Molecular Evidence of Endogenous Reactivation of Mycobacterium tuberculosis after 33 Years of Latent Infection

• Published in: The Journal of infectious diseases Vol. 185; no. 3; pp. 401 - 404
• Main Authors: Lillebaek, Troels, Dirksen, Asger, Baess, Inga, Strunge, Benedicte, Thomsen, Vibeke Ø., Andersen, Åse B.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.02.2002; University of Chicago Press; Oxford University Press
• Subjects: Adult; Bacterial diseases; Bacterial diseases of the respiratory system; Bacteriology; Biological and medical sciences; Concise Communications; Disease risk; DNA, Bacterial - analysis; Epidemiology; Fathers; Fundamental and applied biological sciences. Psychology; Human bacterial diseases; Humans; Infections; Infectious diseases; Latent tuberculosis; Male; Medical sciences; Microbiology; Middle Aged; Mycobacterium tuberculosis; Mycobacterium tuberculosis - classification; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - physiology; Pulmonary tuberculosis; Recurrence; Reinfection; Sons; Time Factors; Tuberculosis; Tuberculosis - etiology; Denmark; Human; Reactivation; Respiratory disease; Mycobacterial infection; Epidemiology; Latency; Infection; Dormancy; Tuberculosis; Mycobacterium tuberculosis; Mycobacteriales; Bacteriosis; Mycobacteriaceae; Bacteria; Actinomycetes
• ISSN: 0022-1899; 1573-6613; 1537-6613
• DOI: 10.1086/338342

Since Robert Koch described the cause of tuberculosis in 1882, the natural history of the disease after primary infection has been subject to debate. Only ∼10% of infected individuals develop active disease, which may appear years to decades after infection. Late onset has been attributed to the endogenous reactivation of dormant bacteria. However, this has not been documented by molecular means for latencies of more than a few years. In Denmark, we have recently recultured 205 freeze-dried Mycobacterium tuberculosis strains obtained from 1961 through 1967. These “historical” strains are analyzed by DNA restriction fragment-length polymorphism testing, and their DNA patterns are compared with those of 4008 recently obtained clinical specimens. This has, surprisingly, yielded molecular evidence of M. tuberculosis reactivation after 33 years of latent infection. A father and son who developed tuberculosis in 1961 and in 1994, respectively, were the only patients infected with strains that share an identical DNA pattern.