| Autor: |
Lutfey M; Tuberculosis Center, Public Health Research Institute, Columbia Presbyterian Medical Center, New York, New York 10016, USA., Della-Latta P, Kapur V, Palumbo LA, Gurner D, Stotzky G, Brudney K, Dobkin J, Moss A, Musser JM, Kreiswirth BN |
| Jazyk: |
angličtina |
| Zdroj: |
American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 1996 Feb; Vol. 153 (2), pp. 837-40. |
| DOI: |
10.1164/ajrccm.153.2.8564140 |
| Abstrakt: |
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. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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