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Jpn J Infect Dis ; 63(6): 412-6, 2010 Nov.
Article in English | MEDLINE | ID: mdl-21099091

ABSTRACT

Mexico is a country with sporadic leprosy cases, and the reemergence of drug resistance is a concern. In this study, molecular analysis of Mycobacterium leprae was employed to clarify the spread of drug-resistant leprosy. Thus, drug resistance-determining regions in the folP1, rpoB, and gyrA genes, which are associated with resistance to dapsone, rifampicin, and ofloxacin, respectively, were analyzed by direct sequencing of the PCR product. No mutations in the folP1 gene were observed in any of the 72 slit skin samples obtained from 38 patients, although two samples carrying a mutation at codon 425 in the rpoB gene, which confers resistance to rifampicin, a key component of multidrug therapy, were identified. In addition, a mutation at codon 91 in the gyrA gene, which correlates with ofloxacin resistance, was found in one sample. These results demonstrate the existence of rifampicin- and ofloxacin-resistant leprosy. Interestingly, wild-type and mutant sequences in the gyrA gene were found to coexist in one clinical sample. In addition, all three drug resistance-related mutations were found in only one of the two earlobes of the patients concerned, suggesting a possible pathway for the spread of drug-resistant M. leprae.


Subject(s)
Drug Resistance, Bacterial/genetics , Leprostatic Agents/pharmacology , Leprosy/epidemiology , Leprosy/microbiology , Mycobacterium leprae/drug effects , Bacterial Proteins/genetics , DNA Gyrase/genetics , DNA, Bacterial/analysis , DNA, Bacterial/genetics , Dapsone/pharmacology , Dapsone/therapeutic use , Drug Therapy, Combination , Ear, External/microbiology , Humans , Leprostatic Agents/therapeutic use , Leprosy/drug therapy , Mexico/epidemiology , Mutation , Mycobacterium leprae/genetics , Ofloxacin/pharmacology , Ofloxacin/therapeutic use , Polymerase Chain Reaction , Prevalence , Rifampin/pharmacology , Rifampin/therapeutic use , Sequence Analysis, DNA
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