INTRODUCTION: The magnitude of drug resistance in Mycobacterium leprae to dapsone, rifampicin, and ofloxacin was studied in three Southeast Asian countries with a high prevalence of leprosy. METHODS: M. leprae from the skin of leprosy patients was collected in North Maluku and North Sulawesi in Indonesia, Yangon in Myanmar, and Cebu in the Philippines. Mutations in the drug resistance determining regions in the folP1, rpoB, and gyrA genes, which have been proven to confer resistance, were analysed. In addition, samples from 51 newly diagnosed cases and 13 patients with leprosy relapse in Cebu were submitted for susceptibility testing in the mouse footpad. RESULTS: Of 252 isolates obtained from new cases, 3% were dapsone resistant and 2% were rifampicin resistant. In samples taken from patients with relapsed leprosy (n = 53), significantly more resistance mutations were detected: 15% had dapsone resistance mutations, and 8% had rifampicin resistance mutations. Two patients with relapsed leprosy had mutations for both dapsone and rifampicin resistance. No mutations conferring quinolone resistance were detected. No mutations were detected in the folP1 gene of M. leprae isolates with a low degree of resistance to dapsone. DISCUSSION: Detection of drug-resistant cases by mutation detection in the drug resistance determining region of the genome is a practical method for monitoring resistance. A comparison of the results obtained in this study with previous data obtained prior to the use of multidrug therapy (MDT), does not indicate clearly whether the magnitude of drug resistance has changed. Larger studies of resistance mutations in M. leprae isolated from patients with relapsed leprosy are needed to confirm our results. CONCLUSION: We recommend monitoring the magnitude of drug resistance globally, by testing M. leprae DNA from relapse cases and a representative sample of new cases.
INTRODUCTION: The magnitude of drug resistance in Mycobacterium leprae to dapsone, rifampicin, and ofloxacin was studied in three Southeast Asian countries with a high prevalence of leprosy. METHODS:M. leprae from the skin of leprosypatients was collected in North Maluku and North Sulawesi in Indonesia, Yangon in Myanmar, and Cebu in the Philippines. Mutations in the drug resistance determining regions in the folP1, rpoB, and gyrA genes, which have been proven to confer resistance, were analysed. In addition, samples from 51 newly diagnosed cases and 13 patients with leprosy relapse in Cebu were submitted for susceptibility testing in the mouse footpad. RESULTS: Of 252 isolates obtained from new cases, 3% were dapsone resistant and 2% were rifampicin resistant. In samples taken from patients with relapsed leprosy (n = 53), significantly more resistance mutations were detected: 15% had dapsone resistance mutations, and 8% had rifampicin resistance mutations. Two patients with relapsed leprosy had mutations for both dapsone and rifampicin resistance. No mutations conferring quinolone resistance were detected. No mutations were detected in the folP1 gene of M. leprae isolates with a low degree of resistance to dapsone. DISCUSSION: Detection of drug-resistant cases by mutation detection in the drug resistance determining region of the genome is a practical method for monitoring resistance. A comparison of the results obtained in this study with previous data obtained prior to the use of multidrug therapy (MDT), does not indicate clearly whether the magnitude of drug resistance has changed. Larger studies of resistance mutations in M. leprae isolated from patients with relapsed leprosy are needed to confirm our results. CONCLUSION: We recommend monitoring the magnitude of drug resistance globally, by testing M. leprae DNA from relapse cases and a representative sample of new cases.
Authors: Marcus Beissner; Nana-Yaa Awua-Boateng; William Thompson; Willemien A Nienhuis; Erasmus Klutse; Pius Agbenorku; Joerg Nitschke; Karl-Heinz Herbinger; Vera Siegmund; Erna Fleischmann; Ohene Adjei; Bernhard Fleischer; Tjip S van der Werf; Thomas Loscher; Gisela Bretzel Journal: Am J Trop Med Hyg Date: 2010-11 Impact factor: 2.345
Authors: Pushpendra Singh; Philippe Busso; Alberto Paniz-Mondolfi; Nacarid Aranzazu; Marc Monot; Nadine Honore; Andrea de Faria Fernandes Belone; Marcos Virmond; Maria Esther Villarreal-Olaya; Carlos Rivas; Stewart T Cole Journal: Antimicrob Agents Chemother Date: 2011-03-28 Impact factor: 5.191
Authors: Wei Li; Rama M Sakamuri; Danielle E Lyons; Florenda M Orcullo; Vidyagouri Shinde; Edred Lao Dela Pena; Armi A Maghanoy; Irene B Mallari; Esterlina V Tan; Indira Nath; Patrick J Brennan; Marivic Balagon; Varalakshmi Vissa Journal: Antimicrob Agents Chemother Date: 2011-08-22 Impact factor: 5.191
Authors: M S Duthie; M N Hay; E M Rada; J Convit; L Ito; L K M Oyafuso; M I P Manini; I M B Goulart; J Lobato; L R Goulart; D Carter; S G Reed Journal: Eur J Clin Microbiol Infect Dis Date: 2011-05-05 Impact factor: 3.267