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1.
Antimicrob Agents Chemother ; 64(7)2020 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-32340990

RESUMEN

A case of Mycobacterium leprae rifampin resistance after irregular antileprosy treatments since 1971 is reported. Whole-genome sequencing from four longitudinal samples indicated relapse due to acquired rifampin resistance and not to reinfection with another strain. A putative compensatory mutation in rpoC was also detected. Clinical improvement was achieved using an alternative therapy.

2.
BMC Infect Dis ; 18(1): 153, 2018 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-29609530

RESUMEN

BACKGROUND: Characterization of the Mycobacterium leprae genome has made possible the development of Polymerase Chain Reaction (PCR) systems that can amplify different genomic regions. Increased reliability and technical efficiency of quantitative PCR (qPCR) makes it a promising tool for early diagnosis of leprosy. Index cases that are multibacillary spread the bacillus silently, even before they are clinically diagnosed. Early detection and treatment could prevent transmission in endemic areas. METHODS: In this study, the qPCR technique is used to detect DNA of M. leprae in samples of slit skin smears (SSS) of the ear lobe and blood of leprosy patients and their asymptomatic household contacts residing in Governador Valadares, MG, Brazil, a hyperendemic area for leprosy. A total of 164 subjects participated in the study: 43 index cases, 113 household contacts, and, as negative controls, 8 individuals who reported no contact with patients nor history of leprosy in the family. The qPCR was performed to amplify 16S rRNA fragments and was specifically designed for M. leprae. RESULTS: Of asymptomatic household contacts, 23.89% showed bacillary DNA by qPCR in samples of SSS and blood. Also, 48.84% of patients diagnosed with leprosy were positive for qPCR while the bacillary load was positive in only 30.23% of patients. It is important to note that most patients were already receiving treatment when the collection of biological material for qPCR was performed. The level of bacillary DNA from household contacts was similar to the DNA levels detected in the group of paucibacillary patients. CONCLUSION: Considering that household contacts comprise a recognizable group of individuals with a high risk of disease, as they live in close proximity to a source of infection, qPCR can be used to estimate the risk of progress towards leprosy among household contacts and as a routine screening method for a chemoprophylactic protocol.


Asunto(s)
Infecciones Asintomáticas/epidemiología , ADN Bacteriano/aislamiento & purificación , Composición Familiar , Lepra/epidemiología , Mycobacterium leprae/genética , Adulto , Brasil/epidemiología , Trazado de Contacto/métodos , Femenino , Humanos , Lepra/diagnóstico , Lepra/transmisión , Masculino , Mycobacterium leprae/aislamiento & purificación , Prevalencia , ARN Ribosómico 16S/análisis , Reacción en Cadena en Tiempo Real de la Polimerasa , Reproducibilidad de los Resultados
3.
Mem Inst Oswaldo Cruz ; 109(7): 944-7, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25411000

RESUMEN

The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP), medium (MP) or low (LP) probability of leprosy or other dermatopathy (OD). Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19), two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.


Asunto(s)
ADN Bacteriano/análisis , Lepra Paucibacilar/diagnóstico , Mycobacterium leprae/genética , Piel/patología , Biopsia/clasificación , Técnicas de Apoyo para la Decisión , Femenino , Humanos , Lepra Paucibacilar/clasificación , Masculino , Reacción en Cadena de la Polimerasa/métodos , Piel/lesiones , Centros de Atención Terciaria
4.
Mem. Inst. Oswaldo Cruz ; 109(7): 944-947, 11/2014. tab, graf
Artículo en Inglés | LILACS | ID: lil-728804

RESUMEN

The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP), medium (MP) or low (LP) probability of leprosy or other dermatopathy (OD). Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19), two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.


Asunto(s)
Femenino , Humanos , Masculino , ADN Bacteriano/análisis , Lepra Paucibacilar/diagnóstico , Mycobacterium leprae/genética , Piel/patología , Biopsia/clasificación , Técnicas de Apoyo para la Decisión , Lepra Paucibacilar/clasificación , Reacción en Cadena de la Polimerasa/métodos , Piel/lesiones , Centros de Atención Terciaria
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