Undetected Multidrug-Resistant Tuberculosis Amplified by First-line Therapy in Mixed Infection

Abstract

Infections with >1 Mycobacterium tuberculosis strain(s) are underrecognized. We show, in vitro and in vivo, how first-line treatment conferred a competitive growth advantage to amplify a multidrug-resistant M. tuberculosis strain in a patient with mixed infection. Diagnostic techniques that identify mixed tubercle bacilli populations are needed to curb the spread of multidrug resistance.

Keywords

• Mycobacterium tuberculosis
• co-infection
• treatment resistance
• multidrug resistant
• drug sensitive
• tuberculosis and other mycobacteria