1. Possible Transmission Mechanisms of Mixed Mycobacterium tuberculosis Infection in High HIV Prevalence Country, Botswana
- Author
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Rosanna Boyd, Alyssa Finlay, Chawangwa Modongo, Patrick K. Moonan, Yeonsoo Baik, Nicola M. Zetola, Eleanor S. Click, James L. Tobias, John E. Oeltmann, and Sanghyuk S. Shin
- Subjects
Epidemiology ,lcsh:Medicine ,HIV Infections ,Minisatellite Repeats ,0302 clinical medicine ,Prevalence ,2.2 Factors relating to the physical environment ,030212 general & internal medicine ,Aetiology ,bacteria ,Botswana ,Bacterial ,Hiv prevalence ,Bacterial Typing Techniques ,mixed infection ,Infectious Diseases ,Possible Transmission Mechanisms of Mixed Mycobacterium tuberculosis Infection in High HIV Prevalence Country, Botswana ,tuberculosis ,Medical Microbiology ,Tuberculosis and other mycobacteria ,Public Health and Health Services ,HIV/AIDS ,Infection ,Mixed infection ,DNA, Bacterial ,Microbiology (medical) ,Tuberculosis ,Genotype ,030231 tropical medicine ,Clinical Sciences ,Locus (genetics) ,Biology ,Microbiology ,lcsh:Infectious and parasitic diseases ,Mycobacterium tuberculosis ,03 medical and health sciences ,Rare Diseases ,Clinical Research ,Genetics ,medicine ,Humans ,lcsh:RC109-216 ,Allele ,Genotyping ,Molecular epidemiology ,Prevention ,Research ,lcsh:R ,HIV ,DNA ,biology.organism_classification ,medicine.disease ,Virology ,Good Health and Well Being ,genotyping - 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.
- Published
- 2020