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Journal of Clinical Microbiology, August 2004, p. 3415-3418, Vol. 42, No. 8
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.8.3415-3418.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Analysis of Clonal Composition of Mycobacterium tuberculosis Isolates in Primary Infections in Children

Darío García de Viedma,* Mercedes Marín, María Jesús Ruiz, and Emilio Bouza

Servicio de Microbiología y Enfermedades Infecciosas, Hospital Gregorio Marañón, Madrid, Spain

Received 9 February 2004/ Returned for modification 25 March 2004/ Accepted 21 April 2004

The assumption that Mycobacterium tuberculosis infections should be considered clonally homogeneous has been weakened in the last few years. Recent studies have shown (i) the isolation of different M. tuberculosis strains from sequential episodes, (ii) mixed infections by two M. tuberculosis strains, and (iii) genetic variations in M. tuberculosis subpopulations due to microevolution events. Nevertheless, it is unknown whether clonal heterogeneity could be found in the initial steps of M. tuberculosis infection, i.e., the primary infection. In the present study we analyzed the clonal composition of the M. tuberculosis isolates causing primary infections in children. Cultures were clonally homogeneous in most cases (11 of 12). In 1 of the 12 cases (8.3%), clonal heterogeneity among the M. tuberculosis isolates was found by spoligotyping and IS6110-based restriction fragment length polymorphism analysis. This case occurred in a 2-year-old child in whom microevolution events were unlikely and who had no risk factors for overexposure to M. tuberculosis. Clonal heterogeneity should also be considered in primary M. tuberculosis infections, including circumstances in which it is usually unexpected.

* Corresponding author. Mailing address: Servicio de Microbiología y Enfermedades Infecciosas, Hospital Gregorio Marañón, C/ Dr Esquerdo 46, 28007 Madrid, Spain. Phone: 91 426 5104. Fax: 91 504 4906. E-mail: dgviedma{at}microb.net.

Journal of Clinical Microbiology, August 2004, p. 3415-3418, Vol. 42, No. 8
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.8.3415-3418.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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