Detection of multiple strains of Mycobacterium tuberculosis using MIRU-VNTR in patients with pulmonary tuberculosis in Kampala, Uganda

BMC Infectious Diseases

Research Article

Lydia Nabyonga¹  David P Kateete¹  Fred A Katabazi¹  Moses L Joloba¹  Benon B Asiimwe¹  Harriet K Mayanja²  Katherine R Dickman³  Christopher Whalen⁴  Alphonse Okwera⁵ 

[1] Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda;Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda;Department of Pediatrics, Boston Medical Center, Boston University, Boston, USA;Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda;Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, USA;Tuberculosis Unit, Mulago National Referral and Teaching Hospital, Kampala, Uganda;

关键词: Pulmonary Tuberculosis;    Sputum Sample;    Multiple Strain;    Drug Resistance Testing;    Mycobacterial Intersperse Repetitive Unit;   

DOI  :  10.1186/1471-2334-10-349

 received in 2010-05-12, accepted in 2010-12-10,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundMany 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.MethodsA 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.ResultsOf 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.ConclusionInfection 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.

【 授权许可】

Unknown   
© Dickman et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.