title: Drug resistance in Mycobacterium leprae from patients with leprosy in China.
abstract: BACKGROUND
  Previous studies of drug resistance have shown that mutations in the drug resistance-determining region (DRDR) in the Folp1, RpoB and GyrA genes of Mycobacterium leprae are responsible for resistance to dapsone, rifampin and ofloxacin, respectively.
  
  
  OBJECTIVE
  To investigate the prevalence of mutations in genes associated with drug resistance in M. leprae isolates from patients with leprosy in Shandong Province.
  
  
  METHODS
  The DRDR in the FolP1, RpoB and GyrA genes was analysed by direct sequencing of the PCR product from 85 isolates of M. leprae sampled from patients with leprosy in Shandong, China.
  
  
  RESULTS
  Sequencing results were obtained for FolP1, RpoB and GyrA in 67, 57 and 81 of the 85 samples, with mutation rates of 1.5% (1/67), 8.8% 5/57 and 25.9% (21/81). Three multidrug-resistant samples were found among the new cases: one had a mutation in both Folp1 and RpoB, while the other two had a mutation in both RpoB and GyrA.
  
  
  CONCLUSIONS
  Primary resistance appears to be to either single drugs or combinations of two drugs. The resistance rate to dapsone seems to be low. To our knowledge, this is the first case of multidrug-resistant M. leprae from China.
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.|School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: D
authors.initials: D
authors.lastname: Liu
authors.affiliation: School of Medicine, Shandong University, Jinan, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.|School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.
authors.forename: X
authors.initials: X
authors.lastname: Fu
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: G
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: X
authors.initials: X
authors.lastname: Yu
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.|Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, Shandong, China.|Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China.
authors.forename: H
authors.initials: H
authors.lastname: Liu
authors.affiliation: Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.|Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, Shandong, China.|Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China.
authors.forename: F
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001426:Bacterial Proteins / Q000235:genetics*; D002681:China / Q000453:epidemiology; D004269:DNA, Bacterial / Q000235:genetics; D003622:Dapsone / Q000494:pharmacology; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000494:pharmacology; D007918:Leprosy / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009154:Mutation; D009166:Mycobacterium leprae / Q000187:drug effects* / Q000235:genetics*; D015242:Ofloxacin / Q000494:pharmacology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012293:Rifampin / Q000494:pharmacology
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D007917:Leprostatic Agents; D003622:Dapsone; D015242:Ofloxacin; D012293:Rifampin