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Muhi S, Buultjens AH, Porter JL, Marshall JL, Doerflinger M, Pidot SJ, O’Brien DP, Johnson PDR, Lavender CJ, Globan M, McCarthy J, Osowicki J, Stinear TP. Mycobacterium ulcerans challenge strain selection for a Buruli ulcer controlled human infection model. PLoS Negl Trop Dis 2024; 18:e0011979. [PMID: 38701090 PMCID: PMC11095734 DOI: 10.1371/journal.pntd.0011979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/15/2024] [Accepted: 04/21/2024] [Indexed: 05/05/2024] Open
Abstract
Critical scientific questions remain regarding infection with Mycobacterium ulcerans, the organism responsible for the neglected tropical disease, Buruli ulcer (BU). A controlled human infection model has the potential to accelerate our knowledge of the immunological correlates of disease, to test prophylactic interventions and novel therapeutics. Here we present microbiological evidence supporting M. ulcerans JKD8049 as a suitable human challenge strain. This non-genetically modified Australian isolate is susceptible to clinically relevant antibiotics, can be cultured in animal-free and surfactant-free media, can be enumerated for precise dosing, and has stable viability following cryopreservation. Infectious challenge of humans with JKD8049 is anticipated to imitate natural infection, as M. ulcerans JKD8049 is genetically stable following in vitro passage and produces the key virulence factor, mycolactone. Also reported are considerations for the manufacture, storage, and administration of M. ulcerans JKD8049 for controlled human infection.
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Affiliation(s)
- Stephen Muhi
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Andrew H. Buultjens
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica L. Porter
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julia L. Marshall
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marcel Doerflinger
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Sacha J. Pidot
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Daniel P. O’Brien
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Infectious Diseases, Barwon Health, Geelong, Victoria, Australia
| | - Paul D. R. Johnson
- Northeast Public Health Unit, Austin Health, Heidelberg, Victoria, Australia
| | - Caroline J. Lavender
- Victorian Infectious Disease Reference Laboratory (VIDRL), Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Maria Globan
- Victorian Infectious Disease Reference Laboratory (VIDRL), Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - James McCarthy
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Joshua Osowicki
- Tropical Diseases Research Group, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Infectious Diseases Unit, Department of General Medicine, Royal Children’s Hospital Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Timothy P. Stinear
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Victorian Infectious Disease Reference Laboratory (VIDRL), Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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Briand M, Boccarossa A, Rieux A, Jacques MA, Ganlanon L, Johnson C, Eveillard M, Marsollier L, Marion E. Emergence and spread of Mycobacterium ulcerans at different geographic scales. Microbiol Spectr 2024; 12:e0382723. [PMID: 38441471 PMCID: PMC10986537 DOI: 10.1128/spectrum.03827-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/10/2024] [Indexed: 04/06/2024] Open
Abstract
The classical lineage of Mycobacterium ulcerans is the most prevalent clonal group associated with Buruli ulcer in humans. Its reservoir is strongly associated with the environment. We analyzed together 1,045 isolates collected from 13 countries on two continents to define the evolutionary history and population dynamics of this lineage. We confirm that this lineage spread over 7,000 years from Australia to Africa with the emergence of outbreaks in distinct waves in the 18th and 19th centuries. In sharp contrast with its global spread over the last century, transmission chains are now mostly local, with little or no dissemination between endemic areas. This study provides new insights into the phylogeography and population dynamics of M. ulcerans, highlighting the importance of comparative genomic analyses to improve our understanding of pathogen transmission. IMPORTANCE Mycobacterium ulcerans is an environmental mycobacterial pathogen that can cause Buruli ulcer, a severe cutaneous infection, mostly spread in Africa and Australia. We conducted a large genomic study of M. ulcerans, combining genomic and evolutionary approaches to decipher its evolutionary history and pattern of spread at different geographic scales. At the scale of villages in an endemic area of Benin, the circulating genotypes have been introduced in recent decades and are not randomly distributed along the river. On a global scale, M. ulcerans has been spreading for much longer, resulting in distinct and compartmentalized endemic foci across Africa and Australia.
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Affiliation(s)
- Martial Briand
- Univ Angers, Institut Agro, INRAE, IRHS, SFR QUASAV, Angers, France
| | | | - Adrien Rieux
- CIRAD, UMR PVBMT, Saint Pierre, La Réunion, France
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Mee PT, Buultjens AH, Oliver J, Brown K, Crowder JC, Porter JL, Hobbs EC, Judd LM, Taiaroa G, Puttharak N, Williamson DA, Blasdell KR, Tay EL, Feldman R, Muzari MO, Sanders C, Larsen S, Crouch SR, Johnson PDR, Wallace JR, Price DJ, Hoffmann AA, Gibney KB, Stinear TP, Lynch SE. Mosquitoes provide a transmission route between possums and humans for Buruli ulcer in southeastern Australia. Nat Microbiol 2024; 9:377-389. [PMID: 38263454 PMCID: PMC10847040 DOI: 10.1038/s41564-023-01553-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/08/2023] [Indexed: 01/25/2024]
Abstract
Buruli ulcer, a chronic subcutaneous infection caused by Mycobacterium ulcerans, is increasing in prevalence in southeastern Australia. Possums are a local wildlife reservoir for M. ulcerans and, although mosquitoes have been implicated in transmission, it remains unclear how humans acquire infection. We conducted extensive field survey analyses of M. ulcerans prevalence among mosquitoes in the Mornington Peninsula region of southeastern Australia. PCR screening of trapped mosquitoes revealed a significant association between M. ulcerans and Aedes notoscriptus. Spatial scanning statistics revealed overlap between clusters of M. ulcerans-positive Ae. notoscriptus, M. ulcerans-positive possum excreta and Buruli ulcer cases, and metabarcoding analyses showed individual mosquitoes had fed on humans and possums. Bacterial genomic analysis confirmed shared single-nucleotide-polymorphism profiles for M. ulcerans detected in mosquitoes, possum excreta and humans. These findings indicate Ae. notoscriptus probably transmit M. ulcerans in southeastern Australia and highlight mosquito control as a Buruli ulcer prevention measure.
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Affiliation(s)
- Peter T Mee
- Centre for AgriBioscience, AgriBio, Agriculture Victoria, Bundoora, Victoria, Australia.
| | - Andrew H Buultjens
- Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Oliver
- Department of Infectious Diseases, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Karen Brown
- Centre for AgriBioscience, AgriBio, Agriculture Victoria, Bundoora, Victoria, Australia
| | - Jodie C Crowder
- Centre for AgriBioscience, AgriBio, Agriculture Victoria, Bundoora, Victoria, Australia
| | - Jessica L Porter
- Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Emma C Hobbs
- Department of Infectious Diseases, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Louise M Judd
- Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - George Taiaroa
- Department of Infectious Diseases, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Natsuda Puttharak
- Centre for AgriBioscience, AgriBio, Agriculture Victoria, Bundoora, Victoria, Australia
| | - Deborah A Williamson
- Department of Infectious Diseases, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute for Infection and Immunity, Melbourne Health, Melbourne, Victoria, Australia
| | - Kim R Blasdell
- Australian Centre for Disease Preparedness, CSIRO, Geelong, Victoria, Australia
| | - Ee Laine Tay
- Department of Health, Melbourne, Victoria, Australia
| | | | - Mutizwa Odwell Muzari
- Medical Entomology, Tropical Public Health Services Cairns, Cairns and Hinterland Hospital and Health Services, Cairns, Queensland, Australia
| | - Chris Sanders
- Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Stuart Larsen
- Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Simon R Crouch
- South East Public Health Unit, Monash Health, Clayton, Victoria, Australia
| | - Paul D R Johnson
- North East Public Health Unit, Austin Health, Heidelberg, Victoria, Australia
| | - John R Wallace
- Department of Biology, Millersville University, Millersville, PA, USA
| | - David J Price
- Department of Infectious Diseases, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Ary A Hoffmann
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Institute, University of Melbourne, Parkville, Victoria, Australia
| | - Katherine B Gibney
- Department of Infectious Diseases, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Timothy P Stinear
- Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
- WHO Collaborating Centre for Mycobacterium ulcerans, Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
| | - Stacey E Lynch
- Centre for AgriBioscience, AgriBio, Agriculture Victoria, Bundoora, Victoria, Australia
- Australian Centre for Disease Preparedness, CSIRO, Geelong, Victoria, Australia
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Kyei-Baffour ES, Owusu-Boateng K, Isawumi A, Mosi L. Pseudogenomic insights into the evolution of Mycobacterium ulcerans. BMC Genomics 2024; 25:87. [PMID: 38253991 PMCID: PMC10802024 DOI: 10.1186/s12864-024-10001-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Buruli ulcer (BU) disease, caused by Mycobacterium ulcerans (MU), and characterized by necrotic ulcers is still a health problem in Africa and Australia. The genome of the bacterium has several pseudogenes due to recent evolutionary events and environmental pressures. Pseudogenes are genetic elements regarded as nonessential in bacteria, however, they are less studied due to limited available tools to provide understanding of their evolution and roles in MU pathogenicity. RESULTS This study developed a bioinformatic pipeline to profile the pseudogenomes of sequenced MU clinical isolates from different countries. One hundred and seventy-two MU genomes analyzed revealed that pseudogenomes of African strains corresponded to the two African lineages 1 and 2. Pseudogenomes were lineage and location specific and African lineage 1 was further divided into A and B. Lineage 2 had less relaxation in positive selection than lineage 1 which may signify different evolutionary points. Based on the Gil-Latorre model, African MU strains may be in the latter stages of evolutionary adaption and are adapting to an environment rich in metabolic resources with a lower temperature and decreased UV radiation. The environment fosters oxidative metabolism and MU may be less reliant on some secondary metabolites. In-house pseudogenomes from Ghana and Cote d'Ivoire were different from other African strains, however, they were identified as African strains. CONCLUSION Our bioinformatic pipeline provides pseudogenomic insights to complement other whole genome analyses, providing a better view of the evolution of the genome of MU and suggest an adaptation model which is important in understanding transmission. MU pseudogene profiles vary based on lineage and country, and an apparent reduction in insertion sequences used for the detection of MU which may adversely affect the sensitivity of diagnosis.
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Affiliation(s)
- Edwin Sakyi Kyei-Baffour
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Kwabena Owusu-Boateng
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Microbial Sciences, University of Surrey, Surrey, UK
| | - Abiola Isawumi
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Lydia Mosi
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana.
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Roy T, Boateng ST, Uddin MB, Banang-Mbeumi S, Yadav RK, Bock CR, Folahan JT, Siwe-Noundou X, Walker AL, King JA, Buerger C, Huang S, Chamcheu JC. The PI3K-Akt-mTOR and Associated Signaling Pathways as Molecular Drivers of Immune-Mediated Inflammatory Skin Diseases: Update on Therapeutic Strategy Using Natural and Synthetic Compounds. Cells 2023; 12:1671. [PMID: 37371141 PMCID: PMC10297376 DOI: 10.3390/cells12121671] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The dysregulated phosphatidylinositol-3-kinase (PI3K)-Akt-mammalian target of rapamycin (mTOR) signaling pathway has been implicated in various immune-mediated inflammatory and hyperproliferative dermatoses such as acne, atopic dermatitis, alopecia, psoriasis, wounds, and vitiligo, and is associated with poor treatment outcomes. Improved comprehension of the consequences of the dysregulated PI3K/Akt/mTOR pathway in patients with inflammatory dermatoses has resulted in the development of novel therapeutic approaches. Nonetheless, more studies are necessary to validate the regulatory role of this pathway and to create more effective preventive and treatment methods for a wide range of inflammatory skin diseases. Several studies have revealed that certain natural products and synthetic compounds can obstruct the expression/activity of PI3K/Akt/mTOR, underscoring their potential in managing common and persistent skin inflammatory disorders. This review summarizes recent advances in understanding the role of the activated PI3K/Akt/mTOR pathway and associated components in immune-mediated inflammatory dermatoses and discusses the potential of bioactive natural products, synthetic scaffolds, and biologic agents in their prevention and treatment. However, further research is necessary to validate the regulatory role of this pathway and develop more effective therapies for inflammatory skin disorders.
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Affiliation(s)
- Tithi Roy
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Samuel T. Boateng
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Mohammad B. Uddin
- Department of Toxicology and Cancer Biology, Center for Research on Environmental Diseases, College of Medicine, University of Kentucky, Lexington, KY 40536, USA;
| | - Sergette Banang-Mbeumi
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
- Division for Research and Innovation, POHOFI Inc., Madison, WI 53744, USA
- School of Nursing and Allied Health Sciences, Louisiana Delta Community College, Monroe, LA 71203, USA
| | - Rajesh K. Yadav
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Chelsea R. Bock
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Joy T. Folahan
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Xavier Siwe-Noundou
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, P.O. Box 218, Pretoria 0208, South Africa;
| | - Anthony L. Walker
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Judy A. King
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA;
- College of Medicine, Belmont University, 900 Belmont Boulevard, Nashville, TN 37212, USA
| | - Claudia Buerger
- Department of Dermatology, Venerology and Allergology, Clinic of the Goethe University, 60590 Frankfurt am Main, Germany;
| | - Shile Huang
- Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA;
- Department of Hematology and Oncology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA
- Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Jean Christopher Chamcheu
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA;
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Tchan BGO, Ngazoa-Kakou S, Aka N, Apia NKB, Hammoudi N, Drancourt M, Saad J. PPE Barcoding Identifies Biclonal Mycobacterium ulcerans Buruli Ulcer, Côte d'Ivoire. Microbiol Spectr 2023; 11:e0034223. [PMID: 37222600 PMCID: PMC10269924 DOI: 10.1128/spectrum.00342-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/08/2023] [Indexed: 05/25/2023] Open
Abstract
Mycobacterium ulcerans, an environmental opportunistic pathogen, causes necrotic cutaneous and subcutaneous lesions, named Buruli ulcers, in tropical countries. PCR-derived tests used to detect M. ulcerans in environmental and clinical samples do not allow one-shot detection, identification, and typing of M. ulcerans among closely related Mycobacterium marinum complex mycobacteria. We established a 385-member M. marinum/M. ulcerans complex whole-genome sequence database by assembling and annotating 341 M. marinum/M. ulcerans complex genomes and added 44 M. marinum/M. ulcerans complex whole-genome sequences already deposited in the NCBI database. Pangenome, core genome, and single-nucleotide polymorphism (SNP) distance-based comparisons sorted the 385 strains into 10 M. ulcerans taxa and 13 M. marinum taxa, correlating with the geographic origin of strains. Aligning conserved genes identified one PPE (proline-proline-glutamate) gene sequence to be species and intraspecies specific, thereby genotyping the 23 M. marinum/M. ulcerans complex taxa. PCR sequencing of the PPE gene correctly genotyped nine M. marinum/M. ulcerans complex isolates among one M. marinum taxon and three M. ulcerans taxa in the African taxon (T2.4). Further, successful PPE gene PCR sequencing in 15/21 (71.4%) swabs collected from suspected Buruli ulcer lesions in Côte d'Ivoire exhibited positive M. ulcerans IS2404 real-time PCR and identified the M. ulcerans T2.4.1 genotype in eight swabs and M. ulcerans T2.4.1/T2.4.2 mixed genotypes in seven swabs. PPE gene sequencing could be used as a proxy for whole-genome sequencing for the one-shot detection, identification, and typing of clinical M. ulcerans strains, offering an unprecedented tool for identifying M. ulcerans mixed infections. IMPORTANCE We describe a new targeted sequencing approach that characterizes the PPE gene to disclose the simultaneous presence of different variants of a single pathogenic microorganism. This approach has direct implications on the understanding of pathogen diversity and natural history and potential therapeutic implications when dealing with obligate and opportunistic pathogens, such as Mycobacterium ulcerans presented here as a prototype.
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Affiliation(s)
- B. G. O. Tchan
- IRD, MEPHI, IHU Méditerranée Infection, Aix-Marseille-Université, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - S. Ngazoa-Kakou
- Plateforme de Biologie Moléculaire, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - N. Aka
- Unité des Mycobactéries Tuberculeuses et Atypiques, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - N. K. B. Apia
- Plateforme de Biologie Moléculaire, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - N. Hammoudi
- IRD, MEPHI, IHU Méditerranée Infection, Aix-Marseille-Université, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - M. Drancourt
- IRD, MEPHI, IHU Méditerranée Infection, Aix-Marseille-Université, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - J. Saad
- IRD, MEPHI, IHU Méditerranée Infection, Aix-Marseille-Université, Marseille, France
- IHU Méditerranée Infection, Marseille, France
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7
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Kurcheid J, Gordon CA, Clarke NE, Wangdi K, Kelly M, Lal A, Mutombo PN, Wang D, Mationg ML, Clements ACA, Muhi S, Bradbury RS, Biggs B, Page W, Williams G, McManus DP, Gray D. Neglected tropical diseases in Australia: a narrative review. Med J Aust 2022; 216:532-538. [DOI: 10.5694/mja2.51533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/25/2021] [Accepted: 11/02/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Johanna Kurcheid
- Australian National University Canberra ACT
- Swiss Tropical and Public Health Institute Basel Switzerland
| | | | - Naomi E Clarke
- Australian National University Canberra ACT
- Kirby Institute University of New South Wales Sydney NSW
| | | | | | - Aparna Lal
- Australian National University Canberra ACT
| | - Polydor N Mutombo
- National Centre for Naturopathic Medicine Southern Cross University Lismore NSW
| | | | | | | | - Stephen Muhi
- Victorian Infectious Diseases Service Royal Melbourne Hospital Melbourne VIC
| | | | - Beverley‐Ann Biggs
- Victorian Infectious Diseases Service Royal Melbourne Hospital Melbourne VIC
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8
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Receveur JP, Bauer A, Pechal JL, Picq S, Dogbe M, Jordan HR, Rakestraw AW, Fast K, Sandel M, Chevillon C, Guégan JF, Wallace JR, Benbow ME. A need for null models in understanding disease transmission: the example of Mycobacterium ulcerans (Buruli ulcer disease). FEMS Microbiol Rev 2022; 46:fuab045. [PMID: 34468735 PMCID: PMC8767449 DOI: 10.1093/femsre/fuab045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/12/2021] [Indexed: 01/19/2023] Open
Abstract
Understanding the interactions of ecosystems, humans and pathogens is important for disease risk estimation. This is particularly true for neglected and newly emerging diseases where modes and efficiencies of transmission leading to epidemics are not well understood. Using a model for other emerging diseases, the neglected tropical skin disease Buruli ulcer (BU), we systematically review the literature on transmission of the etiologic agent, Mycobacterium ulcerans (MU), within a One Health/EcoHealth framework and against Hill's nine criteria and Koch's postulates for making strong inference in disease systems. Using this strong inference approach, we advocate a null hypothesis for MU transmission and other understudied disease systems. The null should be tested against alternative vector or host roles in pathogen transmission to better inform disease management. We propose a re-evaluation of what is necessary to identify and confirm hosts, reservoirs and vectors associated with environmental pathogen replication, dispersal and transmission; critically review alternative environmental sources of MU that may be important for transmission, including invertebrate and vertebrate species, plants and biofilms on aquatic substrates; and conclude with placing BU within the context of other neglected and emerging infectious diseases with intricate ecological relationships that lead to disease in humans, wildlife and domestic animals.
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Affiliation(s)
- Joseph P Receveur
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Alexandra Bauer
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Jennifer L Pechal
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Sophie Picq
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Magdalene Dogbe
- Department of Biological Sciences, Mississippi State University, Starkville, MS, USA
| | - Heather R Jordan
- Department of Biological Sciences, Mississippi State University, Starkville, MS, USA
| | - Alex W Rakestraw
- Department of Biological and Environmental Sciences, The University of West Alabama, Livingston, AL, USA
| | - Kayla Fast
- Department of Biological and Environmental Sciences, The University of West Alabama, Livingston, AL, USA
| | - Michael Sandel
- Department of Biological and Environmental Sciences, The University of West Alabama, Livingston, AL, USA
| | - Christine Chevillon
- Maladies Infectieuses et Vecteurs : Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Université de Montpellier (UM), Centre National de la Recherche Scientifique (CNRS), Institut pour la Recherche et le Développement, Montpellier, France
| | - Jean-François Guégan
- Maladies Infectieuses et Vecteurs : Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Université de Montpellier (UM), Centre National de la Recherche Scientifique (CNRS), Institut pour la Recherche et le Développement, Montpellier, France
- UMR Animal, santé, territoires, risques et écosystèmes, Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE), Centre de coopération internationale en recherche agronomique pour le développement (Cirad), Université de Montpellier (UM), Montpellier, France
| | - John R Wallace
- Department of Biology, Millersville University, Millersville, PA, USA
| | - M Eric Benbow
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
- Ecology, Evolution and Behavior Program, Michigan State University, East Lansing, MI, USA
- AgBioResearch, Michigan State University, East Lansing, MI, USA
- Department of Osteopathic Medical Specialties, Michigan State University, East Lansing, MI, USA
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9
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Silwal P, Kim IS, Jo EK. Autophagy and Host Defense in Nontuberculous Mycobacterial Infection. Front Immunol 2021; 12:728742. [PMID: 34552591 PMCID: PMC8450401 DOI: 10.3389/fimmu.2021.728742] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
Autophagy is critically involved in host defense pathways through targeting and elimination of numerous pathogens via autophagic machinery. Nontuberculous mycobacteria (NTMs) are ubiquitous microbes, have become increasingly prevalent, and are emerging as clinically important strains due to drug-resistant issues. Compared to Mycobacterium tuberculosis (Mtb), the causal pathogen for human tuberculosis, the roles of autophagy remain largely uncharacterized in the context of a variety of NTM infections. Compelling evidence suggests that host autophagy activation plays an essential role in the enhancement of antimicrobial immune responses and controlling pathological inflammation against various NTM infections. As similar to Mtb, it is believed that NTM bacteria evolve multiple strategies to manipulate and hijack host autophagy pathways. Despite this, we are just beginning to understand the molecular mechanisms underlying the crosstalk between pathogen and the host autophagy system in a battle with NTM bacteria. In this review, we will explore the function of autophagy, which is involved in shaping host–pathogen interaction and disease outcomes during NTM infections. These efforts will lead to the development of autophagy-based host-directed therapeutics against NTM infection.
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Affiliation(s)
- Prashanta Silwal
- Department of Microbiology, Chungnam National University College of Medicine, Daejeon, South Korea.,Infection Control Convergence Research Center, Chungnam National University College of Medicine, Daejeon, South Korea
| | - In Soo Kim
- Department of Microbiology, Chungnam National University College of Medicine, Daejeon, South Korea.,Infection Control Convergence Research Center, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Eun-Kyeong Jo
- Department of Microbiology, Chungnam National University College of Medicine, Daejeon, South Korea.,Infection Control Convergence Research Center, Chungnam National University College of Medicine, Daejeon, South Korea
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10
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Muleta AJ, Lappan R, Stinear TP, Greening C. Understanding the transmission of Mycobacterium ulcerans: A step towards controlling Buruli ulcer. PLoS Negl Trop Dis 2021; 15:e0009678. [PMID: 34437549 PMCID: PMC8389476 DOI: 10.1371/journal.pntd.0009678] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Mycobacterium ulcerans is the causative agent of Buruli ulcer, a rare but chronic debilitating skin and soft tissue disease found predominantly in West Africa and Southeast Australia. While a moderate body of research has examined the distribution of M. ulcerans, the specific route(s) of transmission of this bacterium remain unknown, hindering control efforts. M. ulcerans is considered an environmental pathogen given it is associated with lentic ecosystems and human-to-human spread is negligible. However, the pathogen is also carried by various mammals and invertebrates, which may serve as key reservoirs and mechanical vectors, respectively. Here, we examine and review recent evidence from these endemic regions on potential transmission pathways, noting differences in findings between Africa and Australia, and summarising the risk and protective factors associated with Buruli ulcer transmission. We also discuss evidence suggesting that environmental disturbance and human population changes precede outbreaks. We note five key research priorities, including adoption of One Health frameworks, to resolve transmission pathways and inform control strategies to reduce the spread of Buruli ulcer. Buruli ulcer is a debilitating skin and soft tissue disease characterised by large ulcerative wounds that are treated with antibiotics or with adjunctive surgery for advanced cases. Found predominantly in West Africa and Southeast Australia, the causative agent is the environmental bacterial pathogen Mycobacterium ulcerans. Lack of understanding of transmission pathways, combined with the absence of a vaccine, has hindered efforts to control the spread of M. ulcerans. Here, in order to identify probable transmission pathways and inform future studies, we review literature linking M. ulcerans to environmental reservoirs, mammalian hosts, and potential invertebrate vectors. We also summarise factors and behaviours that reduce the risk of developing Buruli ulcer, to inform effective prevention strategies and further shed light on transmission pathways.
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Affiliation(s)
- Anthony J. Muleta
- Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia
| | - Rachael Lappan
- Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia
| | - Timothy P. Stinear
- Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
| | - Chris Greening
- Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia
- Centre to Impact AMR, Monash University, Melbourne, Australia
- * E-mail:
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11
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Bahadoran P, Hammoudi N, Gaudart A, Saad J, Di Filippo Y, Drancourt M, Ruimy R. Case Report: A New Mycobacterium ulcerans Genotype Causing Buruli Ulcer in Côte d'Ivoire. Am J Trop Med Hyg 2021; 104:1782-1783. [PMID: 33819173 PMCID: PMC8103442 DOI: 10.4269/ajtmh.20-1307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/18/2021] [Indexed: 11/07/2022] Open
Abstract
Mycobacterium ulcerans, the opportunistic pathogen causing Buruli ulcer, is reported to affect rural populations in 36 tropical countries. We report one case of Buruli ulcer in a peri-urban area in Côte d'Ivoire, confirmed by whole genome sequencing which indicated a M. ulcerans genotype previously unreported in Côte d'Ivoire.
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Affiliation(s)
- Philippe Bahadoran
- Department of Dermatology, Centre Hospitalier Universitaire de Nice, Université Côte D’Azur, Inserm, Nice, France
| | - Nassim Hammoudi
- IRD, MEPHI, IHU Méditerranée Infection, Aix-Marseille-Université, Marseille, France;,IHU Méditerranée Infection, Marseille, France
| | - Alice Gaudart
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital de l’Archet II, Nice, France
| | - Jamal Saad
- IRD, MEPHI, IHU Méditerranée Infection, Aix-Marseille-Université, Marseille, France;,IHU Méditerranée Infection, Marseille, France
| | - Yoan Di Filippo
- Department of Dermatology, Centre Hospitalier Universitaire de Nice, Université Côte D’Azur, Inserm, Nice, France
| | - Michel Drancourt
- IRD, MEPHI, IHU Méditerranée Infection, Aix-Marseille-Université, Marseille, France;,IHU Méditerranée Infection, Marseille, France
| | - Raymond Ruimy
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital de l’Archet II, Nice, France;,Université Côte D’Azur, Inserm, C3M, Nice, France;,Inserm U1065, C3M, Equipe 6, Nice, France,Address correspondence to Raymond Ruimy, Laboratoire de Bacteriologie, 151, Route de St Antoine de Ginestière, Nice 06000, France. E-mail:
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12
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Coudereau C, Besnard A, Robbe-Saule M, Bris C, Kempf M, Johnson RC, Brou TY, Gnimavo R, Eyangoh S, Khater F, Marion E. Stable and Local Reservoirs of Mycobacterium ulcerans Inferred from the Nonrandom Distribution of Bacterial Genotypes, Benin. Emerg Infect Dis 2021; 26:491-503. [PMID: 32091371 PMCID: PMC7045821 DOI: 10.3201/eid2603.190573] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical disease found in rural areas of West and Central Africa. Despite the ongoing efforts to tackle Buruli ulcer epidemics, the environmental reservoir of its pathogen remains elusive, underscoring the need for new approaches to improving disease prevention and management. In our study, we implemented a local-scale spatial clustering model and deciphered the genetic diversity of the bacteria in a small area of Benin where Buruli ulcer is endemic. Using 179 strain samples from West Africa, we conducted a phylogeographic analysis combining whole-genome sequencing with spatial scan statistics. The 8 distinct genotypes we identified were by no means randomly spread over the studied area. Instead, they were divided into 3 different geographic clusters, associated with landscape characteristics. Our results highlight the ability of M. ulcerans to evolve independently and differentially depending on location in a specific ecologic reservoir.
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13
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Fevereiro J, Fraga AG, Pedrosa J. Genetics in the Host-Mycobacterium ulcerans interaction. Immunol Rev 2021; 301:222-241. [PMID: 33682158 DOI: 10.1111/imr.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
Buruli ulcer is an emerging infectious disease associated with high morbidity and unpredictable outbreaks. It is caused by Mycobacterium ulcerans, a slow-growing pathogen evolutionarily shaped by the acquisition of a plasmid involved in the production of a potent macrolide-like cytotoxin and by genome rearrangements and downsizing. These events culminated in an uncommon infection pattern, whereby M. ulcerans is both able to induce the initiation of the inflammatory cascade and the cell death of its proponents, as well as to survive within the phagosome and in the extracellular milieu. In such extreme conditions, the host is sentenced to rely on a highly orchestrated genetic landscape to be able to control the infection. We here revisit the dynamics of M. ulcerans infection, drawing parallels from other mycobacterioses and integrating the most recent knowledge on its evolution and pathogenicity in its interaction with the host immune response.
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Affiliation(s)
- João Fevereiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandra G Fraga
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Jorge Pedrosa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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14
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Pittet LF, Tebruegge M, Dutta B, Donath S, Messina N, Casalaz D, Hanekom WA, Britton WJ, Robins-Browne R, Curtis N, Ritz N. Mycobacterium ulcerans-specific immune response after immunisation with bacillus Calmette-Guérin (BCG) vaccine. Vaccine 2020; 39:652-657. [PMID: 33371993 DOI: 10.1016/j.vaccine.2020.11.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/17/2020] [Accepted: 11/14/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Bacillus Calmette-Guérin (BCG) vaccine provides partial protection against Buruli ulcer caused by Mycobacterium ulcerans in epidemiological studies. This study aimed to quantify M. ulcerans-specific immune responses induced by BCG immunisation. METHODS Intracellular cytokine analysis of in-vitro experiments done 10 weeks after BCG immunisation in 130 Australian infants randomised to one of three BCG vaccine strains given either at birth (BCG-Denmark, BCG-Japan, or BCG-Russia) or at two months of age (BCG-Denmark). RESULTS Proportions of polyfunctional CD4+ T-cells were higher in M. ulcerans-stimulated compared to unstimulated control samples. These proportions were not influenced by the vaccine strain or timing of the immunisation. The M. ulcerans-specific immune responses showed similar patterns to those observed in M. tuberculosis-stimulated samples, although they were of lower magnitude. CONCLUSIONS Our data show that BCG immunisation induces M. ulcerans-specific immune responses in infants, likely explaining the cross-protective effect observed in epidemiological studies. (ACTRN12608000227392).
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Affiliation(s)
- Laure F Pittet
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Marc Tebruegge
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; University College London Great Ormond Street Institute of Child Health, University College London, London, United Kingdom; Department of Paediatric Infectious Diseases and Immunology, Evelina London Children's Hospital, Guy's and St. Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Binita Dutta
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Louvain, Belgium
| | - Susan Donath
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Nicole Messina
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Dan Casalaz
- Neonatal Intensive Care Unit, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | | | - Warwick J Britton
- Centenary Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Roy Robins-Browne
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Nigel Curtis
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
| | - Nicole Ritz
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; University of Basel Children's Hospital Basel, Infectious Diseases Unit and Migrant Health Service, Basel, Switzerland; Mycobacterial Research Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
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15
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Vandelannoote K, Pluschke G, Bolz M, Bratschi MW, Kerber S, Stinear TP, de Jong BC. Introduction of Mycobacterium ulcerans disease in the Bankim Health District of Cameroon follows damming of the Mapé River. PLoS Negl Trop Dis 2020; 14:e0008501. [PMID: 32886658 PMCID: PMC7473558 DOI: 10.1371/journal.pntd.0008501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/19/2020] [Indexed: 11/18/2022] Open
Abstract
Buruli ulcer (BU) is an emerging ulcerative skin disease caused by infection with Mycobacterium ulcerans. Efforts to control its spread have been hampered by our limited understanding of M. ulcerans reservoirs and transmission, and the factors leading to the emergence of BU disease in a particular region. In this report we investigate an anecdotal link between damming the Mapé River in Cameroon and the emergence of BU in the Health Districts bordering Lake Bankim, the impoundment created by the Mapé dam. We used bacterial population genomics and molecular dating to find compelling support for a 2000 M. ulcerans introduction event that followed about 10 years after the filling of the newly created impoundment in 1988. We compared the genomic reconstructions with high-resolution satellite imagery to investigate what major environmental alterations might have driven the emergence of the new focus.
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Affiliation(s)
- Koen Vandelannoote
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Microbiology and Immunology, The University of Melbourne at the Doherty Institute for Infection & Immunity, Melbourne, Australia
| | - Gerd Pluschke
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Miriam Bolz
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Martin W. Bratschi
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sarah Kerber
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Timothy P. Stinear
- Department of Microbiology and Immunology, The University of Melbourne at the Doherty Institute for Infection & Immunity, Melbourne, Australia
| | - Bouke C. de Jong
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
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16
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Johnson PDR. Buruli ulcer: here today but where tomorrow? LANCET GLOBAL HEALTH 2020; 7:e821-e822. [PMID: 31200878 DOI: 10.1016/s2214-109x(19)30233-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Paul D R Johnson
- Austin Health and University of Melbourne, Melbourne, VIC 3084, Australia.
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17
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Omansen TF, Erbowor-Becksen A, Yotsu R, van der Werf TS, Tiendrebeogo A, Grout L, Asiedu K. Global Epidemiology of Buruli Ulcer, 2010-2017, and Analysis of 2014 WHO Programmatic Targets. Emerg Infect Dis 2020; 25:2183-2190. [PMID: 31742506 PMCID: PMC6874257 DOI: 10.3201/eid2512.190427] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Buruli ulcer is a neglected tropical disease caused by Myocobacterium ulcerans; it manifests as a skin lesion, nodule, or ulcer that can be extensive and disabling. To assess the global burden and the progress on disease control, we analyzed epidemiologic data reported by countries to the World Health Organization during 2010–2017. During this period, 23,206 cases of Buruli ulcer were reported. Globally, cases declined to 2,217 in 2017, but local epidemics seem to arise, such as in Australia and Liberia. In 2013, the World Health Organization formulated 4 programmatic targets for Buruli ulcer that addressed PCR confirmation, occurrence of category III (extensive) lesions and ulcerative lesions, and movement limitation caused by the disease. In 2014, only the movement limitation goal was met, and in 2019, none are met, on a global average. Our findings support discussion on future Buruli ulcer policy and post-2020 programmatic targets.
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18
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Coudereau C, Besnard A, Robbe-Saule M, Bris C, Kempf M, Johnson RC, Brou TY, Gnimavo R, Eyangoh S, Khater F, Marion E. Stable and Local Reservoirs of Mycobacterium ulcerans Inferred from the Nonrandom Distribution of Bacterial Genotypes, Benin. Emerg Infect Dis 2020. [DOI: 10.3201/eid2503.190573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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19
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Vaccine-Specific Immune Responses against Mycobacterium ulcerans Infection in a Low-Dose Murine Challenge Model. Infect Immun 2020; 88:IAI.00753-19. [PMID: 31818964 DOI: 10.1128/iai.00753-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/06/2019] [Indexed: 01/22/2023] Open
Abstract
The neglected tropical disease Buruli ulcer (BU) is an infection of subcutaneous tissue with Mycobacterium ulcerans There is no effective vaccine. Here, we assessed an experimental prime-boost vaccine in a low-dose murine tail infection model. We used the enoyl reductase (ER) domain of the M. ulcerans mycolactone polyketide synthases electrostatically coupled with a previously described Toll-like receptor 2 (TLR-2) agonist-based lipopeptide adjuvant, R4Pam2Cys. Mice were vaccinated and then challenged via tail inoculation with 14 to 20 CFU of a bioluminescent strain of M. ulcerans Mice receiving either the experimental ER vaccine or Mycobacterium bovis bacillus Calmette-Guérin (BCG) were equally protected, with both groups faring significantly better than nonvaccinated animals (P < 0.05). To explore potential correlates of protection, a suite of 29 immune parameters were assessed in the mice at the end of the experimental period. Multivariate statistical approaches were used to interrogate the immune response data to develop disease-prognostic models. High levels of interleukin 2 (IL-2) and low gamma interferon (IFN-γ) produced in the spleen best predicted control of infection across all vaccine groups. Univariate logistic regression revealed vaccine-specific profiles of protection. High titers of ER-specific IgG serum antibodies together with IL-2 and IL-4 in the draining lymph node (DLN) were associated with protection induced by the ER vaccine. In contrast, high titers of IL-6, tumor necrosis factor alpha (TNF-α), IFN-γ, and IL-10 in the DLN and low IFN-γ titers in the spleen were associated with protection following BCG vaccination. This study suggests that an effective BU vaccine must induce localized, tissue-specific immune profiles with controlled inflammatory responses at the site of infection.
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20
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Degnonvi H, Fleuret S, Coudereau C, Gnimavo R, Giffon S, Yeramian E, Johnson RC, Marion E. Effect of well drilling on Buruli ulcer incidence in Benin: a case-control, quantitative survey. Lancet Planet Health 2019; 3:e349-e356. [PMID: 31439316 DOI: 10.1016/s2542-5196(19)30110-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/04/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Buruli ulcer is the third most common mycobacterial disease worldwide. The public health burden of this neglected tropical disease is large, particularly in poor areas of west and central Africa. The development of appropriate preventive strategies is hampered by an incomplete understanding of the epidemiology and transmission of the disease. We investigated the effect of the drilling of wells on Buruli ulcer incidence. METHODS In this case-control, quantitative survey, we obtained field data for Buruli ulcer incidence over a 10-year period from a specialised centre that collected data for the Ouémé and Plateau departments in Benin, and data for well drilling from the Ministry of Energy, Water and Mines in Benin. The coordinates of the wells drilled were obtained during site visits. A case-control study was then done to investigate the role of well water use in protecting against Buruli ulcer. FINDINGS We found a strong inverse correlation between the incidence of Buruli ulcer and the number of new wells drilled in the Bonou municipality (r2=0·8818). A case-control study (106 cases and 212 controls) showed that regular use of the water from the wells for washing, bathing, drinking, or cooking was protective against Buruli ulcer (adjusted odds ratio 0·1, 95% CI 0·04-0·44; p=0·0012). INTERPRETATION This study opens up new possibilities for developing an effective yet affordable policy to fight the disease on a substantial geographical scale. Our study shows that providing access to protected water is an efficient and feasable way to reduce the incidence of Buruli ulcer. FUNDING Fondation Francaise Raoul Follereau, French National Institute of Health and Medical Research, and Région Pays de Loire.
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Affiliation(s)
- Horace Degnonvi
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable, Université d'Abomey Calavi, Cotonou, Benin; Centre de recherche en cancérologie et immunologie Nantes-Angers, French National Institute of Health and Medical Research, Université de Nantes, Université d'Angers, Angers, France
| | - Sebastien Fleuret
- Centre national de la recherche scientifique, UMR Espaces et SOciétés, Université d'Angers, Angers, France
| | - Clement Coudereau
- Centre de recherche en cancérologie et immunologie Nantes-Angers, French National Institute of Health and Medical Research, Université de Nantes, Université d'Angers, Angers, France
| | - Ronald Gnimavo
- Centre de Diagnostic et de Traitement de la lèpre et de l'ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Sigrid Giffon
- Centre national de la recherche scientifique, UMR Espaces et SOciétés, Université d'Angers, Angers, France
| | - Edouard Yeramian
- Unité de microbiologie structurale, Institut Pasteur, Centre National de Recherche Scientifique, Université de Paris, Paris, France
| | - Roch Christian Johnson
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable, Université d'Abomey Calavi, Cotonou, Benin
| | - Estelle Marion
- Centre de recherche en cancérologie et immunologie Nantes-Angers, French National Institute of Health and Medical Research, Université de Nantes, Université d'Angers, Angers, France.
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21
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Mycobacterium ulcerans Population Genomics To Inform on the Spread of Buruli Ulcer across Central Africa. mSphere 2019; 4:4/1/e00472-18. [PMID: 30728280 PMCID: PMC6365612 DOI: 10.1128/msphere.00472-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Buruli ulcer is a neglected tropical disease of skin and subcutaneous tissue caused by infection with the pathogen Mycobacterium ulcerans Many critical issues for disease control, such as understanding the mode of transmission and identifying source reservoirs of M. ulcerans, are still largely unknown. Here, we used genomics to reconstruct in detail the evolutionary trajectory and dynamics of M. ulcerans populations at a central African scale and at smaller geographical village scales. Whole-genome sequencing (WGS) data were analyzed from 179 M. ulcerans strains isolated from all Buruli ulcer foci in the Democratic Republic of the Congo, The Republic of Congo, and Angola that have ever yielded positive M. ulcerans cultures. We used both temporal associations and the study of the mycobacterial demographic history to estimate the contribution of humans as a reservoir in Buruli ulcer transmission. Our phylogeographic analysis revealed one almost exclusively predominant sublineage of M. ulcerans that arose in Central Africa and proliferated in its different regions of endemicity during the Age of Discovery. We observed how the best sampled endemic hot spot, the Songololo territory, became an area of endemicity while the region was being colonized by Belgium (1880s). We furthermore identified temporal parallels between the observed past population fluxes of M. ulcerans from the Songololo territory and the timing of health policy changes toward control of the Buruli ulcer epidemic in that region. These findings suggest that an intervention based on detecting and treating human cases in an area of endemicity might be sufficient to break disease transmission chains, irrespective of other reservoirs of the bacterium.IMPORTANCE Buruli ulcer is a destructive skin and soft tissue infection caused by Mycobacterium ulcerans The disease is characterized by progressive skin ulceration, which can lead to permanent disfigurement and long-term disability. Currently, the major hurdles facing disease control are incomplete understandings of both the mode of transmission and environmental reservoirs of M. ulcerans As decades of spasmodic environmental sampling surveys have not brought us much closer to overcoming these hurdles, the Buruli ulcer research community has recently switched to using comparative genomics. The significance of our research is in how we used both temporal associations and the study of the mycobacterial demographic history to estimate the contribution of humans as a reservoir in Buruli ulcer transmission. Our approach shows that it might be possible to use bacterial population genomics to assess the impact of health interventions, providing valuable feedback for managers of disease control programs in areas where health surveillance infrastructure is poor.
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Scherr N, Bieri R, Thomas SS, Chauffour A, Kalia NP, Schneide P, Ruf MT, Lamelas A, Manimekalai MSS, Grüber G, Ishii N, Suzuki K, Tanner M, Moraski GC, Miller MJ, Witschel M, Jarlier V, Pluschke G, Pethe K. Targeting the Mycobacterium ulcerans cytochrome bc 1:aa 3 for the treatment of Buruli ulcer. Nat Commun 2018; 9:5370. [PMID: 30560872 PMCID: PMC6299076 DOI: 10.1038/s41467-018-07804-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 11/26/2018] [Indexed: 11/21/2022] Open
Abstract
Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical skin disease that is most commonly found in children from West and Central Africa. Despite the severity of the infection, therapeutic options are limited to antibiotics with severe side effects. Here, we show that M. ulcerans is susceptible to the anti-tubercular drug Q203 and related compounds targeting the respiratory cytochrome bc1:aa3. While the cytochrome bc1:aa3 is the primary terminal oxidase in Mycobacterium tuberculosis, the presence of an alternate bd-type terminal oxidase limits the bactericidal and sterilizing potency of Q203 against this bacterium. M. ulcerans strains found in Buruli ulcer patients from Africa and Australia lost all alternate terminal electron acceptors and rely exclusively on the cytochrome bc1:aa3 to respire. As a result, Q203 is bactericidal at low dose against M. ulcerans replicating in vitro and in mice, making the drug a promising candidate for Buruli ulcer treatment. Mycobacterium ulcerans is the causative agent of Buruli ulcer (BU). Existing anti-tubercular drugs have been used to treat the condition with varying success. Here, the authors show that a clinical-stage drug candidate for tuberculosis, Q203, is effective at killing M. ulcerans and is a promising therapeutic candidate for BU.
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Affiliation(s)
- Nicole Scherr
- Swiss Tropical and Public Health Institute, Basel, 4051, Switzerland.,University of Basel, Basel, 4001, Switzerland
| | - Raphael Bieri
- Swiss Tropical and Public Health Institute, Basel, 4051, Switzerland.,University of Basel, Basel, 4001, Switzerland
| | - Sangeeta S Thomas
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, Singapore, 636921, Singapore
| | - Aurélie Chauffour
- CR7, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, Team E13 (Bactériologie), Sorbonne Universités, UPMC Université Paris 06, Paris, 75005, France
| | - Nitin Pal Kalia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, Singapore, 636921, Singapore
| | | | - Marie-Thérèse Ruf
- Swiss Tropical and Public Health Institute, Basel, 4051, Switzerland.,University of Basel, Basel, 4001, Switzerland
| | - Araceli Lamelas
- Swiss Tropical and Public Health Institute, Basel, 4051, Switzerland.,University of Basel, Basel, 4001, Switzerland.,Red de Estudios Moleculares, AvanzadosInstituto de Ecología A. C., Xalapa, 91000, Veracruz, Mexico
| | - Malathy S S Manimekalai
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Gerhard Grüber
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Norihisa Ishii
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, 189-0002, Japan
| | - Koichi Suzuki
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, 189-0002, Japan.,Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University, Tokyo, 173-8605, Japan
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, 4051, Switzerland.,University of Basel, Basel, 4001, Switzerland
| | - Garrett C Moraski
- Department of Chemistry and Biochemistry, Montana State University, Bozeman, MT, 59715, USA
| | - Marvin J Miller
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, 46556, USA
| | | | - Vincent Jarlier
- CR7, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, Team E13 (Bactériologie), Sorbonne Universités, UPMC Université Paris 06, Paris, 75005, France.,CNR-MyRMA, Bactériologie Hygiène, Hôpitaux Universitaires Pitie Salpêtrière-Charles Foix, Paris, 75013, France
| | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Basel, 4051, Switzerland. .,University of Basel, Basel, 4001, Switzerland.
| | - Kevin Pethe
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, Singapore, 636921, Singapore. .,School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore.
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Abstract
Mycobacterium ulcerans is recognised as the third most common mycobacterial infection worldwide. It causes necrotising infections of skin and soft tissue and is classified as a neglected tropical disease by the World Health Organization (WHO). However, despite extensive research, the environmental reservoir of the organism and mode of transmission of the infection to humans remain unknown. This limits the ability to design and implement public health interventions to effectively and consistently prevent the spread and reduce the incidence of this disease. In recent years, the epidemiology of the disease has changed. In most endemic regions of the world, the number of cases reported to the WHO are reducing, with a 64% reduction in cases reported worldwide in the last 9 years. Conversely, in a smaller number of countries including Australia and Nigeria, reported cases are increasing at a rapid rate, new endemic areas continue to appear, and in Australia cases are becoming more severe. The reasons for this changing epidemiology are unknown. We review the epidemiology of M. ulcerans disease worldwide, and document recent changes. We also outline and discuss the current state of knowledge on the ecology of M. ulcerans, possible transmission mechanisms to humans and what may be enabling the spread of M. ulcerans into new endemic areas.
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Wynne JW, Stinear TP, Athan E, Michalski WP, O’Brien DP. Low incidence of recurrent Buruli ulcers in treated Australian patients living in an endemic region. PLoS Negl Trop Dis 2018; 12:e0006724. [PMID: 30102695 PMCID: PMC6107289 DOI: 10.1371/journal.pntd.0006724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/23/2018] [Accepted: 07/28/2018] [Indexed: 12/04/2022] Open
Abstract
We examined recurrent Buruli ulcer cases following treatment and assumed cure in a large cohort of Australian patients living in an endemic area. We report that while the recurrence rate was low (2.81 cases/year/1000 population), it remained similar to the estimated risk of primary infection within the general population of the endemic area (0.85–4.04 cases/year/1,000 population). The majority of recurrent lesions occurred in different regions of the body and were separated by a median time interval of 44 months. Clinical, treatment and epidemiological factors combined with whole genome sequencing of primary and recurrent isolates suggests that in most recurrent cases a re-infection was more likely as opposed to a relapse of the initial infection. Additionally, all cases occurring more than 12 months after commencement of treatment were likely re-infections. Our study provides important prognostic information for patients and their health care providers concerning the nature and risks associated with recurrent cases of Buruli ulcer in Australia. Mycobacterium ulcerans (M. ulcerans) causes a necrotising infection of skin and soft-tissue known as Buruli ulcer. Since the regular use of antibiotics for Buruli ulcer treatment in Australian populations was introduced at the turn of the century, treatment success rates have been very high. However there is no information from the Australian setting on the risk of recurrent disease following treatment and assumed cure, despite this being important prognostic information for patients, their families and health-care providers. Furthermore, it is also not known if recurrent disease represents late relapse of the initial treated infection or a subsequent new infection. In our study we have shown for the first time in Australian patients living in an endemic area that the incidence of recurrent Buruli ulcer following treatment and healing is low, and that this risk is similar to the estimated risk of primary infection within the general population of the endemic area. Furthermore, we have used clinical, treatment and epidemiological data supported by genomic information of M. ulcerans organisms to determine that the majority of recurrent lesions appear to result from re-infection. This suggests that for a proportion of treated patients’ acquired protective immunity against the development of recurrent M. ulcerans disease does not develop from their initial infection.
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Affiliation(s)
- James W. Wynne
- CSIRO, Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Timothy P. Stinear
- Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia
- Doherty Applied Microbial Genomics, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria
| | - Eugene Athan
- Department of Infectious Diseases, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | | | - Daniel P. O’Brien
- Department of Infectious Diseases, Barwon Health, Geelong, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
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25
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Loftus MJ, Trubiano JA, Tay EL, Lavender CJ, Globan M, Fyfe JAM, Johnson PDR. The incubation period of Buruli ulcer (Mycobacterium ulcerans infection) in Victoria, Australia - Remains similar despite changing geographic distribution of disease. PLoS Negl Trop Dis 2018; 12:e0006323. [PMID: 29554096 PMCID: PMC5875870 DOI: 10.1371/journal.pntd.0006323] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/29/2018] [Accepted: 02/16/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Buruli ulcer (BU) is a geographically-restricted infection caused by Mycobacterium ulcerans; contact with an endemic region is the primary risk factor for disease acquisition. Globally, efforts to estimate the incubation period of BU are often hindered as most patients reside permanently in endemic areas. However, in the south-eastern Australian state of Victoria, a significant proportion of people who acquire BU are visitors to endemic regions. During a sustained outbreak of BU on the Bellarine peninsula we estimated a mean incubation period of 4.5 months. Since then cases on the Bellarine peninsula have declined but a new endemic area has developed centred on the Mornington peninsula. METHOD Retrospective review of 443 cases of BU notified in Victoria between 2013 and 2016. Telephone interviews were performed to identify all cases with a single visit to an endemic region, or multiple visits within a one month period. The incubation period was defined as the time between exposure to an endemic region and symptom onset. Data were subsequently combined with those from our earlier study incorporating cases from 2002 to 2012. RESULTS Among the 20 new cases identified in short-term visitors, the mean incubation period was 143 days (4.8 months), very similar to the previous estimate of 135 days (4.5 months). This was despite the predominant exposure location shifting from the Bellarine peninsula to the Mornington peninsula. We found no association between incubation period and age, sex, location of exposure, duration of exposure to an endemic region or location of BU lesion. CONCLUSIONS Our study confirms the mean incubation period of BU in Victoria to be between 4 and 5 months. This knowledge can guide clinicians and suggests that the mode of transmission of BU is similar in different geographic regions in Victoria.
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Affiliation(s)
- Michael J. Loftus
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
- Victorian Department of Health and Human Services, Melbourne, Victoria, Australia
- * E-mail:
| | - Jason A. Trubiano
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, Melbourne University, Parkville, Victoria, Australia
| | - Ee Laine Tay
- Victorian Department of Health and Human Services, Melbourne, Victoria, Australia
| | - Caroline J. Lavender
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia
| | - Maria Globan
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia
| | - Janet A. M. Fyfe
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia
| | - Paul D. R. Johnson
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, Melbourne University, Parkville, Victoria, Australia
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