Isolation of Mycobacterium ulcerans from Swab and Fine-Needle-Aspiration Specimens

Yeboah-Manu, Dorothy; Ampah, Kobina Assan; Asante-Poku, Adwoa; Nakobu, Zuliehatu; Pluschke, Gerd

doi:10.1128/jcm.02279-10

Cited by 20 publications

(22 citation statements)

References 10 publications

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“…the inclusion of (weak) positive and negative controls in every DNA extraction batch and PCR run as well as the inclusion of an internal positive control in every reaction); and (iv) the diagnosis of BU by microscopy is reinforced. Two-thirds of PCR positive specimens can be confirmed by direct smear examination [8], [9], [26], [27]. Direct smear examination is a cheap and fast diagnostic method that can be applied easily in BU endemic areas without the need for expensive and sophisticated equipment [28], [29].…”

Section: Discussionmentioning

confidence: 99%

Multicenter External Quality Assessment Program for PCR Detection of Mycobacterium ulcerans in Clinical and Environmental Specimens

et al. 2014

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Background Mycobacterium ulcerans is the causative agent of Buruli ulcer (BU), a necrotizing disease of the skin, soft tissue and bone. PCR is increasingly used in the diagnosis of BU and in research on the mode of transmission and environmental reservoir of M. ulcerans.Methodology/Principal FindingsThe aim of this study was to evaluate the performance of laboratories in detecting M. ulcerans using molecular tests in clinical and environmental samples by implementing sequential multicenter external quality assessment (EQA) programs. The second round of the clinical EQA program revealed somewhat improved performance.Conclusions/SignificanceOngoing EQA programs remain essential and continued participation in future EQA programs by laboratories involved in the molecular testing of clinical and environmental samples for M. ulcerans for diagnostic and research purposes is strongly encouraged. Broad participation in such EQA programs also benefits the harmonization of quality in the BU research community and enhances the credibility of advances made in solving the transmission enigma of M. ulcerans.

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Section: Discussionmentioning

confidence: 99%

Multicenter External Quality Assessment Program for PCR Detection of Mycobacterium ulcerans in Clinical and Environmental Specimens

et al. 2014

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“…If the early forms are not treated, extensive skin destruction leads to the formation of an ulcer. Laboratory methods for confirmation of clinical diagnosis include culturing for MU from lesion samples, direct acid‐fast bacilli (AFB) detection by microscopy, and PCR to detect bacterial DNA . The major hallmarks of MU infection, which are also used for histopathological confirmation, are the presence of coagulative necrosis, fat cell ghosts, epidermal hyperplasia, and extracellular clusters of AFB in the absence of major inflammatory infiltrates in central parts of the lesions (Fig.…”

Section: Introductionmentioning

confidence: 99%

Challenges associated with the treatment of Buruli ulcer

Aboagye

Kpeli

Tuffour³

et al. 2018

Journal of Leukocyte Biology

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Buruli ulcer (BU), caused by Mycobacterium ulcerans (MU), is the third most important mycobacterial diseases after tuberculosis and leprosy in immunocompetent individuals. Although the mode of transmission remains an enigma, disease incidence has been strongly linked to disturbed environment and wetlands. The blunt of the diseases is recorded in West African countries along the Gulf of Guinea, and children 15 years and below account for about 48% of all cases globally. Prior to 2004, wide surgical excisions and debridement of infected necrotic tissues followed by skin grafting was the accepted definitive treatment of BU. However, introduction of antibiotic therapy, daily oral rifampicin (10 mg/kg) plus intramuscular injection of streptomycin (15 mg/kg), for 8 weeks by the WHO in 2004 has reduced surgery as an adjunct for correction of deformities and improved wound healing. An all-oral regimen is currently on clinical trial to replace the injectable. It is thought that a protective cloud of the cytotoxic toxin mycolactone kills infiltrating leucocytes leading to local immunosuppression and down-regulation of the systemic immune system. Our studies of lesions from BU patients treated with SR have demonstrated treatment-associated initiation of vigorous immune responses and the development of ectopic lymphoid tissue in the BU lesions. Despite these interventions, there are still challenges that bedevil the management of BU including paradoxical reactions, evolution of lesions after therapy, prolong viability of MU in BU lesions, and development of secondary bacterial infection. In this paper, we will mainly focus on the critical and pertinent challenges that undermine BU treatment toward effective control of BU.

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“…Swabs were collected from the undermined edges of ulcerative lesions and fine needle aspirates were collected from cases with non-ulcerative lesions for bacteriological confirmation of BU disease. 39,40 All samples were analyzed by IS2404 quantitative PCR, microscopy and culture. For those patients presenting with multiple lesions, samples were collected from each lesion.…”

Section: Methodsmentioning

confidence: 99%

Challenges Associated with Management of Buruli Ulcer/Human Immunodeficiency Virus Coinfection in a Treatment Center in Ghana: A Case Series Study

Tuffour

Owusu-Mireku

Ruf

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. The synergy between Mycobacterium tuberculosis infection and human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome is well established but not so in Buruli ulcer (BU). We screened confirmed BU cases for HIV infection and followed seven BU/HIV-coinfected patients. Management of BU/HIV was based on the World Health Organization guidelines and patient condition. The HIV positivity among BU patients (8.2%; 11/134) was higher compared with that of general patients attending the facility (4.8%; 718/14,863; P = 0.07) and that of pregnant women alone (2.5%; 279/11,125; P = 0.001). All seven BU/HIV-coinfected cases enrolled in the study presented with very large (category III) lesions with four having multiple lesions compared with 54.5% of category III lesions among HIV-negative BU patients. During the recommended BU treatment with streptomycin and rifampicin (SR) all patients developed immune infiltrates including CD4 T cells in their lesions. However, one patient who received antiretroviral therapy (ART) 1 week after beginning SR treatment developed four additional lesions during antibiotic treatment, while two out of the four who did not receive ART died. Further evidence is required to ascertain the most appropriate time to commence ART in relation to SR treatment to minimize paradoxical reactions.

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Isolation of Mycobacterium ulcerans from Swab and Fine-Needle-Aspiration Specimens

Cited by 20 publications

References 10 publications

Multicenter External Quality Assessment Program for PCR Detection of Mycobacterium ulcerans in Clinical and Environmental Specimens

Multicenter External Quality Assessment Program for PCR Detection of Mycobacterium ulcerans in Clinical and Environmental Specimens

Challenges associated with the treatment of Buruli ulcer

Challenges Associated with Management of Buruli Ulcer/Human Immunodeficiency Virus Coinfection in a Treatment Center in Ghana: A Case Series Study

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