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Schorey JS, Vecchio J, McManus WR, Ongalo J, Webber K. Activation of host nucleic acid sensors by Mycobacterium: good for us or good for them? Crit Rev Microbiol 2024; 50:224-240. [PMID: 38153209 PMCID: PMC10985831 DOI: 10.1080/1040841x.2023.2294904] [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: 09/18/2023] [Accepted: 12/10/2023] [Indexed: 12/29/2023]
Abstract
Although the importance of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) sensors in controlling viral infection is well established, their role in promoting an effective immune response to pathogens other than viruses is less clear. This is particularly true for infections with mycobacteria, as studies point to both protective and detrimental roles for activation of nucleic acid sensors in controlling a mycobacterial infection. Some of the contradiction likely stems from the use of different model systems and different mycobacterial species/strains as well as from which nucleic acid sensors were studied and what downstream effectors were evaluated. In this review, we will describe the different nucleic acid sensors that have been studied in the context of mycobacterial infections, and how the different studies compare. We conclude with a section on how nucleic acid sensor agonists have been used therapeutically and what further information is needed to enhance their potential as therapeutic agents.
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Affiliation(s)
- Jeffery S. Schorey
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556
| | - Joseph Vecchio
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556
| | - William R. McManus
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556
| | - Joshua Ongalo
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556
| | - Kylie Webber
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556
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2
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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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3
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Osei-Owusu J, Aidoo OF, Eshun F, Gaikpa DS, Dofuor AK, Vigbedor BY, Turkson BK, Ochar K, Opata J, Opoku MJ, Ninsin KD, Borgemeister C. Buruli ulcer in Africa: Geographical distribution, ecology, risk factors, diagnosis, and indigenous plant treatment options - A comprehensive review. Heliyon 2023; 9:e22018. [PMID: 38034712 PMCID: PMC10686891 DOI: 10.1016/j.heliyon.2023.e22018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Buruli ulcer (BU), a neglected tropical disease (NTD), is an infection of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. The disease has been documented in many South American, Asian, and Western Pacific countries and is widespread throughout much of Africa, especially in West and Central Africa. In rural areas with scarce medical care, BU is a devastating disease that can leave patients permanently disabled and socially stigmatized. Mycobacterium ulcerans is thought to produce a mycolactone toxin, which results in necrosis of the afflicted tissue and may be involved in the etiology of BU. Initially, patients may notice a painless nodule or plaque on their skin; as the disease progresses, however, it may spread to other parts of the body, including the muscles and bones. Clinical signs, microbial culture, and histological analysis of afflicted tissue all contribute to a diagnosis of BU. Though antibiotic treatment and surgical removal of infected tissue are necessary for BU management, plant-derived medicine could be an alternative in areas with limited access to conventional medicine. Herein we reviewed the geographical distribution, socioeconomic, risk factors, diagnosis, biology and ecology of the pathogen. Complex environmental, socioeconomic, and genetic factors that influence BU are discussed. Further, our review highlights future research areas needed to develop strategies to manage the disease through the use of indigenous African plants.
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Affiliation(s)
- Jonathan Osei-Owusu
- Department of Physical and Mathematical Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Owusu Fordjour Aidoo
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Fatima Eshun
- Department of Geography and Earth Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - David Sewordor Gaikpa
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Aboagye Kwarteng Dofuor
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Bright Yaw Vigbedor
- Department of Basic Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Bernard Kofi Turkson
- Department of Herbal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kingsley Ochar
- Council for Scientific and Industrial Research, Plant Genetic Resources Research Institute, Bunso, Ghana
| | - John Opata
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Maxwell Jnr. Opoku
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Kodwo Dadzie Ninsin
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Christian Borgemeister
- Centre for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113 Bonn, Germany
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Nohrenberg M, Wright A, Krause V. Non-tuberculous mycobacterial skin and soft tissue infections in the Northern Territory, Australia, 1989-2021. Int J Infect Dis 2023; 135:125-131. [PMID: 37524256 DOI: 10.1016/j.ijid.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND A previous review demonstrated that the majority of NTM infections in the Northern Territory (NT) are pulmonary in nature [1], however skin and soft tissue (SST) are likely the next most common sites of disease. The current epidemiology of NTM SST infections across the NT is not known. We aimed to establish the current and historical incidence rates, and the organisms involved. METHODS All NTM cases reported to the Centre for Disease Control in Darwin from 1989-2021 were retrospectively reviewed. RESULTS 226 NTM notifications were reviewed. 73 (32%) cases were SST infections. The incidence of SST cases increased over the study period. Female cases were more common (p=0·002). Disease occurred across a wide age range (1-85 years). Only 16% of cases occurred in Aboriginal individuals which may reflect immunological factors requiring further investigation. Many cases had no clear provocation, but localised skin trauma was the most common risk factor. The most common organism identified was M. fortuitum (41%). Diagnosis was often delayed, with a median time to diagnosis of 69 days (IQR=31-149). Most cases (60%) underwent surgical intervention with adjunctive anti-mycobacterial medical therapy. CONCLUSION NTM SST incidence rates increased over the study period. NTM SST infections are a rare but important differential diagnosis for non-healing cutaneous wounds.
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Affiliation(s)
- Michael Nohrenberg
- Public Health Unit (Centre for Disease Control & Environmental Health), Building 4, 105 Rocklands Drive, Tiwi, Northern Territory, Australia, 0810.
| | - Alyson Wright
- Public Health Unit (Centre for Disease Control & Environmental Health), Building 4, 105 Rocklands Drive, Tiwi, Northern Territory, Australia, 0810; Health Statistics and Informatics, Sector and System Leadership, NT Health, Floor 7, Manunda Place, 38 Cavenagh Street, Darwin
| | - Vicki Krause
- Public Health Unit (Centre for Disease Control & Environmental Health), Building 4, 105 Rocklands Drive, Tiwi, Northern Territory, Australia, 0810
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McNamara BJ, Blasdell KR, Yerramilli A, Smith IL, Clayton SL, Dunn M, Tay EL, Gibney KB, Waidyatillake NT, Hussain MA, Muleme M, O'Brien DP, Athan E. Comprehensive Case-Control Study of Protective and Risk Factors for Buruli Ulcer, Southeastern Australia. Emerg Infect Dis 2023; 29:2032-2043. [PMID: 37735741 PMCID: PMC10521623 DOI: 10.3201/eid2910.230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
To examine protective and risk factors for Buruli ulcer (BU), we conducted a case-control study of 245 adult BU cases and 481 postcode-matched controls across BU-endemic areas of Victoria, Australia. We calculated age- and sex-adjusted odds ratios for socio-environmental, host, and behavioral factors associated with BU by using conditional logistic regression. Odds of BU were >2-fold for persons with diabetes mellitus and persons working outdoors who had soil contact in BU-endemic areas (compared with indoor work) but were lower among persons who had bacillus Calmette-Guérin vaccinations. BU was associated with increasing numbers of possums and with ponds and bore water use at residences. Using insect repellent, covering arms and legs outdoors, and immediately washing wounds were protective; undertaking multiple protective behaviors was associated with the lowest odds of BU. Skin hygiene/protection behaviors and previous bacillus Calmette-Guérin vaccination might provide protection against BU in BU-endemic areas.
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Popa GL, Muntean AA, Popa MI. Recent Advances in the Management Strategies for Buruli Ulcers. Pathogens 2023; 12:1088. [PMID: 37764896 PMCID: PMC10538148 DOI: 10.3390/pathogens12091088] [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: 06/28/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Buruli ulcer (BU) is a bacterial skin infection that is caused by Mycobacterium ulcerans and mainly affects people who reside in the rural areas of Africa and in suburban and beach resort communities in Australia. The infection typically begins as a painless papule or nodule that gradually develops into a large ulcer that can cause substantial impairment, damaging soft tissues and even bones. Early detection and immediate treatment are crucial to preventing further tissue damage and any potential complications, although it is worth noting that access to proper therapeutic resources can be limited in certain areas. The most commonly used antibiotics for treating BU are rifampicin, streptomycin, and clarithromycin; efforts have recently been made to introduce new treatments that increase the effectiveness and adherence to therapy. This article presents the latest research and management strategies regarding BU, providing an updated and intriguing perspective on this topic.
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Affiliation(s)
- Gabriela Loredana Popa
- Department of Microbiology, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Alexandru Andrei Muntean
- Department of Microbiology II, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.M.); (M.I.P.)
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Mircea Ioan Popa
- Department of Microbiology II, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.M.); (M.I.P.)
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
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7
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Bauer IL. The oral repellent - science fiction or common sense? Insects, vector-borne diseases, failing strategies, and a bold proposition. Trop Dis Travel Med Vaccines 2023; 9:7. [PMID: 37381000 DOI: 10.1186/s40794-023-00195-9] [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: 12/21/2022] [Accepted: 06/09/2023] [Indexed: 06/30/2023] Open
Abstract
Over the last decades, unimaginable amounts of money have gone into research and development of vector control measures, repellents, treatment, and vaccines for vector borne diseases. Technological progress and scientific breakthroughs allowed for ever more sophisticated and futuristic strategies. Yet, each year, millions of people still die or suffer from potentially serious consequences of malaria or dengue to more recent infections, such as zika or chikungunya, or of debilitating consequences of neglected tropical diseases. This does not seem value for money. In addition, all current vector control strategies and personal protection methods have shortcomings, some serious, that are either destructive to non-target species or unsatisfactory in their effectiveness. On the other hand, the rapid decline in insect populations and their predators reflects decades-long aggressive and indiscriminate vector control. This major disruption of biodiversity has an impact on human life not anticipated by the well-meaning killing of invertebrates. The objective of this paper is to re-examine current control methods, their effectiveness, their impact on biodiversity, human and animal health, and to call for scientific courage in the pursuit of fresh ideas. This paper brings together topics that are usually presented in isolation, thereby missing important links that offer potential solutions to long-standing problems in global health. First, it serves as a reminder of the importance of insects to human life and discusses the few that play a role in transmitting disease. Next, it examines critically the many currently employed vector control strategies and personal protection methods. Finally, based on new insights into insect chemo-sensation and attractants, this perspective makes a case for revisiting a previously abandoned idea, the oral repellent, and its use via currently successful methods of mass-application. The call is out for focused research to provide a powerful tool for public health, tropical medicine, and travel medicine.
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Affiliation(s)
- Irmgard L Bauer
- College of Healthcare Sciences, Academy - Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia.
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8
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Dhungel L, Bonner R, Cook M, Henson D, Moulder T, Benbow ME, Jordan H. Impact of Temperature and Oxygen Availability on Gene Expression Patterns of Mycobacterium ulcerans. Microbiol Spectr 2023; 11:e0496822. [PMID: 36912651 PMCID: PMC10100886 DOI: 10.1128/spectrum.04968-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/29/2023] [Indexed: 03/14/2023] Open
Abstract
Buruli ulcer disease is a neglected tropical disease caused by the environmental pathogen Mycobacterium ulcerans. The M. ulcerans major virulence factor is mycolactone, a lipid cytotoxic compound whose genes are carried on a plasmid. Although an exact reservoir and mode(s) of transmission are unknown, data provide evidence of both. First, Buruli ulcer incidence and M. ulcerans presence have been linked to slow-moving water with low oxygen. M. ulcerans has also been suggested to be sensitive to UV due to termination in crtI, encoding a phytoene dehydrogenase, required for carotenoid production. Further, M. ulcerans has been shown to cause disease following puncture but not when introduced to open abrasion sites, suggesting that puncture is necessary for transmission and pathology. Despite these findings, the function and modulation of mycolactone and other genes in response to dynamic abiotic conditions such as UV, temperature, and oxygen have not been shown. In this study, we investigated modulation of mycolactone and other genes on exposure to changing UV and oxygen microenvironmental conditions. Mycolactone expression was downregulated on exposure to the single stress high temperature and did not change significantly with exposure to UV; however, it was upregulated when exposed to microaerophilic conditions. Mycolactone expression was downregulated under combined stresses of high temperature and low oxygen, but there was upregulation of several stress response genes. Taken together, results suggest that temperature shapes M. ulcerans metabolic response more so than UV exposure or oxygen requirements. These data help to define the environmental niche of M. ulcerans and metabolic responses during initial human infection. IMPORTANCE Buruli ulcer is a debilitating skin disease caused by the environmental pathogen Mycobacterium ulcerans. M. ulcerans produces a toxic compound, mycolactone, which leads to tissue necrosis and ulceration. Barriers to preventing Buruli ulcer include an incomplete understanding of M. ulcerans reservoirs, how the pathogen is transmitted, and under what circumstances mycolactone and other M. ulcerans genes are expressed and produced in its natural environment and in the host. We conducted a study to investigate M. ulcerans gene expression under several individual or combined abiotic conditions. Our data showed that mycolactone expression was downregulated under combined stresses of high temperature and low oxygen but there was upregulation of several stress response genes. These data are among only a few studies measuring modulation of mycolactone and other M. ulcerans genes that could be involved in pathogen fitness in its natural environment and virulence while within the host.
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Affiliation(s)
- Laxmi Dhungel
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | - Raisa Bonner
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | - Meagan Cook
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | - Duncan Henson
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | - Trent Moulder
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | - M. Eric Benbow
- Department of Entomology, Michigan State University, East Lansing, Michigan, USA
- Ecology, Evolution and Behavior Program, Michigan State University, East Lansing, Michigan, USA
- AgBioResearch, Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Medical Specialties, Michigan State University, East Lansing, Michigan, USA
| | - Heather Jordan
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
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Leuenberger A, Koné BV, N’krumah RTAS, Koffi DY, Bonfoh B, Utzinger J, Pluschke G. Perceived water-related risk factors of Buruli ulcer in two villages of south-central Côte d'Ivoire. PLoS Negl Trop Dis 2022; 16:e0010927. [PMID: 36516125 PMCID: PMC9750022 DOI: 10.1371/journal.pntd.0010927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Buruli ulcer, caused by Mycobacterium ulcerans, is a neglected tropical skin disease that is primarily endemic in West and Central Africa, including Côte d'Ivoire. Studies indicate that M. ulcerans infections are caused by contact with an environmental reservoir of the bacteria, governed by specific human biological conditions. Yet, the nature of this reservoir and the exact mode of transmission remain unknown. METHODOLOGY To identify ecologic risk factors of Buruli ulcer in south-central Côte d'Ivoire, we pursued a qualitative study matched with geo-referencing inquiry. Embedded in a broader integrated wound management research project, we (i) mapped households and water sources of laboratory confirmed Buruli ulcer cases and (ii) interviewed 12 patients and four health care workers to assess exposure to surface water and to deepen the understanding of perceived transmission pathways. PRINCIPAL FINDINGS Water availability, accessibility, and affordability were reported as key determinants for choosing water resources. Furthermore, perceived risks were related to environmental, structural, and individual factors. Despite the presence of improved water sources (e.g., drilled wells), communities heavily relied on unprotected surface water for a multitude of activities. The nearby Bandama River and seasonal waterbodies were frequently used for washing, bathing, and collection of water for drinking and cooking. Many residents also reported to cross the river on a daily basis for agricultural chores, and hence, are exposed to stagnant water during farming activities. CONCLUSIONS/SIGNIFICANCE Our study in two Buruli ulcer endemic villages in south-central Côte d'Ivoire revealed a wide range of water-related domestic activities that might expose people to an increased risk of contracting the disease. Environmental, biological, social, and cultural risk factors are closely interlinked and should be considered in future investigations of Buruli ulcer transmission. Active participation of the communities is key to better understand their circumstances to advance research and fight against Buruli ulcer and other neglected tropical diseases.
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Affiliation(s)
- Andrea Leuenberger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Bognan V. Koné
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Raymond T. A. S. N’krumah
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Université Peleforo Gon Coulibaly de Korhogo, Korhogo, Côte d’Ivoire
| | - Didier Y. Koffi
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Programme National de Lutte contre l’Ulcère de Buruli, Abidjan, Côte d’Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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10
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Marion E, Marsollier L. Mycobacterium ulcerans. Trends Microbiol 2022; 30:1116-1117. [PMID: 36163220 DOI: 10.1016/j.tim.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Estelle Marion
- Université d'Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR, 1302, Angers, France.
| | - Laurent Marsollier
- Université d'Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR, 1302, Angers, France
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11
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Fukano H, Nakanaga K, Goto M, Yoshida M, Ishii N, Hoshino Y. Therapeutic efficacy of rifalazil (KRM-1648) in a M. ulcerans-induced Buruli ulcer mouse model. PLoS One 2022; 17:e0274742. [PMID: 36201529 PMCID: PMC9536621 DOI: 10.1371/journal.pone.0274742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 09/05/2022] [Indexed: 11/07/2022] Open
Abstract
Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans infection that requires long-term antibiotic treatment and/or surgical excision. In this study, we investigated the therapeutic efficacy of the rifamycin derivative, rifalazil (RLZ) (also known as KRM-1648), in an advanced M. ulcerans infection model. Six-week-old female BALB/c mice were infected with 3.25 x 104 colony-forming units (CFU) of M. ulcerans subcutaneously into the bilateral hind footpads. At 33 days post-infection, when the footpads exhibited significant redness and swelling, mice were treated orally with 5 or 10 mg/kg of RLZ for up to 15 weeks. Mice were followed for an additional 15 weeks following treatment cessation. Untreated mice exhibited a progressive increase in footpad redness, swelling, and erosion over time, and all untreated mice reached to endpoint within 5–8 weeks post-bacterial injection. In the RLZ-treated mice, footpad redness and swelling and general condition improved or completely healed, and no recurrence occurred following treatment cessation. After 3 weeks of treatment, the CFU counts from the footpads of recovered RLZ-treated mice showed a 104 decrease compared with those of untreated mice. We observed a further reduction in CFU counts to the detection limit following 6 to 15 weeks of treatment, which did not increase 15 weeks after discontinuing the treatment. Histopathologically, bacteria in the treated mice became fragmented one week after RLZ-treatment. At the final point of the experiment, all the treated mice (5mg/kg/day; n = 6, 10mg/kg/day; n = 7) survived and had no signs of M. ulcerans infection. These results indicate that the rifamycin analogue, RLZ, is efficacious in the treatment of an advanced M. ulcerans infection mouse model.
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Affiliation(s)
- Hanako Fukano
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazue Nakanaga
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masamichi Goto
- Department of Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Mitsunori Yoshida
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norihisa Ishii
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- National Sanatorium Tamazenshoen, Tokyo, Japan
| | - Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail:
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12
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Hopkins SR, Jones IJ, Buck JC, LeBoa C, Kwong LH, Jacobsen K, Rickards C, Lund AJ, Nova N, MacDonald AJ, Lambert-Peck M, De Leo GA, Sokolow SH. Environmental Persistence of the World's Most Burdensome Infectious and Parasitic Diseases. Front Public Health 2022; 10:892366. [PMID: 35875032 PMCID: PMC9305703 DOI: 10.3389/fpubh.2022.892366] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Humans live in complex socio-ecological systems where we interact with parasites and pathogens that spend time in abiotic and biotic environmental reservoirs (e.g., water, air, soil, other vertebrate hosts, vectors, intermediate hosts). Through a synthesis of published literature, we reviewed the life cycles and environmental persistence of 150 parasites and pathogens tracked by the World Health Organization's Global Burden of Disease study. We used those data to derive the time spent in each component of a pathogen's life cycle, including total time spent in humans versus all environmental stages. We found that nearly all infectious organisms were “environmentally mediated” to some degree, meaning that they spend time in reservoirs and can be transmitted from those reservoirs to human hosts. Correspondingly, many infectious diseases were primarily controlled through environmental interventions (e.g., vector control, water sanitation), whereas few (14%) were primarily controlled by integrated methods (i.e., combining medical and environmental interventions). Data on critical life history attributes for most of the 150 parasites and pathogens were difficult to find and often uncertain, potentially hampering efforts to predict disease dynamics and model interactions between life cycle time scales and infection control strategies. We hope that this synthetic review and associated database serve as a resource for understanding both common patterns among parasites and pathogens and important variability and uncertainty regarding particular infectious diseases. These insights can be used to improve systems-based approaches for controlling environmentally mediated diseases of humans in an era where the environment is rapidly changing.
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Affiliation(s)
- Skylar R. Hopkins
- National Center for Ecological Analysis and Synthesis, Santa Barbara, CA, United States
- Department of Applied Ecology, North Carolina State University, Raleigh, NC, United States
- *Correspondence: Skylar R. Hopkins
| | - Isabel J. Jones
- Hopkins Marine Station, Stanford University, Pacific Grove, CA, United States
| | - Julia C. Buck
- Department of Biology and Marine Biology, University of North Carolina Wilmington, Wilmington, NC, United States
| | - Christopher LeBoa
- Department of Epidemiology, Stanford University, Stanford, CA, United States
| | - Laura H. Kwong
- Stanford Woods Institute for the Environment, Stanford University, Stanford, CA, United States
| | - Kim Jacobsen
- School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Chloe Rickards
- Department of Ecology and Evolutionary Biology, University of California, Santa Cruz, Santa Cruz, CA, United States
| | - Andrea J. Lund
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, CA, United States
| | - Nicole Nova
- Department of Biology, Stanford University, Stanford, CA, United States
| | - Andrew J. MacDonald
- Department of Biology, Stanford University, Stanford, CA, United States
- Earth Research Institute, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Miles Lambert-Peck
- United Nations University for the Advanced Study of Sustainability, Tokyo, Japan
| | - Giulio A. De Leo
- Hopkins Marine Station, Stanford University, Pacific Grove, CA, United States
| | - Susanne H. Sokolow
- Hopkins Marine Station, Stanford University, Pacific Grove, CA, United States
- Marine Science Institute, University of California, Santa Barbara, Santa Barbara, CA, United States
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13
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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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14
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Rotureau B, Waleckx E, Jamonneau V, Solano P, Molia S, Debré P, Dellagi K, Morand S. Enhancing research integration to improve One Health actions: learning lessons from neglected tropical diseases experiences. BMJ Glob Health 2022; 7:bmjgh-2022-008881. [PMID: 35688485 PMCID: PMC9189848 DOI: 10.1136/bmjgh-2022-008881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/21/2022] [Indexed: 02/05/2023] Open
Affiliation(s)
- Brice Rotureau
- Parasitology Unit, Institut Pasteur of Guinea, Conakry, Guinea .,Trypanosome Transmission Group, Institut Pasteur, Paris, France
| | - Etienne Waleckx
- INTERTRYP - IRD, CIRAD, University of Montpellier, IRD, Montpellier, France.,Autonomous University of Yucatan, CIR Hideyo Noguchi, Merida, Mexico
| | - Vincent Jamonneau
- INTERTRYP - IRD, CIRAD, University of Montpellier, IRD, Montpellier, France
| | - Philippe Solano
- INTERTRYP - IRD, CIRAD, University of Montpellier, IRD, Montpellier, France
| | - Sophie Molia
- UMR ASTRE, CIRAD, Montpellier, France.,Univ Montpellier CIRAD INRAE, Montpellier, France
| | | | | | - Serge Morand
- CNRS MIVEGEC, IRD, Montpellier University, Montpellier, France.,Faculty of Veterinary Technology, Kasetsart University, Bangkok, Thailand
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15
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Abstract
PURPOSE OF REVIEW The aim of this article is to review the most recent evidences concerning mycobacterial skin infections, limiting the period of literature research to 2020--2021. RECENT FINDINGS Mycobacterial skin infections include a heterogeneous group of cutaneous diseases.Cutaneous tuberculosis is usually the result of hematogenous dissemination or spread from underlying foci and it must be distinguished from tuberculids, resulting from the immunological reaction to Mycobacterium tuberculosis antigens. Leprosy prevalence was drastically reduced after introduction of multidrug therapy in the 1980 s, but cases are still reported due to underdiagnosis, and animal and environmental reservoirs. Recent advances concentrate in the diagnostic field. Specific guidelines for the treatment of nontuberculous mycobacteria skin infections are missing and surgical procedures may be required. Prognosis is better as compared to nontuberculous mycobacteria lung disease. Rapid laboratory-confirmed diagnosis of Buruli ulcer may be achieved by the IS2404 PCR. Among new drugs, telacebec is promising in terms of potency, shorter duration and tolerability in animal studies. A clinical trial in humans is planned. SUMMARY Mycobacterial cutaneous lesions are nonpathognomonic and clinical suspicion must be confirmed by culture or molecular detection. Long-course multidrug treatment is required based on susceptibility tests. Surgical intervention may also be required. Rehabilitation and psychosocial support reduce long-term physical and mental consequences mostly in Buruli ulcer and leprosy.
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16
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Hall BS, Hsieh LTH, Sacre S, Simmonds RE. The One That Got Away: How Macrophage-Derived IL-1β Escapes the Mycolactone-Dependent Sec61 Blockade in Buruli Ulcer. Front Immunol 2022; 12:788146. [PMID: 35154073 PMCID: PMC8826060 DOI: 10.3389/fimmu.2021.788146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Buruli ulcer (BU), caused by Mycobacterium ulcerans, is a devastating necrotizing skin disease. Key to its pathogenesis is mycolactone, the exotoxin virulence factor that is both immunosuppressive and cytotoxic. The discovery that the essential Sec61 translocon is the major cellular target of mycolactone explains much of the disease pathology, including the immune blockade. Sec61 inhibition leads to a loss in production of nearly all cytokines from monocytes, macrophages, dendritic cells and T cells, as well as antigen presentation pathway proteins and costimulatory molecules. However, there has long been evidence that the immune system is not completely incapable of responding to M. ulcerans infection. In particular, IL-1β was recently shown to be present in BU lesions, and to be induced from M. ulcerans-exposed macrophages in a mycolactone-dependent manner. This has important implications for our understanding of BU, showing that mycolactone can act as the "second signal" for IL-1β production without inhibiting the pathways of unconventional secretion it uses for cellular release. In this Perspective article, we validate and discuss this recent advance, which is entirely in-line with our understanding of mycolactone's inhibition of the Sec61 translocon. However, we also show that the IL-1 receptor, which uses the conventional secretory pathway, is sensitive to mycolactone blockade at Sec61. Hence, a more complete understanding of the mechanisms regulating IL-1β function in skin tissue, including the transient intra-macrophage stage of M. ulcerans infection, is urgently needed to uncover the double-edged sword of IL-1β in BU pathogenesis, treatment and wound healing.
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Affiliation(s)
- Belinda S Hall
- Department of Microbial Sciences, School of Bioscience and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Louise Tzung-Harn Hsieh
- Department of Microbial Sciences, School of Bioscience and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sandra Sacre
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Rachel E Simmonds
- Department of Microbial Sciences, School of Bioscience and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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17
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Boccarossa A, Degnonvi H, Brou TY, Robbe-Saule M, Esnault L, Boucaud Y, Eveillard M, Gnimavo R, Hounsou S, Djenontin A, Johnson CR, Fleuret S, Marion E. A combined field study of Buruli ulcer disease in southeast Benin proposing preventive strategies based on epidemiological, geographic, behavioural and environmental analyses. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000095. [PMID: 36962132 PMCID: PMC10021984 DOI: 10.1371/journal.pgph.0000095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/08/2021] [Indexed: 06/18/2023]
Abstract
Buruli ulcer is a neglected tropical disease caused by M. ulcerans, an environmental mycobacterium. This cutaneous infectious disease affects populations with poor access to sanitation, safe water and healthcare living in rural areas of West and Central Africa. Stagnant open bodies of surface water and slow-running streams are the only risk factor identified in Africa, and there is no human-to-human transmission. Appropriate and effective prevention strategies are required for populations living in endemic areas. Based on a multidisciplinary approach in an area in which Buruli ulcer is endemic in South Benin, we investigated the link between all human-environment interactions relating to unprotected water and behaviors associated with Buruli ulcer risk likely to affect incidence rates. We characterised the sources of water as well as water bodies and streams used by communities, by conducting a prospective case-control study directly coupled with geographic field observations, spatial analysis, and the detection of M. ulcerans in the environment. A full list of the free surface waters used for domestic activities was generated for a set of 34 villages, and several types of human behaviour associated with a higher risk of transmission were identified: (i) prolonged walking in water to reach cultivated fields, (ii) collecting water, (iii) and swimming. Combining the results of the different analyses identified the risk factor most strongly associated with Buruli ulcer was the frequency of contact with unprotected and natural water, particularly in regularly flooded or irrigated lowlands. We confirm that the use of clean water from drilled wells confers protection against Buruli ulcer. These specific and refined results provide a broader scope for the design of an appropriate preventive strategy including certain practices or infrastructures observed during our field investigations. This strategy could be improved by the addition of knowledge about irrigation practices and agricultural work in low-lying areas.
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Affiliation(s)
- Alexandra Boccarossa
- Univ Angers, Inserm, CRCINA, Angers, France
- Univ Angers, CNRS, ESO, Angers, France
| | - Horace Degnonvi
- Univ Angers, Inserm, CRCINA, Angers, France
- University Abomey Calavi, Cifred, Benin
| | | | | | | | | | | | | | - Saturnin Hounsou
- University Abomey Calavi, Cifred, Benin
- Faculté des Sciences et Techniques, University of Abomey-Calavi, Abomey Calavi, Benin
| | - Armel Djenontin
- Faculté des Sciences et Techniques, University of Abomey-Calavi, Abomey Calavi, Benin
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18
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Gnimavo R, Besnard A, Degnonvi H, Pipoli Da Fonseca J, Kempf M, Johnson CR, Boccarossa A, Brou YT, Marsollier L, Marion E. Molecular and epidemiological characterization of recurrent Mycobacterium ulcerans infections in Benin. PLoS Negl Trop Dis 2021; 15:e0010053. [PMID: 34962930 PMCID: PMC8746791 DOI: 10.1371/journal.pntd.0010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/10/2022] [Accepted: 12/04/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Buruli 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 FINDINGS We 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/SIGNIFICANCE Second 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.
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Affiliation(s)
- Ronald Gnimavo
- Centre de Diagnostic et de Traitement de l’ulcère de Buruli, Fondation Raoul Follereau, Pobè, Bénin
| | | | - Horace Degnonvi
- Univ Angers, Inserm, INCIT, Angers, France
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d’Abomey Calavi (UAC), Cotonou, Benin
| | | | - Marie Kempf
- Univ Angers, Inserm, CHU Angers, INCIT, Angers, France
| | - Christian Roch Johnson
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d’Abomey Calavi (UAC), Cotonou, Benin
| | - Alexandra Boccarossa
- Univ Angers, Inserm, INCIT, Angers, France
- CNRS, UMR ESO, Université d’Angers, Angers, France
| | - Yao Télesphore Brou
- UMR 228 ESPACE-DEV (IRD, UAG, UM, UR), Station SEAS-OI, Saint Pierre, Ile de la Réunion, France
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