Drug resistance patterns in Mycobacterium leprae isolates from relapsed leprosy patients attending The Leprosy Mission (TLM) Hospitals in India.

Implementation of multidrug therapy (MDT) in leprosy control programmes has significantly reduced the global prevalence of the disease in the last two decades. After many years of use of MDT, it is expected that drug resistance in Mycobacterium leprae may emerge. This is a major concern, especially during the stage of elimination. In the present study, slit-skin smears were collected from 140 leprosy relapse cases from different Leprosy Mission hospitals across India. DNA extracted from 111 (79%) of these samples was analysed for the genes associated with drug resistance in M. leprae. More than 90% of the patients relapsed as multibacillary (MB) cases. In our study, four (3.6%) of the DNA samples analysed showed mutations associated with rifampicin resistance. We also observed that mutations associated with resistance to dapsone and ofloxacin were observed in 9 (8.1%) of the DNA samples each; two samples had both dapsone and ofloxacin resistance. Further surveillance and appropriate interventions are needed to ensure the continued success of chemotherapy for leprosy.

Patrones de resistencia farmacológica en muestras de Mycobacterium leprae de pacientes de lepra con recidivas en los Hospitales de the Leprosy mission (TLM) de India / No disponible

La implementación de la multiterapia (MDT) en los programas de control de la lepra ha reducido la prevalencia global de la enfermedad durante las dos últimas décadas. Después de muchos años de administrar la MDT hay que evaluar si pueden haber casos de resistencia del Mycobacterium leprae frente a la multiterapia. Esto constituye una gran preocupación, especialmente durante la actual fase de eliminación de la lepra. En este trabajo se obtuvieron frotis cutáneos de 140 casos de lepra con recidivas de distintos hospitales de The Leprosy Mission en la India. El DNA extraído de 111 (79%) de estas muestras se analizó para el análisis de genes asociados a la resistencia por M. leprae. Más del 90% de los pacientes recidivaron como multibacilares (MB). En nuestro estudio, cuatro de las muestras de DNA (3·6%) revelaron mutaciones asociadas con resistencia a la rifampicina. También se detectó que las mutaciones asociadas con la resistencia a la dapsona u ofloxacino se detectaron en 9 (8·1%) de las muestras; dos muestras presentaban resistencia a ambos. Se requiere más vigilancia e intervenciones adecuadas para asegurar la eficacia futura de la quimioterapia en la lepra

Implementation of multidrug therapy (MDT) in leprosy control programmes has significantly reduced the global prevalence of the disease in the last two decades. After many years of use of MDT, it is expected that drug resistance in Mycobacterium leprae may emerge. This is a major concern, especially during the stage of elimination. In the present study, slit-skin smears were collected from 140 leprosy relapse cases from different Leprosy Mission hospitals across India. DNA extracted from 111 (79%) of these samples was analysed for the genes associated with drug resistance in M. leprae. More than 90% of the patients relapsed as multibacillary (MB) cases. In our study, four (3·6%) of the DNA samples analysed showed mutations associated with rifampicin resistance. We also observed that mutations associated with resistance to dapsone and ofloxacin were observed in 9 (8·1%) of the DNA samples each; two samples had both dapsone and ofloxacin resistance. Further surveillance and appropriate interventions are needed to ensure the continued success of chemotherapy for leprosy