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Cambau E, Saunderson P, Matsuoka M, Cole ST, Kai M, Suffys P, Rosa PS, Williams D, Gupta UD, Lavania M, Cardona-Castro N, Miyamoto Y, Hagge D, Srikantam A, Hongseng W, Indropo A, Vissa V, Johnson RC, Cauchoix B, Pannikar VK, Cooreman EAWD, Pemmaraju VRR, Gillini L. Antimicrobial resistance in leprosy: results of the first prospective open survey conducted by a WHO surveillance network for the period 2009-15. Clin Microbiol Infect 2018; 24:1305-1310. [PMID: 29496597 PMCID: PMC6286419 DOI: 10.1016/j.cmi.2018.02.022] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Antimicrobial resistance (AMR) is a priority for surveillance in bacterial infections. For leprosy, AMR has not been assessed because Mycobacterium leprae does not grow in vitro. We aim to obtain AMR data using molecular detection of resistance genes and to conduct a prospective open survey of resistance to antileprosy drugs in countries where leprosy is endemic through a WHO surveillance network. METHODS From 2009 to 2015, multi-bacillary leprosy cases at sentinel sites of 19 countries were studied for resistance to rifampicin, dapsone and ofloxacin by PCR sequencing of the drug-resistance-determining regions of the genes rpoB, folP1 and gyrA. RESULTS Among 1932 (1143 relapse and 789 new) cases studied, 154 (8.0%) M. leprae strains were found with mutations conferring resistance showing 182 resistance traits (74 for rifampicin, 87 for dapsone and 21 for ofloxacin). Twenty cases showed rifampicin and dapsone resistance, four showed ofloxacin and dapsone resistance, but no cases were resistant to rifampicin and ofloxacin. Rifampicin resistance was observed among relapse (58/1143, 5.1%) and new (16/789, 2.0%) cases in 12 countries. India, Brazil and Colombia reported more than five rifampicin-resistant cases. CONCLUSIONS This is the first study reporting global data on AMR in leprosy. Rifampicin resistance emerged, stressing the need for expansion of surveillance. This is also a call for vigilance on the global use of antimicrobial agents, because ofloxacin resistance probably developed in relation to the general intake of antibiotics for other infections as it is not part of the multidrug combination used to treat leprosy.
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Affiliation(s)
- E Cambau
- Université Paris Diderot, UMR 1137 IAME Inserm, APHP-Lariboisière, APHP-Pitie-Salpêtrière, Centre de Référence des Mycobactéries et de la résistance des mycobactéries aux antituberculeux, Paris, France.
| | | | - M Matsuoka
- Leprosy Research Centre, National Institute of Infectious Diseases, Tokyo, Japan
| | - S T Cole
- Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, Switzerland; Fondation Raoul Follereau, Paris, France
| | - M Kai
- Leprosy Research Centre, National Institute of Infectious Diseases, Tokyo, Japan
| | - P Suffys
- Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - P S Rosa
- Instituto Lauro de Souza Lima, Sao Paulo, Brazil
| | - D Williams
- National Hansen's Disease Programs, Baton Rouge, USA
| | - U D Gupta
- National JALMA Institute of Leprosy & Other Mycobacterial Diseases, Agra, India
| | - M Lavania
- Stanley Browne Laboratory, TLM Community Hospital, Delhi, India
| | - N Cardona-Castro
- Institute Colombiano de Medicina Tropical, Sabaneta, Antioquia, Colombia
| | - Y Miyamoto
- Leprosy Research Centre, National Institute of Infectious Diseases, Tokyo, Japan
| | - D Hagge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - A Srikantam
- Lepra Blue Peter Public Health and Research Centre, Hyderabad, India
| | - W Hongseng
- Institute of Dermatology, Chinese Academy of Medical Sciences, National Center for STD and Leprosy Control, China CDC, China
| | - A Indropo
- Airlangga University, Surabaya, Indonesia
| | - V Vissa
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | | | - B Cauchoix
- Fondation Raoul Follereau, Paris, France
| | - V K Pannikar
- Global Leprosy Programme, WHO Regional Office for South-East Asia, New Delhi, India
| | - E A W D Cooreman
- Global Leprosy Programme, WHO Regional Office for South-East Asia, New Delhi, India
| | - V R R Pemmaraju
- Global Leprosy Programme, WHO Regional Office for South-East Asia, New Delhi, India
| | - L Gillini
- Global Leprosy Programme, WHO Regional Office for South-East Asia, New Delhi, India
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Yuniati R, Fatihatul FM, Fika A, Prasetyowati S, Indropo A. Mast Cells in Leprosy Patients with Reversal Reactions. Turk J Immunol 2017. [DOI: 10.25002/tji.2017.542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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