Am. J. Respir. Crit. Care Med., Volume 159, Number 6, June 1999, 2014-2017

Transcontinental Spread of Multidrug-resistant Mycobacterium bovis

RICHARD LONG, EVA NOBERT, SYLVIA CHOMYC, JAN van EMBDEN, CIARAN McNAMEE, RAFAEL REY DURAN, JAMES TALBOT, and ANNE FANNING

Departments of Medicine, Medical Microbiology, and Surgery, University of Alberta, Edmonton, Alberta, Canada; Department of Bacteriology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands; and Ministerio de Sanidad y Consumo, Instituto Carlos III, Madrid, Spain

Globally, the proportion of all cases of tuberculosis (TB) caused by drug-resistant strains is increasing. We report the case of a Canadian citizen who acquired a highly drug-resistant strain of Mycobacterium bovis while visiting a relative with AIDS-related tuberculosis in Spain. The origin of the strain was traced using spoligotyping, a polymerase chain reaction (PCR)-based fingerprint technology, and the European DNA database. The level of primary drug resistanceall five first-line drugs and 19 of 21 second-line drugsin this case was unprecedented in Canada. Isolation of this strain from a Canadian citizen represents the first report of its appearance in this hemisphere. The infection was contained and combined medical-surgical treatment delivered.

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