TY - JOUR
T1 - 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
AU - Shin, Sanghyuk S.
AU - Modongo, Chawangwa
AU - Ncube, Ronald
AU - Sepako, Enoch
AU - Klausner, Jeffrey D.
AU - Zetola, Nicola M.
N1 - Publisher Copyright:
© 2014 The Author.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - 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.
AB - 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.
KW - HIV/AIDS; immune suppression
KW - mixed tuberculosis infection
KW - reinfection
KW - tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=84922513764&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922513764&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiu421
DO - 10.1093/infdis/jiu421
M3 - Article
C2 - 25070941
AN - SCOPUS:84922513764
SN - 0022-1899
VL - 211
SP - 347
EP - 351
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 3
ER -