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A Genomic Approach to Resolving Relapse versus Reinfection among Four Cases of Buruli Ulcer.
- Source :
-
PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2015 Nov 30; Vol. 9 (11), pp. e0004158. Date of Electronic Publication: 2015 Nov 30 (Print Publication: 2015). - Publication Year :
- 2015
-
Abstract
- Background: Increased availability of Next Generation Sequencing (NGS) techniques allows, for the first time, to distinguish relapses from reinfections in patients with multiple Buruli ulcer (BU) episodes.<br />Methodology: We compared the number and location of single nucleotide polymorphisms (SNPs) identified by genomic screening between four pairs of Mycobacterium ulcerans isolates collected at the time of first diagnosis and at recurrence, derived from a collection of almost 5000 well characterized clinical samples from one BU treatment center in Benin.<br />Principal Findings: The findings suggest that after surgical treatment-without antibiotics-the second episodes were due to relapse rather than reinfection. Since specific antibiotics were introduced for the treatment of BU, the one patient with a culture available from both disease episodes had M. ulcerans isolates with a genomic distance of 20 SNPs, suggesting the patient was most likely reinfected rather than having a relapse.<br />Conclusions: To our knowledge, this study is the first to study recurrences in M. ulcerans using NGS, and to identify exogenous reinfection as causing a recurrence of BU. The occurrence of reinfection highlights the contribution of ongoing exposure to M. ulcerans to disease recurrence, and has implications for vaccine development.
- Subjects :
- Adolescent
Benin epidemiology
Buruli Ulcer epidemiology
Buruli Ulcer microbiology
Child
Female
Humans
Male
Molecular Epidemiology methods
Mycobacterium ulcerans isolation & purification
Recurrence
Retrospective Studies
Buruli Ulcer diagnosis
Genome, Bacterial
Genomics methods
Molecular Typing methods
Mycobacterium ulcerans classification
Mycobacterium ulcerans genetics
Polymorphism, Single Nucleotide
Subjects
Details
- Language :
- English
- ISSN :
- 1935-2735
- Volume :
- 9
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- PLoS neglected tropical diseases
- Publication Type :
- Academic Journal
- Accession number :
- 26618509
- Full Text :
- https://doi.org/10.1371/journal.pntd.0004158