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Updated: Jul 19, 2026
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An Experimental Model to Study Tuberculosis-Malaria Coinfection upon Natural Transmission of Mycobacterium tuberculosis and Plasmodium berghei
Published on: February 17, 2014
Simultaneous infection with multiple strains of Mycobacterium tuberculosis
C R Braden1, G P Morlock, C L Woodley
1Division of Tuberculosis Elimination, National Center for Human Immunodeficiency Virus, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. crb5@cdc.gov
Summary
Simultaneous Mycobacterium tuberculosis infections with drug-susceptible and drug-resistant strains were identified in two patients. This suggests co-infections may explain conflicting tuberculosis drug-susceptibility test results.
Area of Science:
- Microbiology
- Infectious Diseases
- Genetics
Background:
- Tuberculosis (TB) diagnosis relies on drug-susceptibility testing (DST).
- Conflicting DST results can complicate treatment decisions.
- Understanding Mycobacterium tuberculosis (M.tb) strain diversity is crucial for TB control.
Observation:
- Two patients presented with both drug-susceptible and drug-resistant M.tb isolates.
- Patient 1 had isoniazid-resistant TB, while Patient 2 had multidrug-resistant TB.
- Both patients worked in a medical-waste processing facility, suggesting potential occupational exposure.
Findings:
- Genotyping revealed distinct M.tb strains within individual patients, indicating simultaneous infections.
- Patient 1 harbored both susceptible and isoniazid-resistant strains, differing by IS6110 restriction fragment patterns.
- Patient 2's isolate contained both drug-susceptible and multidrug-resistant colonies with unique restriction fragment profiles.
Implications:
- Simultaneous M.tb infections with multiple strains can occur in immunocompetent individuals.
- Co-infections may lead to ambiguous or conflicting drug-susceptibility results.
- Occupational exposure, such as in medical waste settings, could be a route for M.tb transmission and co-infection.
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