title: Possible mode of emergence for drug-resistant leprosy is revealed by an analysis of samples from Mexico.
abstract: Mexico is a country with sporadic leprosy cases, and the reemergence of drug resistance is a concern. In this study, molecular analysis of Mycobacterium leprae was employed to clarify the spread of drug-resistant leprosy. Thus, drug resistance-determining regions in the folP1, rpoB, and gyrA genes, which are associated with resistance to dapsone, rifampicin, and ofloxacin, respectively, were analyzed by direct sequencing of the PCR product. No mutations in the folP1 gene were observed in any of the 72 slit skin samples obtained from 38 patients, although two samples carrying a mutation at codon 425 in the rpoB gene, which confers resistance to rifampicin, a key component of multidrug therapy, were identified. In addition, a mutation at codon 91 in the gyrA gene, which correlates with ofloxacin resistance, was found in one sample. These results demonstrate the existence of rifampicin- and ofloxacin-resistant leprosy. Interestingly, wild-type and mutant sequences in the gyrA gene were found to coexist in one clinical sample. In addition, all three drug resistance-related mutations were found in only one of the two earlobes of the patients concerned, suggesting a possible pathway for the spread of drug-resistant M. leprae.
authors.affiliation: Leprosy Research Center, National Institute of Infectious Diseases, Tokyo 189-0002, Japan. matsuoka@nih.gp.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsuoka
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Iris Estrada
authors.initials: IE
authors.lastname: Garcia
authors.forename: Mary
authors.initials: M
authors.lastname: Fafutis-Morris
authors.forename: Alberto
authors.initials: A
authors.lastname: Vargas-González
authors.forename: Cristina
authors.initials: C
authors.lastname: Carreño-Martinez
authors.forename: Yukari
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Chie
authors.initials: C
authors.lastname: Nakajima
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D027081:DNA Gyrase / Q000235:genetics; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D003622:Dapsone / Q000494:pharmacology / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004359:Drug Therapy, Combination; D004431:Ear, External / Q000382:microbiology; D006801:Humans; D007917:Leprostatic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007918:Leprosy / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D008800:Mexico / Q000453:epidemiology; D009154:Mutation; D009166:Mycobacterium leprae / Q000187:drug effects* / Q000235:genetics; D015242:Ofloxacin / Q000494:pharmacology / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012293:Rifampin / Q000494:pharmacology / Q000627:therapeutic use; D017422:Sequence Analysis, DNA
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D007917:Leprostatic Agents; D003622:Dapsone; D015242:Ofloxacin; D027081:DNA Gyrase; D012293:Rifampin