title: Dihydropteroate synthase mutations in the folP1 gene predict dapsone resistance in relapsed cases of leprosy.
abstract: Molecular detection was compared with the mouse footpad inoculation test for detection of dapsone resistance in 38 strains of Mycobacterium leprae. Mutations of the folP1 gene (at codons 53 or 55) were found in 6 of 6 strains with high-level resistance, in 3 of 4 strains with intermediate-level resistance, and in 1 of 6 strains with low-level resistance, but not in 22 dapsone-susceptible strains. In cases of infection with strains of M. leprae carrying the folP1 mutation, therapy with dapsone may be replaced by therapy with a fluoroquinolone.
authors.affiliation: Laboratoire de Bacteriologie-Hygiene, Centre National de Reference pour la Resistance des Mycobacteries aux Antituberculeux, Faculte de Medecine Pitie-Salpetriere, Universite Paris, Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Cambau
authors.forename: Laetitia
authors.initials: L
authors.lastname: Carthagena
authors.forename: Aurélie
authors.initials: A
authors.lastname: Chauffour
authors.forename: Baohong
authors.initials: B
authors.lastname: Ji
authors.forename: Vincent
authors.initials: V
authors.lastname: Jarlier
mesh_terms: D000818:Animals; D003622:Dapsone / Q000494:pharmacology* / Q000627:therapeutic use; D004094:Dihydropteroate Synthase / Q000235:genetics*; D004305:Dose-Response Relationship, Drug; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D006801:Humans; D007917:Leprostatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007918:Leprosy / Q000188:drug therapy* / Q000382:microbiology; D051379:Mice; D020125:Mutation, Missense / Q000235:genetics*; D009166:Mycobacterium leprae / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D012008:Recurrence
chemical_list: D007917:Leprostatic Agents; D003622:Dapsone; D004094:Dihydropteroate Synthase