title: Single nucleotide polymorphism typing of Mycobacterium ulcerans reveals focal transmission of buruli ulcer in a highly endemic region of Ghana.
abstract: Buruli ulcer (BU) is an emerging necrotizing disease of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. While proximity to stagnant or slow flowing water bodies is a risk factor for acquiring BU, the epidemiology and mode of M. ulcerans transmission is poorly understood. Here we have used high-throughput DNA sequencing and comparisons of the genomes of seven M. ulcerans isolates that appeared monomorphic by existing typing methods. We identified a limited number of single nucleotide polymorphisms (SNPs) and developed a real-time PCR SNP typing method based on these differences. We then investigated clinical isolates of M. ulcerans on which we had detailed information concerning patient location and time of diagnosis. Within the Densu river basin of Ghana we observed dominance of one clonal complex and local clustering of some of the variants belonging to this complex. These results reveal focal transmission and demonstrate, that micro-epidemiological analyses by SNP typing has great potential to help us understand how M. ulcerans is transmitted.
authors.affiliation: Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Röltgen
authors.forename: Weihong
authors.initials: W
authors.lastname: Qi
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Ruf
authors.forename: Ernestina
authors.initials: E
authors.lastname: Mensah-Quainoo
authors.forename: Sacha J
authors.initials: SJ
authors.lastname: Pidot
authors.forename: Torsten
authors.initials: T
authors.lastname: Seemann
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Stinear
authors.forename: Michael
authors.initials: M
authors.lastname: Käser
authors.forename: Dorothy
authors.initials: D
authors.lastname: Yeboah-Manu
authors.forename: Gerd
authors.initials: G
authors.lastname: Pluschke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015373:Bacterial Typing Techniques; D054312:Buruli Ulcer / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D019353:Endemic Diseases; D005838:Genotype; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D017720:Molecular Epidemiology; D019911:Mycobacterium ulcerans / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction / Q000379:methods; D020641:Polymorphism, Single Nucleotide; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial