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Superinfection with Rifampin-Isoniazid-Streptomycin-Ethambutol (RISE)-resistant Tuberculosis in Three Patients with AIDS: Confirmation by Polymerase Chain Reaction Fingerprinting

1994; American College of Physicians; Volume: 121; Issue: 2 Linguagem: Inglês

10.7326/0003-4819-121-2-199407150-00007

1539-3704

David L. Horn,

Infectious Diseases and Tuberculosis

Brief Communications15 July 1994Superinfection with Rifampin-Isoniazid-Streptomycin-Ethambutol (RISE)-resistant Tuberculosis in Three Patients with AIDS: Confirmation by Polymerase Chain Reaction FingerprintingDavid L. Horn, MD, Dial Hewlett, MD, Walter H. Haas, MD, W. Ray Butler, MS, Celia Alfalla, MD, Edgar Tan, MD, Andrew Levine, MD, Atasu Nayak, MD, and Steven M. Opal, MDDavid L. Horn, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, Dial Hewlett, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, Walter H. Haas, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, W. Ray Butler, MSFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, Celia Alfalla, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, Edgar Tan, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, Andrew Levine, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, Atasu Nayak, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this author, and Steven M. Opal, MDFrom Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-2-199407150-00007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Reinfection with new strains of Mycobacterium tuberculosis has been reported [1-4]. Exogenous reinfection with M. tuberculosis resistant to isoniazid and streptomycin played an important role in an outbreak occurring in a homeless shelter [5]. Recently, restriction fragment-length polymorphism analysis has been used to show exogenous M. tuberculosis reinfection of patients with the acquired immunodeficiency syndrome (AIDS) who have multidrug-resistant tuberculosis that occurred during therapy for the initial drug-sensitive infection [6, 7]. We describe three additional patients in whom rifampin-isoniazid-streptomycin-ethambutol (RISE)-resistant tuberculosis occurred during therapy for drug-susceptible tuberculosis. This was documented by DNA fingerprinting using the mixed-linker polymerase chain reaction (PCR) ...References1. Romeyn JA. Exogenous reinfection in tuberculosis. Am Rev Respir Dis. 1970; 101:923-7. Google Scholar2. Raleigh JW, Wichelhausen RH, Rado TA, Bates JH. Evidence for infection by two distinct strains of Mycobacterium tuberculosis in pulmonary tuberculosis: report of 9 cases. Am Rev Respir Dis. 1975; 112:497-503. Google Scholar3. Raleigh JW, Wichelhausen R. Exogenous reinfection with Mycobacterium tuberculosis confirmed by phage typing. Am Rev Respir Dis. 1973; 108:639-42. Google Scholar4. Bates JH, Stead WW, Rado TA. Phage type of tubercle bacilli isolated from patients with two or more sites of organ involvement. Am Rev Respir Dis. 1976; 114:353-8. Google Scholar5. Nardell E, McInnis B, Thomas B, Weidhaas S. Exogenous reinfection with tuberculosis in a shelter for the homeless. N Engl J Med. 1986; 315:1570-5. Google Scholar6. Small PM, Shafer RW, Hopewell PC, Murphy M, Desmond E, Sierra M, et al. Pathogenesis of increasingly drug resistant tuberculosis: selection of endogenous mutants or exogenous reinfection (Abstract). 1992 World Congress on Tuberculosis, Bethesda, Maryland, 16-19 November 1992. Google Scholar7. Small PM, Shafer RW, Hopewell PC, Singh SP, Murphy MJ, Desmond E, et al. Exogenous reinfection with multidrug-resistant Mycobacterium tuberculosis in patients with advanced HIV infection. N Engl J Med. 1993; 328:1137-44. Google Scholar8. Haas WH, Butler WR, Woodley CL, Crawford JT. Mixed-linker polymerase chain reaction: a new method for rapid fingerprinting of isolates of the Mycobacterium tuberculosis complex. J Clin Microbiol. 1993; 31:1293-8. Google Scholar9. Centers for Disease Control and Prevention. Outbreak of multidrug-resistant tuberculosis at a hospital—New York City, 1991. MMWR 1993; 42:427-34. Google Scholar10. Cave MD, Eisenach KD, McDermott PF, Bates JH, Crawford JT. IS6110: conservation of sequence in the Mycobacterium tuberculosis complex and its utilization in DNA fingerprinting. Mol Cell Probes. 1991; 5:73-80. Google Scholar Author, Article, and Disclosure InformationAuthors: David L. Horn, MD; Dial Hewlett, MD; Walter H. Haas, MD; W. Ray Butler, MS; Celia Alfalla, MD; Edgar Tan, MD; Andrew Levine, MD; Atasu Nayak, MD; Steven M. Opal, MDAffiliations: From Lincoln Medical and Mental Health Center, Bronx, New York; the Centers for Disease Control and Prevention, Atlanta, Georgia; Memorial Hospital of Rhode Island, Providence, Rhode Island.Corresponding Author: Dial Hewlett, Jr., Department of Medicine, Lincoln Medical and Mental Health Center, 234 East 149th Street, Bronx, NY 10451.Acknowledgments: The authors thank Yvonne Lue, PhD, Trevor McLean, Stephen Peterson, MD, Jack Crawford, PhD, and Fred Moore for their assistance. 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