Within-Host Heterogeneity of Mycobacterium tuberculosis Infection Is Associated With Poor Early Treatment Response: A Prospective Cohort Study.
J Infect Dis
; 213(11): 1796-9, 2016 06 01.
Article
em En
| MEDLINE
| ID: mdl-26768249
ABSTRACT
The clinical management of tuberculosis is a major challenge in southern Africa. The prevalence of within-host genetically heterogeneous Mycobacterium tuberculosis infection and its effect on treatment response are not well understood. We enrolled 500 patients with tuberculosis in KwaZulu-Natal and followed them through 2 months of treatment. Using mycobacterial interspersed repetitive units-variable number of tandem repeats genotyping to identify mycobacterial heterogeneity, we report the prevalence and evaluate the association of heterogeneity with treatment response. Upon initiation of treatment, 21.1% of participants harbored a heterogeneous M. tuberculosis infection; such heterogeneity was independently associated with a nearly 2-fold higher odds of persistent culture positivity after 2 months of treatment (adjusted odds ratio, 1.90; 95% confidence interval, 1.03-3.50).
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Base de dados:
MEDLINE
Assunto principal:
Tuberculose Pulmonar
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Heterogeneidade Genética
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Mycobacterium tuberculosis
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Antituberculosos
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article