Fatal Nosocomial MDR TB Identified through Routine Genetic Analysis and Whole-Genome Sequencing

摘要

To the Editor: In November 2012, a 44-year-old HIV-negative white man (patient 1) with fever, fatigue, and breathlessness sought care at a hospital in the United Kingdom. He had never traveled abroad but had biopsy-proven alcoholic cirrhosis. No acid-fast bacilli were seen on multiple samples, including ascitic fluid, and he received treatment for presumptive abdominal tuberculosis (TB). Mycobacterium tuberculosis was subsequently cultured after 12 days. His clinical condition deteriorated, and he died of multiorgan failure 44 days after admission. The cultured M. tuberculosis was subsequentlyconfirmed as multidrug resistant (online Technical Appendix Table, http://wwwnc.cdc.gov/EID/article/21/6/14-1903-Techapp1.pdf).