Probable zoonotic leprosy in the southern United States.
Probable zoonotic leprosy in the southern United States.
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DOI：
10.1056/nejmoa1010536
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发表时间：
2011-04-28
期刊：
影响因子：
--
通讯作者：
Cole ST
中科院分区：
文献类型：
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作者：
Truman RW;Singh P;Sharma R;Busso P;Rougemont J;Paniz-Mondolfi A;Kapopoulou A;Brisse S;Scollard DM;Gillis TP;Cole ST
在美国南部地区，如路易斯安那州和德克萨斯州，在没有外国接触史的本土出生的美国人中有本地麻风病病例。在同一地区以及墨西哥，野生犰狳感染了麻风分枝杆菌。从一只野生犰狳和三名美国麻风病患者身上提取的麻风分枝杆菌的全基因组重测序显示，感染菌株本质上是相同的。将这些菌株与来自亚洲和巴西的麻风分枝杆菌菌株进行基因组比较分析，鉴定出51个单核苷酸多态性和一个11 bp的插入-缺失。我们结合10个可变数串联重复序列，对来自南方5个州的33只野生犰狳、路易斯安那州一家诊所的50名美国门诊患者、64名委内瑞拉患者以及4种国外参考菌株的麻风分枝杆菌菌株进行了这些多态性位点的基因分型。国外暴露患者的麻风分枝杆菌基因型一般反映其原籍国或旅行史。然而，在33只野生犰狳中的28只和39名居住在可能暴露于犰狳传播的麻风分枝杆菌地区的美国患者中发现了一种独特的麻风分枝杆菌基因型（3I-2-v1）。该基因型在世界其他地方未见报道。美国南部的野生犰狳和许多麻风病患者都感染了同一株麻风分枝杆菌。犰狳是麻风分枝杆菌的大型天然宿主，麻风病可能是该地区的一种人畜共患病。（由国家过敏和传染病研究所和其他机构资助。）
In the southern region of the United States, such as in Louisiana and Texas, there are autochthonous cases of leprosy among native-born Americans with no history of foreign exposure. In the same region, as well as in Mexico, wild armadillos are infected with Mycobacterium leprae. Whole-genome resequencing of M. leprae from one wild armadillo and three U.S. patients with leprosy revealed that the infective strains were essentially identical. Comparative genomic analysis of these strains and M. leprae strains from Asia and Brazil identified 51 single-nucleotide polymorphisms and an 11-bp insertion–deletion. We genotyped these polymorphic sites, in combination with 10 variable-number tandem repeats, in M. leprae strains obtained from 33 wild armadillos from five southern states, 50 U.S. outpatients seen at a clinic in Louisiana, and 64 Venezuelan patients, as well as in four foreign reference strains. The M. leprae genotype of patients with foreign exposure generally reflected their country of origin or travel history. However, a unique M. leprae genotype (3I-2-v1) was found in 28 of the 33 wild armadillos and 25 of the 39 U.S. patients who resided in areas where exposure to armadillo-borne M. leprae was possible. This genotype has not been reported elsewhere in the world. Wild armadillos and many patients with leprosy in the southern United States are infected with the same strain of M. leprae. Armadillos are a large natural reservoir for M. leprae, and leprosy may be a zoonosis in the region. (Funded by the National Institute of Allergy and Infectious Diseases and others.)