Metagenomic Analysis of Tuberculosis — Current Limitations

Abstract

To the Editor: Chan and colleagues (July 18 issue)(1) describe a mixed-strain infection with two Mycobacterium tuberculosis genotypes in the mummified body of Terézia Hausmann, who died in the late 18th century. This dual infection would not have been detected with the methods of diagnosis in routine use today. The numbers of mixed infections are massively underestimated because the majority of diagnostic techniques rely on cultures grown from single colonies. With the use of molecular biologic techniques or analysis of multiple colonies, 2 to 19% of patients in countries with a moderate-to-high incidence of tuberculosis have been found to be . . .