 2011-09-28 Impact factor: 5.948
Authors: Nicholas D Walter; Michael Strong; Robert Belknap; Diane J Ordway; Charles L Daley; Edward D Chan Journal: Respirology Date: 2012-07 Impact factor: 6.424
Authors: Ted Cohen; Paul D van Helden; Douglas Wilson; Caroline Colijn; Megan M McLaughlin; Ibrahim Abubakar; Robin M Warren Journal: Clin Microbiol Rev Date: 2012-10 Impact factor: 26.132
Authors: Sanghyuk S Shin; Chawangwa Modongo; Yeonsoo Baik; Christopher Allender; Darrin Lemmer; Rebecca E Colman; David M Engelthaler; Robin M Warren; Nicola M Zetola Journal: J Infect Dis Date: 2018-11-05 Impact factor: 5.226
Authors: Michael Asare-Baah; Marie Nancy Séraphin; LaTweika A T Salmon; Michael Lauzardo Journal: Infect Genet Evol Date: 2020-12-01 Impact factor: 3.342
Authors: Adrian Muwonge; Sydney Malama; Tone B Johansen; Clovice Kankya; Demelash Biffa; Willy Ssengooba; Jacques Godfroid; Berit Djønne; Eystein Skjerve Journal: PLoS One Date: 2013-05-31 Impact factor: 3.240