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Polyclonal and Compartmentalized Infection by Mycobacterium tuberculosis in Patients with Both Respiratory and Extrarespiratory Involvement

Darí García de Viedma, Mercedes Marín, María Jesús Ruiz Serrano, Luis Alcalá and Emilio Bouza
The Journal of Infectious Diseases
Vol. 187, No. 4 (Feb. 15, 2003), pp. 695-699
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30085591
Page Count: 5
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Polyclonal and Compartmentalized Infection by Mycobacterium tuberculosis in Patients with Both Respiratory and Extrarespiratory Involvement
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Abstract

Infection by Mycobacterium tuberculosis (MTB) is assumed to be caused by a single strain, and several MTB strains within the same patient are rarely considered. The present study analyzes the phenomenon of mixed infections by MTB in a group of 50 patients with both respiratory and extrarespiratory tuberculosis. First, the proportion of patients with infection by >1 strain was defined, and second, the clonal composition of the MTB populations at different infected sites was studied. In 3 (6%) of 50 patients, >1 strain was cultured, which indicates that mixed infections are not anecdotal. The coinfecting strains were not equally distributed at the respiratory and extrarespiratory site, which reflects a compartmentalization of the infection. In 1 patient, although 2 strains were found at the respiratory site, only 1 of these strains was involved in the extrarespiratory infection, which suggests that clonal selection can occur in the dissemination of the infection.

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