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

Sanghyuk S. Shin, Chawangwa Modongo, Ronald Ncube, Enoch Sepako, Jeffrey D. Klausner, Nicola M. Zetola

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)347-351
Number of pages5
JournalJournal of Infectious Diseases
Volume211
Issue number3
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Keywords

  • HIV/AIDS; immune suppression
  • mixed tuberculosis infection
  • reinfection
  • tuberculosis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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