title: Visceral leishmaniasis unresponsive to pentostam caused by Leishmania tropica in Kenya.
abstract: We report the characterization of 6 Leishmania tropica isolates from 2 patients with visceral leishmaniasis who were unresponsive to treatment with sodium stibogluconate. The Leishmania isolates, MHOM/KE/81/NLB-029A, -029XIB, and -029XIC and MHOM/KE/81/NLB-030I, -030B, and -030XXA, all from splenic aspirates, were characterized by cellulose acetate electrophoresis using 11 enzymes: malate dehydrogenase, malic enzyme, phosphogluconate dehydrogenase, glucose-6-phosphate dehydrogenase, superoxide dismutase, glutamate-oxaloacetate transaminase, adenylate kinase, nucleoside hydrolase, mannose phosphate isomerase, glucose phosphate isomerase, and phosphoglucomutase. Isozyme migration patterns were indistinguishable from those of 2 WHO reference strains of Leishmania tropica (MHOM/SU/60/LRC-L39, NLB-305 and MHOM/IQ/OO/LRC-L36, NLB-067). These are the first reported cases of visceral leishmaniasis (kala-azar) caused by L. tropica in Africa; these cases were refractory to sodium stibogluconate.
authors.affiliation: Biomedical Sciences Research Centre, Kenya Medical Research Institute, Nairobi.
authors.forename: Y
authors.initials: Y
authors.lastname: Mebrahtu
authors.forename: P
authors.initials: P
authors.lastname: Lawyer
authors.forename: J
authors.initials: J
authors.lastname: Githure
authors.forename: J B
authors.initials: JB
authors.lastname: Were
authors.forename: R
authors.initials: R
authors.lastname: Muigai
authors.forename: L
authors.initials: L
authors.lastname: Hendricks
authors.forename: J
authors.initials: J
authors.lastname: Leeuwenburg
authors.forename: D
authors.initials: D
authors.lastname: Koech
authors.forename: C
authors.initials: C
authors.lastname: Roberts
mesh_terms: D000818:Animals; D000967:Antimony Sodium Gluconate / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004588:Electrophoresis, Cellulose Acetate; D005260:Female; D005942:Gluconates / Q000627:therapeutic use*; D006801:Humans; D007527:Isoenzymes / Q000032:analysis; D007630:Kenya; D007895:Leishmania tropica / Q000145:classification / Q000187:drug effects* / Q000201:enzymology; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008297:Male; D013154:Spleen / Q000469:parasitology
chemical_list: D005942:Gluconates; D007527:Isoenzymes; D000967:Antimony Sodium Gluconate