High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimen
ABSTRACT: Objectives: Drug resistance in leprosy is an emerging concern, leading to treatment failures, recurrences, and potential spread of resistant Mycobacterium leprae in the community. In this study, we aimed to assess drug resistance prevalence and patterns amongst leprosy patients at a terti...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716523001753 |
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| author | Seema Chhabra Tarun Narang Smrity Sahu Keshav Sharma Shilpa Shilpa Ayush Sharma Sejal Jain Itu Singh Rakesh Yadav Manjot Kaur Rahul Sharma Mohd Nadeem Pragati Pandey Ranjana W. Minz Sunil Dogra |
| author_facet | Seema Chhabra Tarun Narang Smrity Sahu Keshav Sharma Shilpa Shilpa Ayush Sharma Sejal Jain Itu Singh Rakesh Yadav Manjot Kaur Rahul Sharma Mohd Nadeem Pragati Pandey Ranjana W. Minz Sunil Dogra |
| author_sort | Seema Chhabra |
| collection | DOAJ |
| description | ABSTRACT: Objectives: Drug resistance in leprosy is an emerging concern, leading to treatment failures, recurrences, and potential spread of resistant Mycobacterium leprae in the community. In this study, we aimed to assess drug resistance prevalence and patterns amongst leprosy patients at a tertiary care referral hospital in India. Methods: Mutations in drug resistance determining regions for dapsone, rifampicin, and ofloxacin of the M. leprae genome in DNA extracted from skin biopsies of 136 leprosy patients (treatment-naive = 67, with persistent skin lesions = 35, with recurrence = 34) were analysed by polymerase chain reaction followed by Sanger sequencing. Wild-type strain (Thai-53) was used as a reference strain. Results: Resistance mutations were identified in a total of 23 patients, constituting 16.9% of the cohort. Within this subset of 23 cases, resistance to ofloxacin was observed in 17 individuals (12.5%), while resistance to both dapsone and rifampicin was detected in three patients each (2.2% for both). The occurrence of ofloxacin resistance showed minimal disparity between recurrent and treatment-naive cases, at 17.6% and 16.4%, respectively. Dapsone resistance emerged in two treatment-naive cases and one case with persistent skin lesions. Notably, none of the treatment-naive cases or those with recurrence/relapse exhibited rifampicin resistance. Subsequently, no statistically significant correlation was identified between other clinical variables and the presence of antimicrobial resistance. Conclusions: The occurrence of resistance to the current multidrug therapy regimen (specifically dapsone and rifampicin) and to ofloxacin, a secondary antileprosy medication in M. leprae, represents a concerning scenario. This calls for an expansion towards bactericidal drug options and the establishment of robust surveillance for drug resistance in countries burdened with high leprosy rates. Moreover, the introduction of stringent antimicrobial stewardship initiatives is imperative. As a single centre study, it represents a limited, cross-sectional view of the real situation in the field. |
| first_indexed | 2024-03-09T14:14:45Z |
| format | Article |
| id | doaj.art-6de96df2880942e78aa414c61523318c |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-03-09T14:14:45Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-6de96df2880942e78aa414c61523318c2023-11-29T04:24:32ZengElsevierJournal of Global Antimicrobial Resistance2213-71652023-12-0135262267High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimenSeema Chhabra0Tarun Narang1Smrity Sahu2Keshav Sharma3Shilpa Shilpa4Ayush Sharma5Sejal Jain6Itu Singh7Rakesh Yadav8Manjot Kaur9Rahul Sharma10Mohd Nadeem11Pragati Pandey12Ranjana W. Minz13Sunil Dogra14Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, India; Alternative corresponding authors. Department of Immunopathology, PGIMER, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India.Department of Dermatology, Venereology & Leprology, PGIMER, Sector-12, Chandigarh, India; Corresponding author. Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, IndiaDepartment of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, IndiaDepartment of Dermatology, Venereology & Leprology, PGIMER, Sector-12, Chandigarh, IndiaDepartment of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, IndiaDepartment of Dermatology, Venereology & Leprology, PGIMER, Sector-12, Chandigarh, IndiaStanley Browne Laboratory, The Leprosy Mission Community Hospital, Nand Nagari, New DelhiDepartment of Medical Microbiology, PGIMER, Sector-12, Chandigarh, IndiaDepartment of Medical Microbiology, PGIMER, Sector-12, Chandigarh, IndiaStanley Browne Laboratory, The Leprosy Mission Community Hospital, Nand Nagari, New DelhiStanley Browne Laboratory, The Leprosy Mission Community Hospital, Nand Nagari, New DelhiDepartment of Dermatology, Venereology & Leprology, PGIMER, Sector-12, Chandigarh, IndiaDepartment of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, IndiaDepartment of Dermatology, Venereology & Leprology, PGIMER, Sector-12, Chandigarh, India; Alternative corresponding authors. Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.ABSTRACT: Objectives: Drug resistance in leprosy is an emerging concern, leading to treatment failures, recurrences, and potential spread of resistant Mycobacterium leprae in the community. In this study, we aimed to assess drug resistance prevalence and patterns amongst leprosy patients at a tertiary care referral hospital in India. Methods: Mutations in drug resistance determining regions for dapsone, rifampicin, and ofloxacin of the M. leprae genome in DNA extracted from skin biopsies of 136 leprosy patients (treatment-naive = 67, with persistent skin lesions = 35, with recurrence = 34) were analysed by polymerase chain reaction followed by Sanger sequencing. Wild-type strain (Thai-53) was used as a reference strain. Results: Resistance mutations were identified in a total of 23 patients, constituting 16.9% of the cohort. Within this subset of 23 cases, resistance to ofloxacin was observed in 17 individuals (12.5%), while resistance to both dapsone and rifampicin was detected in three patients each (2.2% for both). The occurrence of ofloxacin resistance showed minimal disparity between recurrent and treatment-naive cases, at 17.6% and 16.4%, respectively. Dapsone resistance emerged in two treatment-naive cases and one case with persistent skin lesions. Notably, none of the treatment-naive cases or those with recurrence/relapse exhibited rifampicin resistance. Subsequently, no statistically significant correlation was identified between other clinical variables and the presence of antimicrobial resistance. Conclusions: The occurrence of resistance to the current multidrug therapy regimen (specifically dapsone and rifampicin) and to ofloxacin, a secondary antileprosy medication in M. leprae, represents a concerning scenario. This calls for an expansion towards bactericidal drug options and the establishment of robust surveillance for drug resistance in countries burdened with high leprosy rates. Moreover, the introduction of stringent antimicrobial stewardship initiatives is imperative. As a single centre study, it represents a limited, cross-sectional view of the real situation in the field.http://www.sciencedirect.com/science/article/pii/S2213716523001753LeprosyDrug resistanceOfloxacinNorth IndiaRelapsePersistent skin lesions |
| spellingShingle | Seema Chhabra Tarun Narang Smrity Sahu Keshav Sharma Shilpa Shilpa Ayush Sharma Sejal Jain Itu Singh Rakesh Yadav Manjot Kaur Rahul Sharma Mohd Nadeem Pragati Pandey Ranjana W. Minz Sunil Dogra High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimen Journal of Global Antimicrobial Resistance Leprosy Drug resistance Ofloxacin North India Relapse Persistent skin lesions |
| title | High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimen |
| title_full | High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimen |
| title_fullStr | High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimen |
| title_full_unstemmed | High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimen |
| title_short | High frequency of ofloxacin resistance patterns of Mycobacterium leprae from India: An indication to revisit second line anti-leprosy treatment regimen |
| title_sort | high frequency of ofloxacin resistance patterns of mycobacterium leprae from india an indication to revisit second line anti leprosy treatment regimen |
| topic | Leprosy Drug resistance Ofloxacin North India Relapse Persistent skin lesions |
| url | http://www.sciencedirect.com/science/article/pii/S2213716523001753 |
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