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Spread of a low-fitness drug-resistant Mycobacterium tuberculosis strain in a setting of high human immunodeficiency virus prevalence.

Strauss OJ, Warren RM, Jordaan A, Streicher EM, Hanekom M, Falmer AA, Albert H, Trollip A, Hoosain E, van Helden PD, Victor TC

DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/ MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.

The fitness cost associated with the evolution of resistance to rifampin in Mycobacterium tuberculosis may be different in clinical isolates compared to in vitro-generated mutants. An atypical Beijing strain (attenuated phenotype) demonstrated the ability to spread despite acquiring resistance to rifampin. Transmission was linked to human immunodeficiency virus coinfection (P = 0.029), raising concern for the spread of drug resistance in vulnerable populations.

Published 4 April 2008 in J Clin Microbiol, 46(4): 1514-6.
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