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We examined factors associated with mixed-strain Mycobacterium tuberculosis infections among patients at high risk for drug-resistant tuberculosis in Botswana. Thirty-seven (10.0%) of 370 patients with tuberculosis had mixed M. tuberculosis infections, based on 24-locus mycobacterial interspersed repetitive unit-variable number of tandem repeats genotyping. In log-binomial regression analysis, age &lt;37 years (adjusted prevalence ratio [PR], 1.92; 95% confidence interval [CI], 1.01-3.57) and prior tuberculosis treatment (adjusted PR, 2.31; 95% CI, 1.09-4.89) were associated with mixed M. tuberculosis infections. Among human immunodeficiency virus-infected patients, prior tuberculosis treatment (adjusted PR, 2.11; 95% CI, 1.04-4.31) and CD4(+) T-cell count of &lt;100 cells/μl (adjusted PR, 10.18; 95% CI, 2.48-41.71) were associated with mixed M. tuberculosis infections. Clinical suspicion of mixed M. tuberculosis infections should be high for patients with advanced immunosuppression and a prior history of tuberculosis treatment.

the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases

Advanced Immune Suppression is Associated With Increased Prevalence of Mixed-Strain<i>Mycobacterium tuberculosis</i>Infections Among Persons at High Risk for Drug-Resistant Tuberculosis in Botswana

Advanced Immune Suppression is Associated With Increased Prevalence of Mixed-StrainMycobacterium tuberculosisInfections Among Persons at High Risk for Drug-Resistant Tuberculosis in Botswana