TY - JOUR
T1 - Antimicrobial resistance in leprosy
T2 - results of the first prospective open survey conducted by a WHO surveillance network for the period 2009–15
AU - WHO surveillance network of antimicrobial resistance in leprosy
AU - Cambau, E.
AU - Saunderson, P.
AU - Matsuoka, M.
AU - Cole, S. T.
AU - Kai, M.
AU - Suffys, P.
AU - Rosa, P. S.
AU - Williams, D.
AU - Gupta, U. D.
AU - Lavania, M.
AU - Cardona-Castro, N.
AU - Miyamoto, Y.
AU - Hagge, D.
AU - Srikantam, A.
AU - Hongseng, W.
AU - Indropo, A.
AU - Vissa, V.
AU - Johnson, R. C.
AU - Cauchoix, B.
AU - Pannikar, V. K.
AU - Cooreman, E. A.W.D.
AU - Pemmaraju, V. R.R.
AU - Gillini, L.
AU - Kriswamati, A.
AU - Al-Samie, Abdul Rahim
AU - Issoufou, Ahamed
AU - Tiendrebeogo, Alexandre
AU - Kingalu, Amri Miraju
AU - Randrianantoandro, Andriamira
AU - Kumar, Anil
AU - Chauffour, Aurelie
AU - Win, Aye Aye
AU - Pandey, Basudev
AU - Agrawal, C. M.
AU - Widaningrum, Christiana
AU - Schmotzer, Christine
AU - Kafando, Christophe
AU - Bhandari, Chuda Mani
AU - Sema, Cynthia
AU - Vidanagama, D. S.
AU - Scollard, David M.
AU - Beyene, Demmissew
AU - Morelo, Eliane Faria
AU - Kassa, Elizabeth Dizaneh
AU - Ramarolahy, Enerantien Benoit
AU - Claco, Eric
AU - Villalon, Ernesto ES
AU - Sidibe, Famoussa
AU - Sakho, Fatoumata
AU - Cho, Sang Nae Ray
N1 - Funding Information:
Logistics, materials and meetings benefit from annual grants from ministries of health from all countries and from non-governmental agencies supporting leprosy, including Fondation Raoul Follereau, American Leprosy Missions, National Hansen's Disease Programs, Sasakawa Memorial Health Foundation, Damien Foundation and Lepra. Specific grants were also used to support the study: Swiss National Science Foundation grant IZRJZ3_164174.
Funding Information:
Logistics, materials and meetings benefit from annual grants from ministries of health from all countries and from non-governmental agencies supporting leprosy, including Fondation Raoul Follereau , American Leprosy Missions , National Hansen's Disease Programs , Sasakawa Memorial Health Foundation , Damien Foundation and Lepra . Specific grants were also used to support the study: Swiss National Science Foundation grant IZRJZ3_164174 .
Publisher Copyright:
© 2018 The Authors
PY - 2018/12
Y1 - 2018/12
N2 - 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.
AB - 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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U2 - 10.1016/j.cmi.2018.02.022
DO - 10.1016/j.cmi.2018.02.022
M3 - Article
C2 - 29496597
AN - SCOPUS:85044608156
SN - 1198-743X
VL - 24
SP - 1305
EP - 1310
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 12
ER -
