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Mixed infections and rifampin hetero-resistance of Mycobacterium tuberculosis clinical isolates

Abstract : Mixed infections and hetero-resistance of Mycobacterium tuberculosis add greater difficulty to the diagnosis, treatment, and control of tuberculosis. However, there is still no proper solution to deal with them. This study was aimed to investigate the potential relationship between mixed infections and hetero-resistance and determine the high risk groups related to them. A total of 499 resistant and susceptible isolates were subjected to spoligotyping and 24-locus variable-number tandem repeat methods to analyse their genotypic lineages and the occurrence of mixed infections. Two hundred and ninety two randomly-selected isolates were sequenced on rpoB gene to examine the mutations and hetero-resistance. The results showed that 12 patients had mixed infections and the corresponding isolates belonged to Manu2 (n = 8), Beijing (n = 2), T (n = 1), and unknown (n = 1). Manu2 was found to be significantly associated with mixed infections (odds ratio, 47.72; confidence interval, 9.68 to 235.23; P < 0.01). Four isolates (1.37%) were confirmed as hetero-resistant, among which three (75%) were caused by mixed infections and belonged to Manu2. Additionally, 3.8% rifampin-resistant isolates showing no mutation in rpoB gene were significantly associated with mixed infections (χ2, 56.78, P < 0.01). This study revealed that Manu2 was the predominant group in the cases of mixed infections for the first time, and this might be the main reason for hetero-resistance and a possible mechanism for rifampin-resistant isolates without any mutation in rpoB gene. Further studies should focus on this lineage to clarify its relevance to mixed infections.
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Contributor : Nalin Rastogi Connect in order to contact the contributor
Submitted on : Wednesday, May 20, 2015 - 10:01:18 PM
Last modification on : Saturday, September 26, 2020 - 12:27:31 AM

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Chao Zheng, Song Li, Zhongyue Luo, Rui Pi, Honghu Sun, et al.. Mixed infections and rifampin hetero-resistance of Mycobacterium tuberculosis clinical isolates. Journal of Clinical Microbiology, 2015, 53 (7), pp.2138-2147. ⟨10.1128/JCM.03507-14⟩. ⟨pasteur-01154012⟩



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