Molecular investigation of multiple strain infections in patients with tuberculosis in Mubende district, Uganda
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
Infection, Genetics and Evolution
Abstract
Multiple strain tuberculosis (TB) infections are now an acceptable facet of tuberculosis epidemiology.
Identification of patients infected with more than one strain gives an insight in disease dynamics at individual
and population level. This study therefore aimed at identifying multiple strain infections among TB
infected patients. Furthermore, to determine factors associated with multiple strain infections in
Mubende district of Uganda.
A total of 72 Mycobacterium tuberculosis isolates from patients at Mubende regional referral hospital
were characterized using 15 loci MIRU-VNTR, Spoligotyping and deletion analysis. Genotypic and epidemiological
data were analyzed using MIRU-VNTR plus, Bionumerics software version 6.1 and an exact
logistic regression model respectively.
Eight (11.1%) of the 72 patients had mixed TB infections. Five were exclusively pulmonary mixed infections
while three had both pulmonary and extra-pulmonary infections (Compartmentalized TB infections).
Unlike previous studies that have linked this phenomenon to Beijing strains, multiple strains in
this study belonged to T2-Uganda, X2 and T1 lineages. Two of the pulmonary mixed infections were resistant
to rifampicin or isoniazid. All except one were HIV positive, newly diagnosed cases and urban residents
of Mubende district.
The study revealed that one in nine urban dwelling, HIV/TB co-infected patient were infected with
more than one M. tuberculosis strains. The molecular findings give indications of a vital component of
the disease dynamics that is most likely under looked at clinical level.
Description
Keywords
Mixed infections, Mycobacterium tuberculosis, Mubende, Uganda
Citation
Muwonge, A., Kankya, C., Olea-Popelka, F., Biffa, D., Ssengooba, W., Berit, D., ... & Johansen, T. B. (2013). Molecular investigation of multiple strain infections in patients with tuberculosis in Mubende district, Uganda. Infection, Genetics and Evolution, 17, 16-22. http://dx.doi.org/10.1016/j.meegid.2013.03.039