Undetected multidrug-resistant tuberculosis amplified by first-line therapy in mixed infection

Suzanne M. Hingley-Wilson (Lead / Corresponding author), Rosalyn Casey, David Connell, Samuel Bremang, Jason T Evans, Peter M. Hawkey, Grace E Smith, Annette Jepson, Stuart Philip, Onn Min Kon, Ajit Lalvani

    Research output: Contribution to journalArticlepeer-review

    34 Citations (Scopus)


    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.

    Original languageEnglish
    Pages (from-to)1138-1141
    Number of pages4
    JournalEmerging Infectious Diseases
    Issue number7
    Publication statusPublished - Jul 2013


    • Aged
    • Antitubercular Agents/pharmacology
    • Coinfection/diagnosis
    • Culture Techniques
    • Delayed Diagnosis
    • Drug Resistance, Multiple, Bacterial
    • Drug Therapy, Combination
    • Ethambutol/pharmacology
    • Humans
    • Isoniazid/pharmacology
    • Male
    • Minisatellite Repeats
    • Molecular Diagnostic Techniques
    • Multilocus Sequence Typing
    • Mycobacterium tuberculosis/genetics
    • Treatment Outcome
    • Tuberculosis, Multidrug-Resistant/diagnosis
    • Tuberculosis, Pulmonary/diagnosis


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