Hatta M, van Beers S M, Madjid B, Djumadi A, de Wit M Y, Klatser P R
Department of Medical Microbiology, Hasanuddin University, South Sulawesi, Indonesia.
Trans R Soc Trop Med Hyg. 1995 Jul-Aug;89(4):381-5. doi: 10.1016/0035-9203(95)90018-7.
In order to understand better the relationship among Mycobacterium leprae, its transmission and the human host or the chain of infection which may lead to the development of leprosy, we performed a population survey in which nasal carriage of M. leprae was determined by a specific polymerase chain reaction (PCR), 2 years after an earlier survey in the same population. 1923 persons were registered, 1171 were clinically examined for signs of leprosy, and 418 were tested by PCR. The detection rate of leprosy in the study area had not changed significantly during the 2 years' observation period since the introduction of multi-drug therapy, i.e. 6/1000 compared to 7.7/1000 2 years before. Of 6 newly detected cases, 5 were diagnosed as having paucibacillary leprosy. The presence of M. leprae could be demonstrated by PCR in 2.9% (12/418) of the persons. PCR positivity was not persistent over the 2 years. All the PCR positive persons identified in the first survey were negative in the second, indicating that M. leprae nasal carriage is transient. As in the previous survey, we found evidence for widespread M. leprae nasal carriage as determined by PCR among the general population in an area in which leprosy is endemic. In addition, our data indicated that PCR positivity can occur in certain clusters in the community. This clustering seems to be time-dependent, not necessarily related to the presence of patients.
为了更好地理解麻风分枝杆菌、其传播与人类宿主之间的关系，或可能导致麻风病发生的感染链，我们在同一人群进行了一项群体调查，该调查在早期调查的2年后开展，通过特异性聚合酶链反应（PCR）测定麻风分枝杆菌的鼻腔携带情况。登记了1923人，其中1171人接受了麻风病体征的临床检查，418人接受了PCR检测。自采用多药疗法以来，在2年的观察期内，研究区域内麻风病的检出率没有显著变化，即每千人为6例，而2年前为每千人为7.7例。在6例新检出的病例中，5例被诊断为少菌型麻风病。通过PCR可在2.9%（12/418）的人中检测到麻风分枝杆菌的存在。PCR阳性在这2年中并非持续存在。在第一次调查中鉴定出的所有PCR阳性者在第二次调查中均为阴性，表明麻风分枝杆菌的鼻腔携带是短暂的。与之前的调查一样，我们发现，在麻风病流行地区的普通人群中，通过PCR测定，麻风分枝杆菌的鼻腔携带情况普遍存在。此外，我们的数据表明，PCR阳性可能出现在社区的某些聚集人群中。这种聚集似乎与时间有关，不一定与患者的存在有关。
