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Published on: September 5, 2017
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Mycobacterium tuberculosis polyclonal infections through treatment and recurrence
Pooja Pandey1, Anuj K Bhatnagar2, Anant Mohan3
1Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Plos One
|August 20, 2020
Summary
Polyclonal tuberculosis infections, involving multiple genotypes, are common and can change during treatment. These mixed infections are linked to increased drug resistance and challenge traditional views of TB reactivation.
Area of Science:
- Molecular epidemiology of infectious diseases
- Microbiology and immunology of tuberculosis
Background:
- Tuberculosis (TB) can be caused by mixed/polyclonal infections with different genotypes.
- Understanding the dynamics of mixed TB infections during treatment is crucial for pathogenesis insights.
Purpose of the Study:
- To investigate the evolution of mixed TB infections throughout treatment and follow-up.
- To determine the role of polyclonal infections in TB disease pathogenesis.
Main Methods:
- Longitudinal sputum sample collection from 157 treatment-naïve TB patients over 24 months.
- Genotyping (spoligotyping, MIRU-VNTR, SNP) and drug-susceptibility testing (MGIT 960) of isolates.
- Analysis of all isolated colonies on agar for spoligotyping to detect mixed infections.
Main Results:
- 84.7% of baseline cultures were positive; 32.3% exhibited mixed genotypes.
- 55.8% of patients with mixed infections showed genotype changes during treatment.
- Polyclonal infections were associated with higher rates of drug resistance (53.5% vs. 11.1%).
Conclusions:
- Polyclonal TB infections are persistent and can change during a single disease episode.
- Current culture methods may underestimate the prevalence of mixed genotypes.
- Polyclonal infections may be common in TB, challenging traditional reactivation/reinfection theories.
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