Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb 1;211(3):347-51.
doi: 10.1093/infdis/jiu421. Epub 2014 Jul 28.

Advanced immune suppression is associated with increased prevalence of mixed-strain Mycobacterium tuberculosis infections among persons at high risk for drug-resistant tuberculosis in Botswana

Sanghyuk S Shin  1 , Chawangwa Modongo  2 , Ronald Ncube  3 , Enoch Sepako  4 , Jeffrey D Klausner  1 , Nicola M Zetola  5
Affiliations

Advanced immune suppression is associated with increased prevalence of mixed-strain Mycobacterium tuberculosis infections among persons at high risk for drug-resistant tuberculosis in Botswana

Sanghyuk S Shin et al. J Infect Dis. .

Abstract

We examined factors associated with mixed-strain Mycobacterium tuberculosis infections among patients at high risk for drug-resistant tuberculosis in Botswana. Thirty-seven (10.0%) of 370 patients with tuberculosis had mixed M. tuberculosis infections, based on 24-locus mycobacterial interspersed repetitive unit-variable number of tandem repeats genotyping. In log-binomial regression analysis, age <37 years (adjusted prevalence ratio [PR], 1.92; 95% confidence interval [CI], 1.01-3.57) and prior tuberculosis treatment (adjusted PR, 2.31; 95% CI, 1.09-4.89) were associated with mixed M. tuberculosis infections. Among human immunodeficiency virus-infected patients, prior tuberculosis treatment (adjusted PR, 2.11; 95% CI, 1.04-4.31) and CD4(+) T-cell count of <100 cells/μl (adjusted PR, 10.18; 95% CI, 2.48-41.71) were associated with mixed M. tuberculosis infections. Clinical suspicion of mixed M. tuberculosis infections should be high for patients with advanced immunosuppression and a prior history of tuberculosis treatment.

Keywords: HIV/AIDS; immune suppression; mixed tuberculosis infection; reinfection; tuberculosis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Prevalence of mixed-strain Mycobacterium tuberculosis infections, by CD4+ T-cell count and prior history of tuberculosis treatment, among human immunodeficiency virus–infected patients evaluated for multidrug-resistant tuberculosis in Botswana, January 2012–March 2013.
See this image and copyright information in PMC

References

    1. van Rie A, Victor TC, Richardson M, et al. Reinfection and mixed infection cause changing Mycobacterium tuberculosis drug-resistance patterns. Am J Respir Crit Care Med. 2005;172:636–42. - PMC - PubMed
    1. Cohen T, van Helden PD, Wilson D, et al. Mixed-strain Mycobacterium tuberculosis infections and the implications for tuberculosis treatment and control. Clin Microbiol Rev. 2012;25:708–19. - PMC - PubMed
    1. Huyen MNT, Kremer K, Lan NTN, et al. Mixed tuberculosis infections in rural south Vietnam. J Clin Microbiol. 2012;50:1586–92. - PMC - PubMed
    1. Muwonge A, Kankya C, Olea-Popelka F, et al. Molecular investigation of multiple strain infections in patients with tuberculosis in Mubende district, Uganda. Infect Genet Evol. 2013;17:16–22. - PubMed
    1. Warren RM, Victor TC, Streicher EM, et al. Patients with Active Tuberculosis often Have Different Strains in the Same Sputum Specimen. Am J Respir Crit Care Med. 2004;169:610–4. - PubMed

Publication types