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M9650248.TXT
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1996-03-09
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Document 0248
DOCN M9650248
TI Independent origin of mono-rifampin-resistant Mycobacterium tuberculosis
in patients with AIDS.
DT 9605
AU Lutfey M; Della-Latta P; Kapur V; Palumbo LA; Gurner D; Stotzky G;
Brudney K; Dobkin J; Moss A; Musser JM; Kreiswirth BN; Tuberculosis
Center, Public Health Research Institute, Columbia; Presbyterian Medical
Center, New York, New York 10016, USA.
SO Am J Respir Crit Care Med. 1996 Feb;153(2):837-40. Unique Identifier :
AIDSLINE MED/96160606
AB 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.
DE Antibiotics, Antitubercular/*THERAPEUTIC USE AIDS-Related Opportunistic
Infections/*DRUG THERAPY/MICROBIOLOGY/ TRANSMISSION Drug Resistance,
Microbial Genes, Structural, Bacterial Human Microbial Sensitivity
Tests Mycobacterium tuberculosis/*DRUG EFFECTS/GENETICS Point Mutation
Polymorphism, Restriction Fragment Length Rifampin/*THERAPEUTIC USE
RNA Polymerases/GENETICS Support, U.S. Gov't, P.H.S. Treatment Refusal
Tuberculosis, Pulmonary/*DRUG THERAPY/MICROBIOLOGY/TRANSMISSION JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).