Possible Transmission Mechanisms of Mixed Mycobacterium tuberculosis Infection in High HIV Prevalence Country, Botswana

Yeonsoo Baik, Chawangwa Modongo, Patrick K. Moonan, Eleanor S. Click, James L. Tobias, Rosanna Boyd, Alyssa Finlay, John E. Oeltmann, Sanghyuk S. Shin, Nicola M. Zetola

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Tuberculosis caused by concurrent infection with multiple Mycobacterium tuberculosis strains (i.e., mixed infection) challenges clinical and epidemiologic paradigms. We explored possible transmission mechanisms of mixed infection in a population-based, molecular epidemiology study in Botswana during 2012–2016. We defined mixed infection as multiple repeats of alleles at >2 loci within a discrete mycobacterial interspersed repetitive unit–variable-number tandem-repeat (MIRU-VNTR) result. We compared mixed infection MIRU-VNTR results with all study MIRU-VNTR results by considering all permutations at each multiple allele locus; matched MIRU-VNTR results were considered evidence of recently acquired strains and nonmatched to any other results were considered evidence of remotely acquired strains. Among 2,051 patients, 34 (1.7%) had mixed infection, of which 23 (68%) had recently and remotely acquired strains. This finding might support the mixed infection mechanism of recent transmission and simultaneous remote reactivation. Further exploration is needed to determine proportions of transmission mechanisms in settings where mixed infections are prevalent.

Original languageEnglish (US)
Pages (from-to)953-960
Number of pages8
JournalEmerging Infectious Diseases
Volume26
Issue number5
DOIs
StatePublished - May 2020
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Possible Transmission Mechanisms of Mixed Mycobacterium tuberculosis Infection in High HIV Prevalence Country, Botswana'. Together they form a unique fingerprint.

Cite this