FW: (LML) Confronting multiple-drug resistant (MDR) bacilli

 

Leprosy Mailing List – July 27,  2019

 

Ref.:   (LML)  Confronting multiple-drug resistant (MDR) bacilli

From:  Pieter Schreuder, Maastricht, the Netherlands

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Dear colleagues, 

 

 

Last week (July 20, 2019), Joel Almeida wrote in LML about "Confronting multiple-drug resistant (MDR) bacilli" and referred to the following article: "Emergence and transmission of drug/multidrug-resistant Mycobacterium leprae in a former leprosy colony in the Brazilian Amazon". By Rosa PS, et al. In: Clin Infect Dis. 2019 Jul 1. pii: ciz570. doi: 10.1093/cid/ciz570.

 

May be not everyone was able to download and read this article. Here follows the abstract:

BACKGROUND:

Leprosy has been treated with multidrug therapy (MDT) distributed for free across the globe and regarded as highly efficient. However, the impossibility to grow M. leprae in axenic media has historically impaired assessment of M. leprae resistance, a parameter only recently detectable through molecular methods.

METHODS:

A systematic, population-based search for M. leprae resistance in suspected leprosy relapse cases and contacts was performed in Prata Village, an isolated, hyper-endemic former leprosy colony located in Pará state, the Brazilian Amazon. Results led to an extended active search involving the entire Prata population. Confirmed leprosy cases were investigated for bacterial resistance using a combination of in vivo testing and direct sequencing of resistance genes folP1, rpoB and gyrA. Molecular epidemiology analysis was performed using data from 17 variable number tandem repeats (VNTR).

RESULTS:

M. leprae was obtained from biopsies of 37 leprosy cases (18 relapses and 19 new); 16 (43.24%) displayed drug-resistance variants. Multi-drug resistance to rifampicin and dapsone was observed in 8 relapses and 4 new cases. Single resistance to rifampicin was detected in one new case. Resistance to dapsone was present in two relapses and one new case. Combined molecular resistance and VNTR data revealed evidence of intra-familial primary transmission of resistant M. leprae.

CONCLUSIONS:

A comprehensive, population-based systematic approach to investigate M. leprae resistance in a unique population revealed an alarming scenario of emergence and transmission of resistant strains. These findings may be used for the development of new strategies for surveillance of drug resistance in other populations.

 

LML is always prepared to publish abstracts of articles of interest. It had been proposed to set up a small working group for this purpose, but there was not sufficient interest and willingness to participate in such an exercise.

For copies of articles which can not be found on the internet contact Jiske Erlings, INFOLEP, Amsterdam, the Netherlands: Infolep@leprastichting.nl

 

Best wishes,

 

Pieter AM Schreuder

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

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