{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:28:55Z","timestamp":1791296935300,"version":"4.1.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2010,12,1]],"date-time":"2010-12-01T00:00:00Z","timestamp":1291161600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/2.0"},{"start":{"date-parts":[[2010,12,10]],"date-time":"2010-12-10T00:00:00Z","timestamp":1291939200000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/2.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Many studies using DNA fingerprinting to differentiate <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (MTB) strains reveal single strains in cultures, suggesting that most disease is caused by infection with a single strain. However, recent studies using molecular epidemiological tools that amplify multiple targets have demonstrated simultaneous infection with multiple strains of MTB. We aimed to determine the prevalence of MTB multiple strain infections in Kampala, and the impact of these infections on clinical presentation of tuberculosis (TB) and response to treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A total of 113 consecutive smear and culture positive patients who previously enrolled in a house-hold contact study were included in this study. To determine whether infection with multiple MTB strains has a clinical impact on the initial presentation of patients, retrospective patient data (baseline clinical, radiological and drug susceptibility profiles) was obtained. To determine presence of infections with multiple MTB strains, MIRU-VNTR (Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeats) -PCR was performed on genomic DNA extracted from MTB cultures of smear positive sputum samples at baseline, second and fifth months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 113 patients, eight (7.1%) had infection with multiple MTB strains, coupled with a high rate of HIV infection (37.5% versus 12.6%, <jats:italic>p<\/jats:italic> = 0.049). The remaining patients (105) were infected with single MTB strains. The proportions of patients with MTB smear positive cultures after two and five months of treatment were similar. There was no difference between the two groups for other variables.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Infection with multiple MTB strains occurs among patients with first episode of pulmonary tuberculosis in Kampala, in a setting with high TB incidence. Infection with multiple MTB strains had little impact on the clinical course for individual patients. This is the first MIRU-VNTR-based study from in an East African country.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-10-349","type":"journal-article","created":{"date-parts":[[2011,1,5]],"date-time":"2011-01-05T20:09:56Z","timestamp":1294258196000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Detection of multiple strains of Mycobacterium tuberculosis using MIRU-VNTR in patients with pulmonary tuberculosis in Kampala, Uganda"],"prefix":"10.1186","volume":"10","author":[{"given":"Katherine R","family":"Dickman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Nabyonga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P","family":"Kateete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred A","family":"Katabazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benon B","family":"Asiimwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet K","family":"Mayanja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alphonse","family":"Okwera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Whalen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses L","family":"Joloba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2010,12,10]]},"reference":[{"issue":"3","key":"1329_CR1","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/0962-8479(94)90002-7","volume":"75","author":"V Balasubramanian","year":"1994","unstructured":"Balasubramanian V, Wiegeshaus EH, Taylor BT, Smith DW: Pathogenesis of tuberculosis: pathway to apical localization. Tubercle and Lung Disease. 1994, 75 (3): 168-178. 10.1016\/0962-8479(94)90002-7.","journal-title":"Tubercle and Lung Disease"},{"issue":"2","key":"1329_CR2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.ccm.2005.02.005","volume":"26","author":"CL Daley","year":"2005","unstructured":"Daley CL: Molecular Epidemiology: A Tool for Understanding Control of Tuberculosis Transmission. Clinics in Chest Medicine. 2005, 26 (2): 217-231. 10.1016\/j.ccm.2005.02.005.","journal-title":"Clinics in Chest Medicine"},{"issue":"3","key":"1329_CR3","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1055\/s-2004-829502","volume":"25","author":"K DeRiemer","year":"2004","unstructured":"DeRiemer K, Daley CL: Tuberculosis transmission based on molecular epidemiologic research. Semin Respir Crit Care Med. 2004, 25 (3): 297-306. 10.1055\/s-2004-829502.","journal-title":"Semin Respir Crit Care Med"},{"issue":"16","key":"1329_CR4","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1056\/NEJM199910143411609","volume":"341","author":"PE Fine","year":"1999","unstructured":"Fine PE, Small PM: Exogenous reinfection in tuberculosis. N Engl J Med. 1999, 341 (16): 1226-1227. 10.1056\/NEJM199910143411609.","journal-title":"N Engl J Med"},{"issue":"9294","key":"1329_CR5","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1016\/S0140-6736(01)06712-5","volume":"358","author":"P Sonnenberg","year":"2001","unstructured":"Sonnenberg P, Murray J, Glynn JR, Shearer S, Kambashi B, Godfrey-Faussett P: HIV-1 and recurrence, relapse, and reinfection of tuberculosis after cure: a cohort study in South African mineworkers. Lancet. 2001, 358 (9294): 1687-1693. 10.1016\/S0140-6736(01)06712-5.","journal-title":"Lancet"},{"issue":"12","key":"1329_CR6","doi-asserted-by":"crossref","first-page":"4478","DOI":"10.1128\/JCM.38.12.4478-4484.2000","volume":"38","author":"AS de Boer","year":"2000","unstructured":"de Boer AS, Kremer K, Borgdorff MW, de Haas PEW, Heersma HF, van Soolingen D: Genetic Heterogeneity in Mycobacterium tuberculosis Isolates Reflected in IS6110 Restriction Fragment Length Polymorphism Patterns as Low-Intensity Bands. J Clin Microbiol. 2000, 38 (12): 4478-4484.","journal-title":"J Clin Microbiol"},{"issue":"5","key":"1329_CR7","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1097\/00002030-199904010-00011","volume":"13","author":"F Chaves","year":"1999","unstructured":"Chaves F, Dronda F, Alonso-Sanz M, Noriega AR: Evidence of exogenous reinfection and mixed infection with more than one strain of Mycobacterium tuberculosis among Spanish HIV-infected inmates. AIDS. 1999, 13 (5): 615-620. 10.1097\/00002030-199904010-00011.","journal-title":"AIDS"},{"issue":"11","key":"1329_CR8","doi-asserted-by":"publisher","first-page":"5660","DOI":"10.1128\/JCM.43.11.5660-5664.2005","volume":"43","author":"D Garcia de Viedma","year":"2005","unstructured":"Garcia de Viedma D, Alonso Rodriguez N, Andres S, Ruiz Serrano MJ, Bouza E: Characterization of clonal complexity in tuberculosis by mycobacterial interspersed repetitive unit-variable-number tandem repeat typing. J Clin Microbiol. 2005, 43 (11): 5660-5664. 10.1128\/JCM.43.11.5660-5664.2005.","journal-title":"J Clin Microbiol"},{"issue":"8","key":"1329_CR9","doi-asserted-by":"publisher","first-page":"2750","DOI":"10.1128\/JCM.40.8.2750-2754.2002","volume":"40","author":"M Richardson","year":"2002","unstructured":"Richardson M, Carroll NM, Engelke E, Van Der Spuy GD, Salker F, Munch Z, Gie RP, Warren RM, Beyers N, Van Helden PD: Multiple Mycobacterium tuberculosis strains in early cultures from patients in a high-incidence community setting. J Clin Microbiol. 2002, 40 (8): 2750-2754. 10.1128\/JCM.40.8.2750-2754.2002.","journal-title":"J Clin Microbiol"},{"key":"1329_CR10","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/1465-9921-7-99","volume":"7","author":"IC Shamputa","year":"2006","unstructured":"Shamputa IC, Jugheli L, Sadradze N, Willery E, Portaels F, Supply P, Rigouts L: Mixed infection and clonal representativeness of a single sputum sample in tuberculosis patients from a penitentiary hospital in Georgia. Respir Res. 2006, 7: 99-10.1186\/1465-9921-7-99.","journal-title":"Respir Res"},{"issue":"5","key":"1329_CR11","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1164\/rccm.200305-714OC","volume":"169","author":"RM Warren","year":"2004","unstructured":"Warren RM, Victor TC, Streicher EM, Richardson M, Beyers N, van Pittius NCG, van Helden PD: Patients with Active Tuberculosis often Have Different Strains in the Same Sputum Specimen. Am J Respir Crit Care Med. 2004, 169 (5): 610-614. 10.1164\/rccm.200305-714OC.","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"1329_CR12","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1086\/368368","volume":"187","author":"G de Viedma Dar\u00edo","year":"2003","unstructured":"de Viedma Dar\u00edo G, Mar\u00edn M, Ruiz Serrano Mar\u00eda J, Alcal\u00e1 L, Bouza E: Polyclonal and Compartmentalized Infection by Mycobacterium tuberculosis in Patients with Both Respiratory and Extrarespiratory Involvement. The Journal of Infectious Diseases. 2003, 187 (4): 695-699.","journal-title":"The Journal of Infectious Diseases"},{"issue":"8","key":"1329_CR13","doi-asserted-by":"publisher","first-page":"3415","DOI":"10.1128\/JCM.42.8.3415-3418.2004","volume":"42","author":"D Garcia de Viedma","year":"2004","unstructured":"Garcia de Viedma D, Marin M, Ruiz MJ, Bouza E: Analysis of clonal composition of Mycobacterium tuberculosis isolates in primary infections in children. J Clin Microbiol. 2004, 42 (8): 3415-3418. 10.1128\/JCM.42.8.3415-3418.2004.","journal-title":"J Clin Microbiol"},{"key":"1329_CR14","unstructured":"World Health Organisation: Global tuberculosis control: a short update to the 2009 report. [http:\/\/www.who.int\/tb\/publications\/global_report\/2009\/update\/en\/index.html]"},{"issue":"9","key":"1329_CR15","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1093\/aje\/kwg227","volume":"158","author":"D Guwatudde","year":"2003","unstructured":"Guwatudde D, Nakakeeto M, Jones-Lopez EC, Maganda A, Chiunda A, Mugerwa RD, Ellner JJ, Bukenya G, Whalen CC: Tuberculosis in Household Contacts of Infectious Cases in Kampala, Uganda. Am J Epidemiol. 2003, 158 (9): 887-898. 10.1093\/aje\/kwg227.","journal-title":"Am J Epidemiol"},{"issue":"10","key":"1329_CR16","first-page":"891","volume":"3","author":"PM Mudido","year":"1999","unstructured":"Mudido PM, Guwatudde D, Nakakeeto MK, Bukenya GB, Nsamba D, Johnson JL, Mugerwa RD, Ellner JJ, Whalen CC: The effect of bacille Calmette-Guerin vaccination at birth on tuberculin skin test reactivity in Ugandan children. Int J Tuberc Lung Dis. 1999, 3 (10): 891-895.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"1","key":"1329_CR17","doi-asserted-by":"crossref","first-page":"55","DOI":"10.4269\/ajtmh.2006.75.55","volume":"75","author":"CC Whalen","year":"2006","unstructured":"Whalen CC, Chiunda A, Zalwango S, Nshuti L, Jones-Lopez E, Okwera A, Hirsch C, Peters P, Boom WH, Mugerwa RD: Immune correlates of acute Mycobacterium tuberculosis infection in household contacts in Kampala, Uganda. Am J Trop Med Hyg. 2006, 75 (1): 55-61.","journal-title":"Am J Trop Med Hyg"},{"key":"1329_CR18","first-page":"1262","volume":"10","author":"J Muhumuza","year":"2006","unstructured":"Muhumuza J, Asiimwe BB, Kayes S, Mugyenyi P, Whalen C, Mugerwa RD, Boom H, Eisenach KD, Joloba ML: Introduction of an in-house PCR for routine identification of M. tuberculosis in a low-income country. The International Journal of Tuberculosis and Lung Disease. 2006, 10: 1262-1267.","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"issue":"12","key":"1329_CR19","doi-asserted-by":"publisher","first-page":"4498","DOI":"10.1128\/JCM.01392-06","volume":"44","author":"P Supply","year":"2006","unstructured":"Supply P, Allix C, Lesjean S, Cardoso-Oelemann M, Rusch-Gerdes S, Willery E, Savine E, de Haas P, van Deutekom H, Roring S, et al: Proposal for Standardization of Optimized Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeat Typing of Mycobacterium tuberculosis. J Clin Microbiol. 2006, 44 (12): 4498-4510. 10.1128\/JCM.01392-06.","journal-title":"J Clin Microbiol"},{"key":"1329_CR20","unstructured":"Multilocus Variable Number Tandem Repeat Genotyping of Mycobacterium tuberculosis, Technical Guide. [http:\/\/www.miru-vntrplus.org\/MIRU\/index.faces]"},{"issue":"12","key":"1329_CR21","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.1001\/jama.1992.03490120095035","volume":"268","author":"KM De Cock","year":"1992","unstructured":"De Cock KM, Soro B, Coulibaly IM, Lucas SB: Tuberculosis and HIV infection in sub-Saharan Africa. JAMA. 1992, 268 (12): 1581-1587. 10.1001\/jama.268.12.1581.","journal-title":"JAMA"},{"issue":"3","key":"1329_CR22","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1128\/jcm.32.3.672-678.1994","volume":"32","author":"LF Kox","year":"1994","unstructured":"Kox LF, Rhienthong D, Miranda AM, Udomsantisuk N, Ellis K, van Leeuwen J, van Heusden S, Kuijper S, Kolk AH: A more reliable PCR for detection of Mycobacterium tuberculosis in clinical samples. J Clin Microbiol. 1994, 32 (3): 672-678.","journal-title":"J Clin Microbiol"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2334-10-349.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/1471-2334-10-349\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2334-10-349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2334-10-349.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T04:01:06Z","timestamp":1630468866000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/1471-2334-10-349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,12]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2010,12]]}},"alternative-id":["1329"],"URL":"https:\/\/doi.org\/10.1186\/1471-2334-10-349","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,12]]},"assertion":[{"value":"12 May 2010","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2010","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2010","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"349"}}