Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/47823
Title: Exogenous reinfection with tuberculosis on a European Island with a moderate incidence of disease
Authors: Caminero, José A.
Pena, María J.
Campos-Herrero, María I. 
Rodríguez, José C.
Afonso, Octavio
Martin, Carlos
Pavón, José M. 
Torres, María J.
Burgos, Marcos
Cabrera, Pedro 
Small, Peter M.
Enarson, Donald A.
Keywords: Resistant Mycobacterium-Tuberculosis
Fragment-Length-Polymorphism
Pulmonary Tuberculosis
Infection
Recurrence, et al
Issue Date: 2001
Publisher: 1073-449X
Journal: American Journal of Respiratory and Critical Care Medicine 
Abstract: The frequency and determinants of exogenous reinfection and of endogenous reactivation of tuberculosis in patients previously treated are poorly understood. In Gran Canaria Island, Spain, between 1991 and 1996, 962 tuberculosis cases were confirmed by culture. Drug susceptibility testing was performed on available bacterial isolates and IS6110-based RFLP genotyping was carried out. Twenty-three patients (2.4%) had two positive cultures separated by at least 12 mo, 18 of whom had bacterial DNA available for genotypic analysis. The initial and final isolates from eight (44%) were different genotypes, indicating exogenous reinfection. Six of them were retreated after cure and two retreated after default. Six were HIV seronegative and two were HIV seropositive. Endogenous reactivation was seen in the remaining 10 patients of whom eight were retreated after default and two after cure. Three of the eight (38%) being retreated after default developed multidrug resistance. One genotype was responsible for a second episode of tuberculosis in five cases, three exogenous reinfections and two endogenous reactivations. In the context of a moderate incidence of tuberculosis, exogenous reinfection is an important cause of TB recurrence, even in HIV-seronegative patients.
URI: http://hdl.handle.net/10553/47823
ISSN: 1073-449X
DOI: 10.1164/ajrccm.163.3.2003070
Source: American Journal of Respiratory and Critical Care Medicine[ISSN 1073-449X],v. 163, p. 717-720
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