Robert W. Shafer

Publication Details

  • TEMPORAL TRENDS AND TRANSMISSION PATTERNS DURING THE EMERGENCE OF MULTIDRUG-RESISTANT TUBERCULOSIS IN NEW-YORK-CITY - A MOLECULAR EPIDEMIOLOGIC ASSESSMENT JOURNAL OF INFECTIOUS DISEASES Shafer, R. W., Small, P. M., Larkin, C., Singh, S. P., Kelly, P., Sierra, M. F., SCHOOLNIK, G., Chirgwin, K. D. 1995; 171 (1): 170-176

    Abstract:

    To ascertain the role of human immunodeficiency virus (HIV) and Mycobacterium tuberculosis transmission on multidrug-resistant (MDR) tuberculosis (TB) emergence in New York City, medical records, drug susceptibilities, and restriction fragment length polymorphisms (RFLPs) of TB cases at a city hospital between two 9-month periods (1987-1988 and 1990-1991) were reviewed. The proportion of TB patients with MDRTB increased from 10% (27/267) to 17% (38/222; P = .03). Among MDRTB patients of known HIV status, the proportion with HIV increased from 16% (3/19) to 58% (22/38; P = .006). HIV-infected MDRTB patients were more likely than the seronegative ones to have initial MDRTB (88% vs. 56%; P = .03). Among 56 MDR cases with RFLP results, 12 had unique patterns; 44 belonged to one of six clusters. During 1990-1991, 27 (75%) of 36 MDRTB patients were infected with strains isolated from HIV-seronegative patients during 1987-1988. The increase in MDRTB caused by transmission from immunocompetent to immunocompromised persons underscores the urgency of TB control in populations with increasing HIV prevalence.

    View details for Web of Science ID A1995PZ87300024

    View details for PubMedID 7798657

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