Widespread Dissemination of a Drug‐Susceptible Strain ofMycobacterium tuberculosis

作者：Cindy R. Friedman, Geoff C. Quinn, Barry N. Kreiswirth, David C. Perlman, Nadim Salomon, Neil W. Schluger, Michael Lutfey, Judith Berger, Natasha Poltoratskaia, Lee Woodland Riley · 发表于：The Journal of Infectious Diseases · 年份：1997 · DOI：10.1086/514067 · 被引用次数：76 · 研究领域：Tuberculosis Research and Epidemiology、Pneumonia and Respiratory Infections、Mycobacterium research and diagnosis

In New York City, a large proportion of new tuberculosis cases has been caused by 1 drug-susceptible strain (called C strain) of Mycobacterium tuberculosis. Between 1991 and 1994, among >600 tuberculosis patients consecutively identified in four large hospitals in the city, 54 with C strain, 69 with non-C cluster pattern strains, and 42 with noncluster pattern strains were studied. Susceptibility to reactive nitrogen intermediates (RNI) of selected isolates was compared. In a case-control analysis, 51% of patients with C strain, 28% with non-C cluster strains (P < .05), and 14% with noncluster strains (P < .01) were found to be injection drug users. C strain but not 13 other unrelated isolates were resistant to RNI. Injection drug use may provide a selective pressure for an RNI-resistant tubercle bacillus to emerge, which may give the organism a biologic advantage and explain the widespread dissemination of C strain M. tuberculosis within the city.