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      Acquired drug resistance in Mycobacterium tuberculosis isolates recovered from compliant patients with human immunodeficiency virus-associated tuberculosis.

      Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

      AIDS-Related Opportunistic Infections, drug therapy, microbiology, Antitubercular Agents, therapeutic use, DNA, Bacterial, analysis, DNA-Directed RNA Polymerases, genetics, Drug Resistance, Microbial, Humans, Isoniazid, Mycobacterium tuberculosis, drug effects, isolation & purification, Patient Compliance, Rifampin, Tuberculosis, complications

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          Abstract

          We describe five compliant patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) that relapsed, with acquisition of resistance by the original Mycobacterium tuberculosis strains. Both the first and second isolates from each patient had the same IS (insertion sequence) 6110-based DNA fingerprint patterns. Three of the five patients developed TB that was resistant to rifampin alone; no mutation in the region of the rpoB gene was detected by a line probe assay in two of the isolates from these patients. We discuss several factors presumably associated with acquired drug resistance in HIV-infected patients, including exogenous reinfection, drug interactions, malabsorption of drugs, and the presence of a large organism burden.

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          9402354

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