Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy cases
ABSTRACT: Objectives: Purulia is one of the high-endemic districts for leprosy in West Bengal (the eastern part of India). The annual new case detection rate (ANCDR) of leprosy in West Bengal is 6.04/100000 (DGHS 2019–20). Our earlier report provided evidence of secondary drug resistance in relapse...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716522001412 |
| _version_ | 1798003307422154752 |
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| author | Madhvi Ahuja Itu Singh, Dr, PhD Mallika Lavania, Dr, PhD Vinay Kumar Pathak Joydeepa Darlong, Dr, MD Ravindra P Turankar, Dr, PhD S. Hembrom, Dr Shoor Veer Singh, Dr Utpal Sengupta, Dr, PhD |
| author_facet | Madhvi Ahuja Itu Singh, Dr, PhD Mallika Lavania, Dr, PhD Vinay Kumar Pathak Joydeepa Darlong, Dr, MD Ravindra P Turankar, Dr, PhD S. Hembrom, Dr Shoor Veer Singh, Dr Utpal Sengupta, Dr, PhD |
| author_sort | Madhvi Ahuja |
| collection | DOAJ |
| description | ABSTRACT: Objectives: Purulia is one of the high-endemic districts for leprosy in West Bengal (the eastern part of India). The annual new case detection rate (ANCDR) of leprosy in West Bengal is 6.04/100000 (DGHS 2019–20). Our earlier report provided evidence of secondary drug resistance in relapse cases of leprosy. The aim of the current study was to observe primary drug resistance patterns for dapsone, rifampicin, and ofloxacin amongst new leprosy patients from Purulia, West Bengal in order to better understand the emergence of primary resistance to these drugs. Methods: In the present study, slit-skin smear samples were collected from 145 newly diagnosed leprosy cases from The Leprosy Mission (TLM) Purulia hospital between 2017 and 2018. DNA was extracted from these samples and the Mycobacterium leprae genome was analyzed for genes associated with drug resistance by polymerase chain reaction (PCR), followed by Sanger sequencing. Wild-type strain (Thai-53) and mouse footpad-derived drug-resistant strain (Z-4) were used as reference strains. Results: Of 145 cases, 25 cases showed mutations in genes associated with resistance to rifampicin, dapsone, and ofloxacin (as described by the World Health Organization, rpoB, folP, and gyrA, respectively) through Sanger sequencing. Of these 25 cases, 16 cases showed mutations in ofloxacin, two cases showed mutations in combinations of ofloxacin and rifampicin, four cases showed a mutation only in rifampicin, one case showed mutations in combinations of rifampicin and dapsone, and two cases showed mutations only in dapsone. Conclusion: Results from this study indicated the emergence of resistance to antileprosy drugs in new cases of leprosy. As ofloxacin is the alternate drug for the treatment of rifampicin-resistant cases, the emergence of new cases with resistance to ofloxacin indicates that ofloxacin-resistant M. leprae strains are actively circulating in this endemic region (i.e., Purulia, West Bengal), posing challenges for the effective treatment of rifampicin-resistant cases. |
| first_indexed | 2024-04-11T12:05:40Z |
| format | Article |
| id | doaj.art-bd45203774cc431396d3f88affc52989 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-04-11T12:05:40Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-bd45203774cc431396d3f88affc529892022-12-22T04:24:44ZengElsevierJournal of Global Antimicrobial Resistance2213-71652022-09-0130282285Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy casesMadhvi Ahuja0Itu Singh, Dr, PhD1Mallika Lavania, Dr, PhD2Vinay Kumar Pathak3Joydeepa Darlong, Dr, MD4Ravindra P Turankar, Dr, PhD5S. Hembrom, Dr6Shoor Veer Singh, Dr7Utpal Sengupta, Dr, PhD8Stanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, India; Department of Biotechnology, GLA University, Mathura, IndiaStanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, IndiaStanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, India; Enteric Viruses Group, Indian Council of Medical Research National Institute of Virology, Pune, India; Formerly at Stanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, India; Corresponding author: Enteric Viruses Group, ICMR-National Institute of Virology, Pune 411001, Maharashtra, India.Stanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, IndiaStanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, India; The Leprosy Mission Hospital, Purulia, IndiaStanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, IndiaThe Leprosy Mission Hospital, Purulia, IndiaDepartment of Biotechnology, GLA University, Mathura, IndiaStanley Browne Laboratory, The Leprosy Mission Community Hospital, New Delhi, IndiaABSTRACT: Objectives: Purulia is one of the high-endemic districts for leprosy in West Bengal (the eastern part of India). The annual new case detection rate (ANCDR) of leprosy in West Bengal is 6.04/100000 (DGHS 2019–20). Our earlier report provided evidence of secondary drug resistance in relapse cases of leprosy. The aim of the current study was to observe primary drug resistance patterns for dapsone, rifampicin, and ofloxacin amongst new leprosy patients from Purulia, West Bengal in order to better understand the emergence of primary resistance to these drugs. Methods: In the present study, slit-skin smear samples were collected from 145 newly diagnosed leprosy cases from The Leprosy Mission (TLM) Purulia hospital between 2017 and 2018. DNA was extracted from these samples and the Mycobacterium leprae genome was analyzed for genes associated with drug resistance by polymerase chain reaction (PCR), followed by Sanger sequencing. Wild-type strain (Thai-53) and mouse footpad-derived drug-resistant strain (Z-4) were used as reference strains. Results: Of 145 cases, 25 cases showed mutations in genes associated with resistance to rifampicin, dapsone, and ofloxacin (as described by the World Health Organization, rpoB, folP, and gyrA, respectively) through Sanger sequencing. Of these 25 cases, 16 cases showed mutations in ofloxacin, two cases showed mutations in combinations of ofloxacin and rifampicin, four cases showed a mutation only in rifampicin, one case showed mutations in combinations of rifampicin and dapsone, and two cases showed mutations only in dapsone. Conclusion: Results from this study indicated the emergence of resistance to antileprosy drugs in new cases of leprosy. As ofloxacin is the alternate drug for the treatment of rifampicin-resistant cases, the emergence of new cases with resistance to ofloxacin indicates that ofloxacin-resistant M. leprae strains are actively circulating in this endemic region (i.e., Purulia, West Bengal), posing challenges for the effective treatment of rifampicin-resistant cases.http://www.sciencedirect.com/science/article/pii/S2213716522001412Primary drug resistanceOfloxacin resistanceLeprosy |
| spellingShingle | Madhvi Ahuja Itu Singh, Dr, PhD Mallika Lavania, Dr, PhD Vinay Kumar Pathak Joydeepa Darlong, Dr, MD Ravindra P Turankar, Dr, PhD S. Hembrom, Dr Shoor Veer Singh, Dr Utpal Sengupta, Dr, PhD Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy cases Journal of Global Antimicrobial Resistance Primary drug resistance Ofloxacin resistance Leprosy |
| title | Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy cases |
| title_full | Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy cases |
| title_fullStr | Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy cases |
| title_full_unstemmed | Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy cases |
| title_short | Ofloxacin resistance in multibacillary new leprosy cases from Purulia, West Bengal: a threat to effective secondary line treatment for rifampicin-resistant leprosy cases |
| title_sort | ofloxacin resistance in multibacillary new leprosy cases from purulia west bengal a threat to effective secondary line treatment for rifampicin resistant leprosy cases |
| topic | Primary drug resistance Ofloxacin resistance Leprosy |
| url | http://www.sciencedirect.com/science/article/pii/S2213716522001412 |
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