RESUMO
A skin biopsy sample was obtained from a relapsed lepromatous leprosy patient from the central area of Mexico. Genes associated with resistance to anti-leprosy drugs were analyzed by DNA sequence assay. A single nucleotide substitution was found at codon 53 (ACC-->GCC) in the folP gene, which is known to confer dapsone resistance. No mutations in the rpoB and gyrA, which indicate resistance to rifampicin and fluoroquinoles, were detected. This is the first reported case of dapsone resistant leprosy in Mexico in which the cause of the resistance is shown at genomic level. Evaluation of drug resistance by identifying known mutations in these genes by PCR is simple and reliable. Testing for resistance to anti-leprosy drugs should be performed in relapses or intractable cases for a better outcome.
Assuntos
Proteínas de Bactérias/genética , DNA Bacteriano/genética , Dapsona/farmacologia , Di-Hidropteroato Sintase/genética , Farmacorresistência Bacteriana/genética , Hansenostáticos/farmacologia , Hanseníase Virchowiana/microbiologia , Mycobacterium leprae/efeitos dos fármacos , Mutação Puntual , Proteínas de Bactérias/fisiologia , Códon/genética , Análise Mutacional de DNA , Dapsona/uso terapêutico , Di-Hidropteroato Sintase/fisiologia , Humanos , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/tratamento farmacológico , México , Mycobacterium leprae/genética , Mycobacterium leprae/isolamento & purificação , Recidiva , Análise de Sequência de DNARESUMO
The variance of tandem repeats in the rpoT gene of Mycobacterium leprae was recently demonstrated. The objects of this study was to examine the proportion and distributions of the genotypes of M. leprae in Korea and to compared it with genotypes of M. leprae form foreign leprosy patients using difference of the tandem repeats. Among 101 cases, 72 isolated from Korea and 4 cases from Japan (except Okinawa) demonstrated four copies of the 6 bp tandem repeats in the rpoT gene, and three copies were found in isolates from two korean, 2 cases of Okinawa in Japan, and those from Southeast Asian countries, Peru and Paraguay. These results reveal the genetic diversity of M. leprae and the related genotype-specific distribution in the world. In this study, a more detailed explanation can be also possible regarding the transmission route of M. leprae.
