| Background: Leprosy, which is caused by infection with Mycobacterium leprae(M. leprae), is a chronic infectious disease. It has always been a major health concern because it can progress to peripheral neuropathy and permanent progressive deformity. The current strategy for leprosy control is based on the multidrug therapy(MDT),recommended by the World Health Organization in 1982. Combination therapy with dapsone, rifampicin, and clofazimine is recommended for the treatment of multibacillary leprosy, whereas therapy with dapsone and rifampicin is for the paucibacillary leprosy. In addition, ofloxacin is a key drug in the treatment of single-lesion leprosy cases and drug-resistant cases. Drug resistance for dapsone, rifampin, ofloxacin has been reported since 1964. There have been an increasing number of reports about the M. leprae strains resistant to multiple drugs. Previous studies of drug resistance demonstrated that mutations in the drug resistance determining region(DRDR) in the Folp1, RpoB and GyrA genes were responsible for resistance to dapsone, rifampicin, and ofloxacin, respectively. Recent extensive studies of drug-resistant M. leprae strains showed that the frequency of drug resistance to the three antibiotics varied among countries.Objective: 1. To detecte the mutation of drug resistance in M. leprae isolates from leprosy patients in Shandong Province; 2. To determine the prevalence of the three gene mutations in Shandong.methods:weobtainedfromleprosypatientsinshandongprovinceofchina.dnawasextractedfromskinbiopsy,andweperformedpcramplificationofthethreegenesofm.leprae.thenthepcrproductswerepurifiedandsequenced.results:onemutationwasfoundin67folp1samples.fiveisolatesshowedthemutationsintherpobgeneofm.leprae.themutationratesoffolp1andrpobwere1/67(1.5%)and5/57(8.8%),respectively.inaddition,threemutidrug-resistantsampleswereobservedinthestudy,oneshowingmutationsinthefolp1 andrpobgene,andtheothertwoshowingintherpobandgyragene.conclusion:ourstudyindicatedthelowrateofresistancetodapsoneandtheprimaryresistancetosingle-drugormultiple-drugsamongnewleprosycases.further,wealsoreportedfirstcasesofm.lepraeresistanttomultidrugfromnewcasesinchina. |
