Drug resistance patterns in Mycobacterium leprae isolates from relapsed leprosy patients attending The Leprosy Mission (TLM) Hospitals in India

Towards leprosy elimination by 2020: forecasts of epidemiological indicators of leprosy in Corrientes, a province of northeastern Argentina that is a pioneer in leprosy elimination

“…However, the proportion of MB cases increased in the same period and will continue to increase in the future. This is a characteristic of the stage of leprosy elimination and could be due to the use of multi-drug therapy (MDT) for several years, because drugs acts efficiently on susceptible strains of M. le- prae but genetically resistant strains persist ( Lavania et al 2014 , Beltrán-Alzate et al 2016 ). Considering that the proportion of MB cases represent cases at risk of complications, these findings imply the need to extend the chemotherapeutic coverage to all patients or to supply alternative drugs to those patients resistant to conventional treatment ( Yamaguchi et al 2016 ).…”

Recent laboratory advances in diagnostics and monitoring response to treatment in leprosy

“…[ 80 ] In the recent past, a quantitative real-time (RT)-PCR based on hsp18 mRNA, demonstrated that after 2 years of MDT treatment, no viable ML could be detected in 47 leprosy cases; however, considerable amount of DNA could be detected in many of these samples suggesting that RT-PCR could be used effectively in monitoring patients under chemotherapy. [ 81 ] The method using RT-PCR was not further developed because of its complexity to perform under field conditions. However, with the emergence of drug-resistant ML, this technique is presently being employed in reference laboratories in samples collected from the remote areas.…”

“…However, with the emergence of drug-resistant ML, this technique is presently being employed in reference laboratories in samples collected from the remote areas. [ 81 82 ] Specificity and sensitivity of the PCR-based assays have been listed in Table 1 .…”

“…Emergence of drug resistance in leprosy has been recently reported from several countries including India. [ 81 82 ] As mouse foot pad technique for the detection of drug resistance takes a minimum of 6 months, molecular-based techniques in finding mutation in drug-resistant determining region (DRDR) of ML are being used in patients who are not responding to MDT. Many of the mutations responsible for drug resistance in folP1 r egion for DDS, GyrA region for Oflaxacin, and rpoB region for Rifampicin have been shown to be responsible for resistance in ML.…”

Emergence of primary drug resistance to rifampicin in Mycobacterium leprae strains from leprosy patients in India

“…As rifampicin is the main drug used in MDT and the only bactericidal drug, it is very important to follow the emergence of rifampicin-resistant mutants in leprosy patients. It has already been indicated in the recent published literature from Brazil and India [4,5] that rifampicin-resistant cases are appearing in many endemic areas of these countries. To overcome the challenge of containing the disease and to sustain the ongoing declining trend of leprosy in endemic countries, it is essential to monitor drug sensitivity patterns in the present settings.…”