along with subclinical mycobacterium tuberculosis (mtb), another one of my concerns is mixed mtb infections (simultaneous infection with drug-resistant and drug-susceptible mtb). multiple mtb strains have been detected from the same patient in separate sites (lung vs intrabdominal for example), the same specimen type at different times during treatment, and within the same sample. in gabarone and ghanzi districts, botswana, a recent journal of infectious diseases study by dr. sanghyuk shin, dr. nicola zetola and colleagues demonstrated that mixed mtb infections were associated with poor treatment outcomes.
i spent time in gabarone at princess marina hospital in 2007, and it’s amazing to think about how much molecular techniques have advanced since then.
how important of a phenomenon do you think mixed mtb infections are? do advanced molecular techniques need to be performed in all patients who are being evaluated for tuberculosis? how can we diagnose drug resistant tb faster?
best regards, philip lederer
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