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QJM : Monthly Journal of the... Nov 2020
Topics: Buruli Ulcer; DNA, Bacterial; Humans; Mycobacterium ulcerans; Sequence Analysis, DNA
PubMed: 32129872
DOI: 10.1093/qjmed/hcaa080 -
Expert Review of Molecular Diagnostics Dec 2018: Buruli ulcer (BU) is a neglected disease which has been reported from mostly impoverished, remote rural areas from 35 countries worldwide. BU affects skin,... (Review)
Review
: Buruli ulcer (BU) is a neglected disease which has been reported from mostly impoverished, remote rural areas from 35 countries worldwide. BU affects skin, subcutaneous tissue, and bones, and may cause massive tissue destruction and life-long disabilities if not diagnosed and treated early. Without laboratory confirmation diagnostic and treatment errors may occur. This review describes the application of IS PCR, the preferred diagnostic test, in the area of individual patient management and clinico-epidemiological studies. : A Medline search included publications on clinical sample collection, DNA extraction, and PCR detection formats of the past and present, potential and limitations of clinical application, as well as clinico-epidemiological studies. : A global network of reference laboratories basically provides the possibility for PCR confirmation of 70% of all BU cases worldwide as requested by the WHO. Keeping laboratory confirmation on a constant level requires continuous outreach activities. Among the potential measures to maintain sustainability of laboratory confirmation and outreach activities are decentralized or mobile diagnostics available at point of care, such as IS-based LAMP, which complement the standard IS-based diagnostic tools available at central level.
Topics: Bone and Bones; Buruli Ulcer; Humans; Mycobacterium ulcerans; Polymerase Chain Reaction; Skin; Subcutaneous Tissue
PubMed: 30381977
DOI: 10.1080/14737159.2018.1543592 -
Emerging Infectious Diseases Mar 2008Eight adult patients (ages 18-58, 5 women) with Buruli ulcer (BU) confirmed by at least 2 diagnostic methods were seen in a 10-year period. Attempts to culture...
Eight adult patients (ages 18-58, 5 women) with Buruli ulcer (BU) confirmed by at least 2 diagnostic methods were seen in a 10-year period. Attempts to culture Mycobacterium ulcerans failed. Five patients came from jungle areas, and 3 from the swampy northern coast of Peru. The patients had 1-5 lesions, most of which were on the lower extremities. One patient had 5 clustered gluteal lesions; another patient had 2 lesions on a finger. Three patients were lost to follow-up. All 5 remaining patients had moderate disease. Diverse treatments (antituberculous drugs, World Health Organization [WHO] recommended antimicrobial drug treatment for BU, and for 3 patients, excision surgery) were successful. Only 1 patient (patient 7) received the specific drug treatment recommended by WHO. BU is endemic in Peru, although apparently infrequent. Education of populations and training of health workers are first needed to evaluate and understand the full extent of BU in Peru.
Topics: Adolescent; Adult; Antitubercular Agents; Buruli Ulcer; Female; Humans; Male; Middle Aged; Mycobacterium ulcerans; Peru; Plant Preparations; Retrospective Studies; Time Factors
PubMed: 18325248
DOI: 10.3201/eid1403.070904 -
Environment International May 2006Buruli ulcer (BU), an often-deforming skin ulceration caused by Mycobacterium ulcerans (MU), is now considered by the World Health Organization to be the third most... (Review)
Review
Buruli ulcer (BU), an often-deforming skin ulceration caused by Mycobacterium ulcerans (MU), is now considered by the World Health Organization to be the third most common mycobacterium infection. However, the reservoir of MU in the environment and the epidemiology of BU are poorly understood. The disease is prevalent in riverine, slow-flowing and swampy areas of several tropical and subtropical regions of the world, especially in West Africa where the disease is rapidly increasing in incidence. This paper presents a review of published literature concerning epidemiology of, transmission and susceptibility to MU infection. It considers several endemic natural environments and their influence on infection.
Topics: Animals; Communicable Diseases; Disease Susceptibility; Geography; Humans; Immunization; Mycobacterium Infections; Mycobacterium ulcerans; Risk Factors; World Health Organization
PubMed: 16492390
DOI: 10.1016/j.envint.2006.01.002 -
The American Journal of Tropical... Sep 2019Buruli ulcer is an infectious disease provoking chronic, disabling skin ulcers in mammals and humans. Buruli ulcer is caused by , an environmental mycobacterium...
Buruli ulcer is an infectious disease provoking chronic, disabling skin ulcers in mammals and humans. Buruli ulcer is caused by , an environmental mycobacterium synthesizing a toxin called mycolactone responsible for the pathogenicity. The reservoirs and the modes of transmission of remain elusive, limiting the prophylaxis capabilities in rural areas in endemic countries. In Australia, several studies have demonstrated the probable role of possums as reservoirs. In Côte d'Ivoire, some studies have speculated on the potential role of grasscutters in the transmission cycle of . In this study, we detected -specific sequences in rectal contents and spleens collected in wild grasscutters hunted in Buruli ulcer-endemic area in Côte d'Ivoire, but not in farmed negative control animals and in domesticated animals, namely, pigs, goats, cattle, and dogs, living in close contact with the local population. Some grasscutters exhibited the same sequence pattern in the feces and spleen. These observations confirm the asymptomatic gut carriage of in this mammal species. Moreover, these observations suggest the dissemination of from the gut to the spleen in grasscutters. These observations suggest that, in some mammals, is not only an inoculated pathogen but also a translocating invasive pathogen.
Topics: Animals; Asymptomatic Infections; Bacterial Translocation; Buruli Ulcer; Cote d'Ivoire; Disease Reservoirs; Gastrointestinal Tract; Mycobacterium ulcerans; Rodentia; Spleen
PubMed: 31333157
DOI: 10.4269/ajtmh.19-0137 -
Nature Reviews. Microbiology Jan 2009Buruli ulcer is an emerging human disease caused by infection with a slow-growing pathogen, Mycobacterium ulcerans, that produces mycolactone, a cytotoxin with... (Review)
Review
Buruli ulcer is an emerging human disease caused by infection with a slow-growing pathogen, Mycobacterium ulcerans, that produces mycolactone, a cytotoxin with immunomodulatory properties. The disease is associated with wetlands in certain tropical countries, and evidence for a role of insects in transmission of this pathogen is growing. Comparative genomic analysis has revealed that M. ulcerans arose from Mycobacterium marinum, a ubiquitous fast-growing aquatic species, by horizontal transfer of a virulence plasmid that carries a cluster of genes for mycolactone production, followed by reductive evolution. Here, the ecology, microbiology, evolutionary genomics and immunopathology of Buruli ulcer are reviewed.
Topics: Buruli Ulcer; Evolution, Molecular; Humans; Mycobacterium ulcerans
PubMed: 19079352
DOI: 10.1038/nrmicro2077 -
Antimicrobial Agents and Chemotherapy Apr 2022Buruli ulcer disease is a neglected necrotizing and disabling cutaneous tropical illness caused by Mycobacterium ulcerans. Fluoroquinolone (FQ), used in the treatment of...
Buruli ulcer disease is a neglected necrotizing and disabling cutaneous tropical illness caused by Mycobacterium ulcerans. Fluoroquinolone (FQ), used in the treatment of this disease, has been known to act by inhibiting the enzymatic activities of DNA gyrase. However, the detailed molecular basis of these characteristics and the FQ resistance mechanisms in M. ulcerans remains unknown. This study investigated the detailed molecular mechanism of M. ulcerans DNA gyrase and the contribution of FQ resistance using recombinant proteins from the M. ulcerans subsp. shinshuense and Agy99 strains with reduced sensitivity to FQs. The IC of FQs against Ala91Val and Asp95Gly mutants of M. ulcerans shinshuense and Agy99 GyrA subunits were 3.7- to 42.0-fold higher than those against wild-type (WT) enzyme. Similarly, the quinolone concentrations required to induce 25% of the maximum DNA cleavage (CC) was 10- to 210-fold higher than those for the WT enzyme. Furthermore, the interaction between the amino acid residues of the WT/mutant M. ulcerans DNA gyrase and FQ side chains were assessed by molecular docking studies. This was the first elaborative study demonstrating the contribution of mutations in M. ulcerans DNA GyrA subunit to FQ resistance .
Topics: DNA Gyrase; Drug Resistance, Bacterial; Fluoroquinolones; Microbial Sensitivity Tests; Molecular Docking Simulation; Mutation; Mycobacterium ulcerans; Quinolones
PubMed: 35041504
DOI: 10.1128/AAC.01902-21 -
Current Opinion in Infectious Diseases Oct 2010After tuberculosis, leprosy (Mycobacterium leprae) and Buruli ulcer (M. ulcerans infection) are the second and third most common mycobacterial infections in humankind,... (Review)
Review
PURPOSE OF REVIEW
After tuberculosis, leprosy (Mycobacterium leprae) and Buruli ulcer (M. ulcerans infection) are the second and third most common mycobacterial infections in humankind, respectively. Recent advances in both diseases are summarized.
RECENT FINDINGS
Leprosy remains a public health problem in some countries, and new case detections indicate active transmission. Newly identified M. lepromatosis, closely related to M. leprae, may cause disseminated leprosy in some regions. In genome-wide screening in China, leprosy susceptibility associates with polymorphisms in seven genes, many involved with innate immunity. World Health Organization multiple drug therapy administered for 1 or 2 years effectively arrests disseminated leprosy but disability remains a public health concern. Relapse is infrequent, often associated with higher pretreatment M. leprae burdens. M. ulcerans, a re-emerging environmental organism, arose from M. marinum and acquired a virulence plasmid coding for mycolactone, a necrotizing, immunosuppressive toxin. Geographically, there are multiple strains of M. ulcerans, with variable pathogenicity and immunogenicity. Molecular epidemiology is describing M. ulcerans evolution and genotypic variants. First-line therapy for Buruli ulcer is rifampin + streptomycin, sometimes with surgery, but improved regimens are needed.
SUMMARY
Leprosy and Buruli ulcer are important infections with significant public health implications. Modern research is providing new insights into molecular epidemiology and pathogenesis, boding well for improved control strategies.
Topics: Anti-Bacterial Agents; Buruli Ulcer; Genetic Predisposition to Disease; Humans; Leprosy; Molecular Epidemiology; Mycobacterium leprae; Mycobacterium ulcerans; Virulence
PubMed: 20581668
DOI: 10.1097/QCO.0b013e32833c2209 -
Methods in Molecular Biology (Clifton,... 2022As acknowledged by the Clinical and Laboratory Standards Institute (CLSI), there is an insufficient evidence base on which to recommend a standard method for...
As acknowledged by the Clinical and Laboratory Standards Institute (CLSI), there is an insufficient evidence base on which to recommend a standard method for antimicrobial susceptibility testing against M. ulcerans. The agar proportion method has been recognized as the standard method for susceptibility testing against Mycobacterium tuberculosis complex (MTBC) isolates for decades (Woods GL, Engenack NL, Lin G, Turnidge JD (2018) CLSI standards: guidelines for health care excellence. Susceptibility testing of mycobacteria, Nocardia spp., and other aerobic Actinomycetes, 3rd edn. Clinical and Laboratory Standards Institute Copyright©2018 Clinical and Laboratory Standards Institute, Wayne (PA)). While it is more labor-intensive and requires larger amounts of drug or compound than broth-based testing, we recommend the agar proportion method for determination of minimum inhibitory concentrations against M. ulcerans. Herewith we present the method we implemented in our laboratory over the last 2 decades.
Topics: Agar; Anti-Bacterial Agents; Microbial Sensitivity Tests; Mycobacterium ulcerans; Pharmaceutical Preparations
PubMed: 34643913
DOI: 10.1007/978-1-0716-1779-3_18 -
Transactions of the Royal Society of... Oct 2009Lesions due to Mycobacterium ulcerans infection may have more synonyms and eponyms than any other disease. New diseases are named for the person who discovered them,... (Review)
Review
Lesions due to Mycobacterium ulcerans infection may have more synonyms and eponyms than any other disease. New diseases are named for the person who discovered them, from the place from which they were first described or some major clinical feature. 'Buruli ulcer', the name by which the disease is most frequently known, is none of these. Classically, the disease presents as extensive, undermined ulcers, first described by Searls from Bairnsdale in southeastern Australia, names that gave the disease its two eponyms. A case is made for the term 'Buruli ulcer' to be dropped from the medical literature and the disease to be known as 'ulcerans disease' or simply 'ulcerans'.
Topics: Buruli Ulcer; Eponyms; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium ulcerans; Skin Ulcer; Terminology as Topic
PubMed: 19203770
DOI: 10.1016/j.trstmh.2008.12.009