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Related Experiment Videos

DNA fingerprint changes in tuberculosis: reinfection, evolution, or laboratory error?

Judith R Glynn1, Malcolm D Yates, Amelia C Crampin

  • 1Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. judith.glynn@lshtm.ac.uk

The Journal of Infectious Diseases
|August 21, 2004
PubMed
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Mycobacterium tuberculosis DNA fingerprint patterns evolve, with reinfection being a key factor in recurrent tuberculosis, especially in HIV-positive individuals. Understanding these patterns is crucial for effective treatment strategies.

Area of Science:

  • Microbiology
  • Genetics
  • Epidemiology

Background:

  • DNA fingerprint patterns of Mycobacterium tuberculosis strains are dynamic.
  • Variations arise from pattern evolution, new infections, and laboratory errors.
  • These factors influence understanding tuberculosis transmission and recurrence.

Purpose of the Study:

  • To investigate the significance of pattern evolution, new infections, and laboratory error in Mycobacterium tuberculosis DNA fingerprinting.
  • To differentiate between relapse and reinfection in recurrent tuberculosis cases.
  • To assess the impact of HIV status on tuberculosis recurrence patterns.

Main Methods:

  • Restriction fragment-length polymorphism (RFLP) was used to fingerprint Mycobacterium tuberculosis isolates from northern Malawi (1996-2001).

Related Experiment Videos

  • Laboratory error rates were assessed using dates and isolated positive cultures.
  • Pattern evolution was analyzed within and between individuals, and relapse versus reinfection was estimated in recurrent TB cases.

    • Main Results:

    • RFLP data from 930 isolates (806 individuals) showed a maximum laboratory error rate of 3.9%.
    • Pattern evolution was more frequent in linked individuals (17%) than during relapse (11%) or treatment (3%).
    • In HIV-positive individuals with recurrent TB, 7 of 12 cases were due to reinfection, versus 0 of 8 in HIV-negative individuals (P=.01).

    Conclusions:

    • The rate of DNA fingerprint pattern evolution is non-linear and may differ between within-host and between-host transmission.
    • Reinfection is a significant cause of recurrent tuberculosis, particularly in HIV-positive individuals.
    • Findings suggest the need for secondary prophylaxis and/or antiretroviral therapy in HIV-positive individuals with recurrent TB.