Journal Article

Analysis of Drug-Resistant Strains of <i>Mycobacterium leprae</i> in an Endemic Area of Vietnam

Masanori Kai, Nhu Ha Nguyen Phuc, Hoang An Nguyen, Thi Hoang Bich Diu Pham, Khanh Hoa Nguyen, Yuji Miyamoto, Yumi Maeda, Yasuo Fukutomi, Noboru Nakata, Masanori Matsuoka, Masahiko Makino and Thanh Tan Nguyen

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 52, issue 5, pages e127-e132
Published in print March 2011 | ISSN: 1058-4838
Published online March 2011 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1093/cid/ciq217
Analysis of Drug-Resistant Strains of Mycobacterium leprae in an Endemic Area of Vietnam

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(See brief report by Ramien and Wong, e133-e135.)

Background. Multidrug therapy has effectively reduced the number of leprosy cases in the world. However, the rate of reduction has decelerated over the years, giving early detection of Mycobacterium leprae and epidemiological study of relapse renewed relevance in attempts to eliminate the disease.

Methods. A molecular epidemiological survey for drug-resistant M. leprae was conducted in the central and highland regions of Vietnam. A total of 423 samples taken from patients, including 83 patients with new cases, 321 patients receiving treatment, and 19 patients with relapse, were studied for detection of M. leprae with mutations relating to drug resistance by sequencing the drug resistance determining region of the folP1, rpoB, and gyrA genes, which are responsible for dapsone, rifampicin, and ofloxacin resistance, respectively.

Results. Nineteen mutations were found in the folP1 gene samples, and no mutations relating to drug resistance were found in either the rpoB or gyrA genes. Samples from patients with relapse showed folP1 mutation rates as high as 57%, and the mutation rates in samples from new and recent cases were <10%. Patients with relapse who had histories of treatment with dapsone monotherapy showed high mutation rates (78%), compared with patients with relapse who had previously only received multidrug therapy (33%).

Conclusions. Our study indicated high rates of dapsone resistance in patients with relapse, compared with patients with new and recent cases of leprosy. Moreover, it was observed that many of the patients with relapse who had dapsone-resistant mutations had histories of treatment with dapsone monotherapy.

Journal Article.  3222 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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