Molecular and epidemiological characterization of recurrent Mycobacterium ulcerans infections in Benin.

Autor: Ronald Gnimavo, Alban Besnard, Horace Degnonvi, Juliana Pipoli Da Fonseca, Marie Kempf, Christian Roch Johnson, Alexandra Boccarossa, Yao Télesphore Brou, Laurent Marsollier, Estelle Marion
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: PLoS Neglected Tropical Diseases, Vol 15, Iss 12, p e0010053 (2021)
Druh dokumentu: article
ISSN: 1935-2727
1935-2735
DOI: 10.1371/journal.pntd.0010053
Popis: BackgroundBuruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans, an environmental mycobacterium. Although transmission of M. ulcerans remains poorly understood, the main identified risk factor for acquiring Buruli ulcer is living in proximity of potentially contaminated water sources. Knowledge about the clinical features of Buruli ulcer and its physiopathology is increasing, but little is known about recurrence due to reinfection.Methodology/principal findingsWe describe two patients with Buruli ulcer recurrence due to reinfection with M. ulcerans, as demonstrated by comparisons of DNA from the strains isolated at the time of the first diagnosis and at recurrence. Based on the spatial distribution of M. ulcerans genotypes in this region and a detailed study of the behavior of these two patients with respect to sources of water as well as water bodies and streams, we formulated hypotheses concerning the sites at which they may have been contaminated.Conclusions/significanceSecond episodes of Buruli ulcer may occur through reinfection, relapse or a paradoxical reaction. We formally demonstrated that the recurrence in these two patients was due to reinfection. Based on the sites at which the patients reported engaging in activities relating to water, we were able to identify possible sites of contamination. Our findings indicate that the non-random distribution of M. ulcerans genotypes in this region may provide useful information about activities at risk.
Databáze: Directory of Open Access Journals
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