Mutations in the drug resistance‐determining region of Mycobacterium lepromatosis isolated from leprosy patients in Mexico

Abstract

Mycobacterium lepromatosis, an independent species from Mycobacterium leprae, has been found to be a causative agent for diffuse lepromatous leprosy (DLL) in Mexico, but remains poorly studied. Here, the drug resistance-determining regions (DRDR) of folP1, rpoB and gyrA (conferring resistance to dapsone, rifampicin and quinolone, respectively) in M. lepromatosis from leprosy patients in Mexico were characterized. No mutations or silent mutations were found at previously characterized major sites in DRDR of M. lepromatosis. However, a non-synonymous mutation was found in codon 54 between two major sites of the folP1 DRDR in M. lepromatosis sequences. All M. lepromatosis isolates showed CAG sequence in codon 54 of folP1. Because the next codons 53 and 55 are known as major mutation sites for drug resistance, more detailed analysis using more samples is needed to determine whether it influences susceptibility to dapsone and/or efficiency of folate biosynthesis in M. lepromatosis or not.

Detection of <em>Mycobacterium lepromatosis</em> in patients with leprosy in India

“…The finding of 4 cases with M. lepromatosis infection from 82 relapsed cases strongly indicates that this mycobacterial species is also prevalent in India. Kai et al 19 also reported similar findings after analysis of biopsies obtained from 19 lepromatous cases from Mexico. As the present study was limited to a few selected samples, the data is not suitable to provide data on the actual prevalence of leprosy caused by this mycobacterial species in the country.…”

“…In the recent past, many studies/case reports have been described with clinical presentations matching very closely those in Lucio phenomenon from other parts of the world, like Brazil and Malaysia, along with confirmation based on molecular findings. 18 , 19 The present study was carried out to assess the prevalence of newly discovered bacteria in DLL patients from India. For the first time, using specific DNA sequences, the presence of M. lepromatosis in diffuse LL has been reported in India.…”

Mycobacterium lepromatosis as a Second Agent of Hansen’s Disease

“…Subsequent case reports indicated that M. lepromatosis was not related specifically to DLL, but also with other multibacillary forms of HD. Dual infection with M. lepromatosis and M. leprae has also been reported in case reports from South America (Aldama Olmedo et al, 2020) and South East Asia (Han et al, 2012a;Widiatma and Sukanto, 2019) and in surveys of specimens from Mexico and Brazil (Han et al, 2012b(Han et al, , 2014Kai et al, 2016;Torres-Guerrero et al, 2018;Sharma et al, 2020). Medical and scientific literature refers to both species as the causal agents of HD, but cases attributed to M. lepromatosis infection are infrequently reported, and the clinical aspects of HD caused by M. lepromatosis remain poorly characterized.…”

World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy: a systematic review and meta-analysis

“…Finally, none of these studies reported antibiotic resistance pattern of M. leprae. There are reports on drug resistance in leprosy patients [45][46][47][48][49] and can be one of the reasons of the relapse rate increase in the last years [50]. Considering some of the areas with leprosy had also high incidence of resistant tuberculosis (such us India) and MDT share rifampin as an important drug with sensitive tuberculosis, closer follow-up and drug resistance studies should be done in these areas.…”