National Reference Center for Sanitary Dermatology and Leprosy, Hospital das Clínicas, Uberlândia, Brazil.
Clin Microbiol Infect. 2011 Nov;17(11):1653-8. doi: 10.1111/j.1469-0691.2010.03453.x. Epub 2011 Mar 3.
Leprosy is an important health problem in Brazil despite extensive use of multidrug therapy. The nasal mucosa is the preferential site of entry and exit of Mycobacterium leprae, and although lesions have been found in the oral mucosa, its potential involvement in the transmission of leprosy bacilli has never been investigated. We investigated the presence of the M. leprae DNA in buccal swabs of leprosy patients (334) and household contacts (1288) through polymerase chain reaction (PCR), and correlated this with clinical and laboratorial evaluations. The overall positivity for patients and contacts was 18.26% and 6.83%, respectively. Subclinical infection among contacts was considered when PCR and anti-PGL-1 ELISA presented positive results. This study provides evidence that the oral mucosa may be a secondary site of M. leprae transmission and infection, and contacts with bacillary DNA may be actively involved in transmission. We have also shown that bacilli DNA is more frequently found in the oral mucosa of PB patients. Our findings have great epidemiological relevance and indicate an additional strategy for leprosy control programmes and dental clinics.
麻风病是巴西的一个重要健康问题，尽管广泛使用了多种药物疗法。鼻黏膜是麻风分枝杆菌进出的首选部位，尽管口腔黏膜也发现了病变，但从未研究过其在麻风杆菌传播中的潜在作用。我们通过聚合酶链反应（PCR）检测了麻风病患者（334 例）和家庭接触者（1288 例）的口腔拭子中麻风分枝杆菌 DNA 的存在情况，并将其与临床和实验室评估相关联。患者和接触者的总体阳性率分别为 18.26%和 6.83%。当 PCR 和抗 PGL-1 ELISA 结果呈阳性时，被认为是接触者的亚临床感染。这项研究提供了证据表明，口腔黏膜可能是麻风分枝杆菌传播和感染的第二部位，带有杆菌 DNA 的接触者可能会积极参与传播。我们还发现，PB 患者的口腔黏膜中更常发现杆菌 DNA。我们的发现具有重要的流行病学意义，并为麻风病控制规划和牙科诊所提供了额外的策略。
