Recurrent tuberculosis in Houston, Texas: a population-based study.

OBJECTIVE To determine the predictors of recurrence of tuberculosis (TB), the drug resistance pattern of Mycobacterium tuberculosis strains recovered from recurrent TB patients, and the frequency of re-infection with a new M. tuberculosis strain among patients with recurrent disease. DESIGN A population-based, retrospective case-control study using the Houston Tuberculosis Initiative database. RESULTS We found that, among 100 patients with recurrent TB who completed adequate therapy for a first episode of TB, not receiving directly observed therapy, pulmonary disease, HIV/AIDS diagnosis, not having a family physician, being unemployed and using public transportation were predictors of recurrent disease. There was a significant increase in drug-resistant M. tuberculosis strains in the second episode of disease compared to the first episode (21.3% vs. 8.2%, P = 0.04). Exogenous re-infection with a new strain of M. tuberculosis was found to cause 24-31% of recurrent TB. CONCLUSION Recurrent TB in Houston is associated with a significant increase in drug-resistant M. tuberculosis strains. Re-infection with a new M. tuberculosis strain causes a significant proportion of recurrent TB in an area of low TB incidence. Patients with HIV/AIDS constitute a population at increased risk of disease recurrence.

[1]  C. Gilks,et al.  Increased recurrence of tuberculosis in HIV-1-infected patients in Kenya , 1993, The Lancet.

[2]  I. Kleinschmidt,et al.  The impact of HIV infection on recurrence of tuberculosis in South African gold miners. , 2000, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[3]  J Li,et al.  Relapse in persons treated for drug-susceptible tuberculosis in a population with high coinfection with human immunodeficiency virus in New York City. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  M. Raviglione,et al.  Drug-resistant tuberculosis: review of the worldwide situation and the WHO/IUATLD Global Surveillance Project. International Union Against Tuberculosis and Lung Disease. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  P. Small,et al.  Clinical consequences and transmissibility of drug-resistant tuberculosis in southern Mexico. , 2000, Archives of internal medicine.

[6]  P D van Helden,et al.  Exogenous reinfection as a cause of recurrent tuberculosis after curative treatment. , 1999, The New England journal of medicine.

[7]  T. Whittam,et al.  Restricted structural gene polymorphism in the Mycobacterium tuberculosis complex indicates evolutionarily recent global dissemination. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[8]  R. Chaisson,et al.  Relapse rates after short-course (6-month) treatment of tuberculosis in HIV-infected and uninfected persons. , 1999, AIDS.

[9]  Giulia Marchetti,et al.  Molecular Epidemiology Study of Exogenous Reinfection in an Area with a Low Incidence of Tuberculosis , 2001, Journal of Clinical Microbiology.

[10]  N. Binkin,et al.  Determinants of drug-resistant tuberculosis: analysis of 11 countries. , 2001, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[11]  D van Soolingen,et al.  Simultaneous detection and strain differentiation of Mycobacterium tuberculosis for diagnosis and epidemiology , 1997, Journal of clinical microbiology.

[12]  P E Fine,et al.  The natural history of tuberculosis: the implications of age-dependent risks of disease and the role of reinfection , 1997, Epidemiology and Infection.

[13]  J. T. Crawford,et al.  Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a standardized methodology , 1993, Journal of clinical microbiology.

[14]  R. Chaisson,et al.  Six-month supervised intermittent tuberculosis therapy in Haitian patients with and without HIV infection. , 1996, American journal of respiratory and critical care medicine.

[15]  R. Chaisson,et al.  Rifapentine and isoniazid once a week versus rifampicin and isoniazid twice a week for treatment of drug-susceptible pulmonary tuberculosis in HIV-negative patients: a randomised clinical trial , 2002, The Lancet.

[16]  D. Snider,et al.  Treatment of tuberculosis and tuberculosis infection in adults and children. American Thoracic Society and The Centers for Disease Control and Prevention. , 1994, American journal of respiratory and critical care medicine.

[17]  J. T. Crawford,et al.  Simultaneous infection with multiple strains of Mycobacterium tuberculosis. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[18]  J. T. Crawford,et al.  A CONTINUING SURVEY OF DRUG-RESISTANT TUBERCULOSIS , 1997 .

[19]  S. Vermund,et al.  A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. , 1989, The New England journal of medicine.

[20]  P. Piot,et al.  Pulmonary tuberculosis in HIV-infected patients in Zaire. A controlled trial of treatment for either 6 or 12 months. , 1995, The New England journal of medicine.

[21]  W. Stead,et al.  Phage type of tubercle bacilli isolated from patients with two or more sites of organ involvement. , 2015, The American review of respiratory disease.

[22]  R. Brindle,et al.  Quantitative bacillary response to treatment in HIV-associated pulmonary tuberculosis. , 1993, The American review of respiratory disease.

[23]  K. D. de Cock,et al.  Two‐year follow‐up of persons with HIV‐1− and HIV‐2‐associated pulmonary tuberculosis treated with short‐course chemotherapy in West Africa , 1995, AIDS.

[24]  S. Weis,et al.  The effect of directly observed therapy on the rates of drug resistance and relapse in tuberculosis. , 1994, The New England journal of medicine.

[25]  G. Schoolnik,et al.  An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus. An analysis using restriction-fragment-length polymorphisms. , 1992, The New England journal of medicine.

[26]  Dinakar,et al.  T cell cytokine responses in persons with tuberculosis and human immunodeficiency virus infection. , 1994, The Journal of clinical investigation.

[27]  O Afonso,et al.  Exogenous reinfection with tuberculosis on a European island with a moderate incidence of disease. , 2001, American journal of respiratory and critical care medicine.

[28]  Christopher Dye,et al.  Global trends in resistance to antituberculosis drugs. World Health Organization-International Union against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance. , 2001, The New England journal of medicine.

[29]  K. Castro,et al.  Survey of drug resistance of Mycobacterium tuberculosis in 3 Mexican states, 1997. , 2000, Archives of internal medicine.

[30]  D. Snider,et al.  Recurrent tuberculosis: why do patients develop disease again? A United States Public Health Service cooperative survey. , 1988, American Journal of Public Health.

[31]  C. Connolly,et al.  Relapse and mortality among HIV-infected and uninfected patients with tuberculosis successfully treated with twice weekly directly observed therapy in rural South Africa. , 1999, AIDS.

[32]  J. T. Crawford,et al.  A continuing survey of drug-resistant tuberculosis, New York City, April 1994. , 1997, Archives of internal medicine.