从印度麻风病患者中检测出耐多药麻风分枝杆菌。

Molecular detection of multidrug-resistant Mycobacterium leprae from Indian leprosy patients.

机构信息

Stanley Browne Research Laboratory, The Leprosy Mission (TLM) Community Hospital, Nand Nagri, Shahdara, New Delhi 110093, India.

出版信息

J Glob Antimicrob Resist. 2018 Mar;12:214-219. doi: 10.1016/j.jgar.2017.10.010. Epub 2017 Oct 31.

DOI:10.1016/j.jgar.2017.10.010

PMID:29097343

Abstract

OBJECTIVES

The emergence of multidrug-resistant (MDR) organisms for any infectious disease is a public health concern. Global efforts to control leprosy by intensive chemotherapy have led to a significant decrease in the number of registered patients. Currently recommended control measures for treating leprosy with multidrug therapy (MDT) were designed to prevent the spread of dapsone-resistant Mycobacterium leprae strains. Here we report the identification of MDR M. leprae from relapse leprosy patients from endemic regions in India.

METHODS

Resistance profiles to rifampicin, dapsone and ofloxacin of the isolated strains were confirmed by identification of mutations in genes previously shown to be associated with resistance to each drug. Between 2009-2016, slit-skin smear samples were collected from 239 relapse and 11 new leprosy cases from hospitals of The Leprosy Mission across India. DNA was extracted from the samples and was analysed by PCR targeting the rpoB, folP and gyrA genes associated with resistance to rifampicin, dapsone and ofloxacin, respectively, in M. leprae. M. leprae Thai-53 (wild-type) and Zensho-4 (MDR) were used as reference strains.

RESULTS

Fifteen strains showed representative mutations in at least two resistance genes. Two strains showed mutations in all three genes responsible for drug resistance. Seven, seven and one strain, respectively, showed mutations in genes responsible for rifampicin and dapsone resistance, for dapsone and ofloxacin resistance and for rifampicin and ofloxacin resistance.

CONCLUSION

This study showed the emergence of MDR M. leprae in MDT-treated leprosy patients from endemic regions of India.

摘要

目的

任何传染病出现多药耐药（MDR）病原体都是一个公共卫生关注点。全球通过强化化疗控制麻风病的努力已导致登记患者数量显著减少。目前推荐使用多药疗法（MDT）治疗麻风病的控制措施旨在预防对氨苯砜耐药麻风分枝杆菌菌株的传播。在此，我们报告了从印度流行地区复发麻风病患者中鉴定出 MDR 麻风分枝杆菌的情况。

方法

通过鉴定先前与每种药物耐药相关的基因中的突变，确认分离株对利福平、氨苯砜和氧氟沙星的耐药谱。2009-2016 年，从印度各地麻风病使命医院的 239 例复发和 11 例新麻风病病例中收集了皮肤切片样本。从样本中提取 DNA，并通过针对 rpoB、folP 和 gyrA 基因的 PCR 分析，分别鉴定与麻风分枝杆菌对利福平、氨苯砜和氧氟沙星耐药相关的基因。使用麻风分枝杆菌 Thai-53（野生型）和 Zensho-4（MDR）作为参考菌株。