Microbial colonizers in leprosy skin ulcers and intensity of inflammation.

The microflora of 55 patients with leprosy skin ulcers was studied and related to a weighted inflammatory score (IS). The control group consisted of 18 ulcers with different underlying pathology. Leprosy ulcers were characterized by the exclusive presence of two types of branching gram-positive rods; a particular interesting proposal is that Mycobacterium leprae share common antigens with these unusual "leprosy ulcer associated" organisms and group G beta-hemolytic streptococci. In the leprosy group, corynebacteria and branching rods accounted for 97% of gram-positive bacilli and Bacillus species constituted only 3%. In the control group, B. species formed 50% of gram-positive rods; the rest were corynebacteria (p = 0.03). In the leprosy group, one third of the gram-positive bacteria were branching rods; none of them was acid fast. Ten of them were identified as Arcanobacterium haemolyticum, and the remaining 7 could not be identified. The IS of leprosy patients was lower than in the control group. The presence of more than two species of facultative or aerobic gram-negative rods or single species of pyogenic gram-positive cocci correlated with a high IS. The presence of two or more different pyogenic cocci resulted in a lower IS. Further studies into the nature of leprosyunique organisms as well as the inflammation inhibition factors in mixed infections are warranted. It is recommended that management of ulcers should consist of the application of local disinfection and early treatment of episodes of inflammation with a combination of fluoroquinolone and penicillin.

Description of Corynebacterium tuberculostearicum sp. nov., a leprosy-derived Corynebacterium.

Leprosy-derived corynebacteria (LDC) have been extensively studied over the past decade. A composite of their biological properties (cell morphology, staining reactions, cellular inclusions and guanine-plus-cytosine content of their deoxyribonucleic acid; 16 strains studied) and their chemical structures (peptidoglycan type, major cell wall polysaccharide, major glycolipid as well as characteristic mycolic acids) appears to define them as members of the genus Corynebacterium. In relation to other corynebacteria found in humans, including "JK corynebacteria", they seem to be distinct. They are here named Corynebacterium tuberculostearicum sp. nov. because they produce a 10-methyloctadecanoic (tuberculostearic) acid (8 strains studied). This and some of their other attributes are considered in relation to properties of leprosy bacilli and Mycobacterium leprae.