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1.
Int J Infect Dis ; 96: 172-179, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32371193

ABSTRACT

BACKGROUND: Human-to-human transmission of Mycobacterium leprae among household contacts of active leprosy cases is significant, and surveillance of household contacts is vital to interrupting the transmission chain for this disease. This study was conducted to identify similarities in M. leprae strains, based on genomic single nucleotide polymorphisms (SNPs), among cases and their household contacts and in multicase families in order to decipher possible associations, transmission links, various clinical conditions of index cases that enhance person-to-person transmission, and timelines for transmission patterns. METHODS: PCR for M. leprae DNA detection (amplification of the Rlep gene) and SNP subtyping of M. leprae strains was performed for 61 index cases and one of their household contacts. Additionally, we studied six families with multiple cases of leprosy, to understand timelines of infectivity and its relation to severity of the disease in the index cases. RESULTS: Index cases with lepromatous (LL) and borderline lepromatous (BL) leprosy, together with a positive bacteriological index (BI) for M. leprae, result in a higher percentage of their contacts subclinically infected with M. leprae, with odds ratios (OR) of 6.6 (95% confidence interval (CI) 1.6-27.6) for BL and LL, and 7.07 (CI 1.41-35.41) for BI-positive index cases. 75% of the case-contact pairs had a similar SNP subtype of M. leprae. The timeline of infection in multicase families revealed that contacts were infected during the BI-positive period of the index case. CONCLUSION: Using molecular methods, we determined that positivity for M. leprae DNA in contacts of index leprosy cases was attributed to clinical characteristics of leprosy in the index cases. LL and BL forms of leprosy, together with positive BI, contributed to dissemination of infection to household contacts. In conclusion, we found a relationship between SNP subtypes within index case-contact pairs. This method can help decipher the transmission patterns and identify individuals at risk of contracting leprosy.


Subject(s)
Leprosy/epidemiology , Mycobacterium leprae/genetics , Adolescent , Adult , Family Characteristics , Female , Humans , Leprosy/microbiology , Leprosy/transmission , Male , Middle Aged , Molecular Epidemiology , Mycobacterium leprae/classification , Mycobacterium leprae/isolation & purification , Polymerase Chain Reaction/methods , Polymorphism, Single Nucleotide , Young Adult
2.
Int J Lepr Other Mycobact Dis ; 71(1): 18-21, 2003 Mar.
Article in English | MEDLINE | ID: mdl-12914130

ABSTRACT

This is the first report of secondary resistance to rifampin following MDT in a patient with prolonged, but irregular treatment. Repeated mouse foot-pad studies demonstrated resistance to dapsone after several years of monotherapy, and following subsequent MDT the studies demonstrated the development of resistance to rifampin.


Subject(s)
Dapsone/therapeutic use , Drug Resistance, Multiple , Leprostatic Agents/pharmacology , Leprostatic Agents/therapeutic use , Leprosy/drug therapy , Rifampin/pharmacology , Rifampin/therapeutic use , Dapsone/pharmacology , Drug Resistance, Bacterial , Drug Therapy, Combination , Humans , Male , Middle Aged
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