[Drug resistance of multibacillary leprosy patients in Japan--results of molecular genetic analyses].
Gene mutation of Mycobacterium leprae was studied on bacilli-positive multibacillary leprosy patients since 2000 in Japan.


METHODS
LL 31 cases, BL 7 cases.


RESULTS
gene mutation of folP was found in 19/36 cases (52.8%), that of rpoB in 13/33 cases (39.4%), that of gyrA in 6/31 cases (16.8%). Five cases showed both mutations of folP and rpoB, and one case showed those of fol/P and gyrA. Mutations of folP, rpoB andgyrA all were found in 4/36 cases (10.3%). High incidence of resistance to DDS or rifampicin was observed, and incidence of resistance to of loxacin was considerably high. These results reveal existence of multidrug-resistant bacilli in Japanese leprosy patients. Treatment of these cases was arranged according to the result of gene mutation analysis and satisfactory effects were obtained in 34/38 cases. One case did not response to newer treatment. Three cases refused use of improved treatment and their disease activities are not controlled. This study proved that gene mutation analysis is a rapid and accurate method to know the drug resistance against DDS, rifampicin and new quinolones, and important in chemotherapy of leprosy.
Ozaki
Motoaki
M
Nagashima Aisei-en National Leprosarium, 6539 Mushiake, Okuchou, Setouchi, Okayama 701-4592, Japan. mozak@maia.eonet.ne.jp
D000818:Animals; D001426:Bacterial Proteins / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005260:Female; D006801:Humans; D007564:Japan; D007917:Leprostatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007918:Leprosy / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D051379:Mice; D009154:Mutation; D009166:Mycobacterium leprae / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D016133:Polymerase Chain Reaction
D001426:Bacterial Proteins; D007917:Leprostatic Agents