Antimicrobial resistance in leprosy: results of the first prospective open survey conducted by a WHO surveillance network for the period 2009-15.
Antimicrobial resistance in leprosy: results of the first prospective open survey conducted by a WHO surveillance network for the period 2009-15.
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DOI：
10.1016/j.cmi.2018.02.022
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
WHO surveillance network of antimicrobial resistance in leprosy
中科院分区：
文献类型：
--
作者：
Cambau E;Saunderson P;Matsuoka M;Cole ST;Kai M;Suffys P;Rosa PS;Williams D;Gupta UD;Lavania M;Cardona-Castro N;Miyamoto Y;Hagge D;Srikantam A;Hongseng W;Indropo A;Vissa V;Johnson RC;Cauchoix B;Pannikar VK;Cooreman EAWD;Pemmaraju VRR;Gillini L;WHO surveillance network of antimicrobial resistance in leprosy
抗生素耐药性（AMR）是细菌感染监测的优先事项。对于麻风病，由于麻风分枝杆菌在体外不能生长，因此尚未评估AMR。我们的目标是通过耐药基因的分子检测获得AMR数据，并通过世卫组织监测网络在麻风流行的国家进行抗麻风药物耐药性的前瞻性公开调查。从2009年到2015年，通过对rpoB、folP 1和gyrA基因的耐药决定区进行PCR测序，研究了19个国家哨点的多杆菌麻风病例对利福平、氨苯砜和氧氟沙星的耐药性。在研究的1932例（1143例复发和789例新发）病例中，发现154株（8.0%）麻风分枝杆菌菌株具有赋予耐药性的突变，显示出182种耐药性状（利福平74种，氨苯砜87种，氧氟沙星21种）。20例对利福平和氨苯砜耐药，4例对氧氟沙星和氨苯砜耐药，无1例对利福平和氧氟沙星耐药。在12个国家的复发病例（58/1143，5.1%）和新发病例（16/789，2.0%）中观察到利福平耐药。印度、巴西和哥伦比亚报告了5例以上的利福平耐药病例。这是第一项报告全球麻风AMR数据的研究。出现了利福平耐药性，强调需要扩大监测。这也是对全球使用抗菌药物的警惕，因为氧氟沙星耐药性可能与其他感染的抗生素的一般摄入有关，因为它不是用于治疗麻风病的多种药物组合的一部分。
Antimicrobial resistance (AMR) is a priority for surveillance in bacterial infections. For leprosy, AMR has not been assessed because Mycobacterium leprae does not grow in vitro. We aim to obtain AMR data using molecular detection of resistance genes and to conduct a prospective open survey of resistance to antileprosy drugs in countries where leprosy is endemic through a WHO surveillance network. From 2009 to 2015, multi-bacillary leprosy cases at sentinel sites of 19 countries were studied for resistance to rifampicin, dapsone and ofloxacin by PCR sequencing of the drug-resistance-determining regions of the genes rpoB, folP1 and gyrA. Among 1932 (1143 relapse and 789 new) cases studied, 154 (8.0%) M. leprae strains were found with mutations conferring resistance showing 182 resistance traits (74 for rifampicin, 87 for dapsone and 21 for ofloxacin). Twenty cases showed rifampicin and dapsone resistance, four showed ofloxacin and dapsone resistance, but no cases were resistant to rifampicin and ofloxacin. Rifampicin resistance was observed among relapse (58/1143, 5.1%) and new (16/789, 2.0%) cases in 12 countries. India, Brazil and Colombia reported more than five rifampicin-resistant cases. This is the first study reporting global data on AMR in leprosy. Rifampicin resistance emerged, stressing the need for expansion of surveillance. This is also a call for vigilance on the global use of antimicrobial agents, because ofloxacin resistance probably developed in relation to the general intake of antibiotics for other infections as it is not part of the multidrug combination used to treat leprosy.
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影响因子：
3.8
作者：
Beltrán-Alzate C;López Díaz F;Romero-Montoya M;Sakamuri R;Li W;Kimura M;Brennan P;Cardona-Castro N
通讯作者：
Cardona-Castro N
影响因子：
3
作者：
Matsuoka, Masanori;Aye, Khin Saw;Suzuki, Yasuhiko
通讯作者：
Suzuki, Yasuhiko
影响因子：
2.1
作者：
Kai, M;Matsuoka, M;Kashiwabara, Y
通讯作者：
Kashiwabara, Y
影响因子：
14.2
作者：
Andre, E.;Goeminne, L.;Cambau, E.
通讯作者：
Cambau, E.
影响因子：
3.8
作者：
Cambau E;Chauffour-Nevejans A;Tejmar-Kolar L;Matsuoka M;Jarlier V
通讯作者：
Jarlier V