title: Detection of Mycobacterium ulcerans DNA in the Environment, Ivory Coast.
abstract: BACKGROUND
  Ivory Coast is a West African country with the highest reported cases of Buruli ulcer, a disabling subcutaneous infection due to Mycobacterium ulcerans. However, the prevalence of environmental M. ulcerans is poorly known in this country.
  
  
  METHODS
  We collected 496 environmental specimens consisting of soil (n = 100), stagnant water (n = 200), plants (n = 100) and animal feces (n = 96) in Ivory Coast over five months in the dry and wet seasons in regions which are free of Buruli ulcer (control group A; 250 specimens) and in regions where the Buruli ulcer is endemic (group B; 246 specimens). After appropriate total DNA extraction incorporating an internal control, the M. ulcerans IS2404 and KR-B gene were amplified by real-time PCR in samples. In parallel, a calibration curve was done for M. ulcerans Agy99 IS2404 and KR-B gene.
  
  
  RESULTS
  Of 460 samples free of PCR inhibition, a positive real-time PCR detection of insertion sequence IS2404 and KR-B gene was observed in 1/230 specimens in control group A versus 9/230 specimens in group B (P = 0.02; Fisher exact test). Positive specimens comprised seven stagnant water specimens, two feces specimens confirmed to be of Thryonomys swinderianus (agouti) origin by real-time PCR of the cytb gene; and one soil specimen. Extrapolation from the calibration curves indicated low inoculums ranging from 1 to 102 mycobacteria/mL.
  
  
  CONCLUSIONS
  This study confirms the presence of M. ulcerans in the watery environment surrounding patients with Buruli ulcer in Ivory Coast. It suggests that the agouti, which is in close contacts with populations, could play a role in the environmental cycle of M. ulcerans, as previously suggested for the closely related possums in Australia.
authors.affiliation: Aix Marseille Université, URMITE, UMR, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine, Marseille, France.|Laboratoire de biotechnologies, UFR Biosciences, Université Félix Houphouet Boigny Abidjan, Côte d'Ivoire.
authors.forename: Roger Bi Diangoné
authors.initials: RB
authors.lastname: Tian
authors.affiliation: Laboratoire de biotechnologies, UFR Biosciences, Université Félix Houphouet Boigny Abidjan, Côte d'Ivoire.
authors.forename: Sébastian
authors.initials: S
authors.lastname: Niamké
authors.affiliation: Aix Marseille Université, URMITE, UMR, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine, Marseille, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Tissot-Dupont
authors.affiliation: Aix Marseille Université, URMITE, UMR, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine, Marseille, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
mesh_terms: D000818:Animals; D007560:Cote d'Ivoire; D004269:DNA, Bacterial / Q000032:analysis*; D005243:Feces / Q000382:microbiology*; D019911:Mycobacterium ulcerans / Q000235:genetics* / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction; D012988:Soil Microbiology
chemical_list: D004269:DNA, Bacterial