Autochthonous leprosy in Europe: a case report and literature review

Beauvillain, Quentin; Lok, C.; Joachim, Camille; Hamdad, Farida; Lafabregue, E.; Attencourt, Christophe; Sevestre, Henri; Chaby, G.

doi:10.1016/j.ijid.2021.07.023

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…During the treatment process with MDT, the resistance rate for RIF, DDS, and OFL combination was 10.18% (95% CI: 7.85 to 12.51), while the single resistance rates were 4.40% (95% CI: 3.02–5.77), 2.00% (95% CI: 2.48–5.06), and 1.73% (95% CI: 0.99–3.00), respectively. The results are similar to the previous studies [ 43 , 44 ]. For instance, in a large cohort study of leprosy established by several national sentinel testing centers, 8.0% of the strains had varying degrees of resistance (RIF: 3.8%, DDS: 4.5%, OFL: 1.10%, MDR: 1.24%).…”

Section: Discussionsupporting

confidence: 93%

Drug Resistance (Dapsone, Rifampicin, Ofloxacin) and Resistance-Related Gene Mutation Features in Leprosy Patients: A Systematic Review and Meta-Analysis

Li,

Yang

et al. 2022

IJMS

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Dapsone (DDS), Rifampicin (RIF) and Ofloxacin (OFL) are drugs recommended by the World Health Organization (WHO) for the treatment of leprosy. In the context of leprosy, resistance to these drugs occurs mainly due to mutations in the target genes (Folp1, RpoB and GyrA). It is important to monitor antimicrobial resistance in patients with leprosy. Therefore, we performed a meta-analysis of drug resistance in Mycobacterium leprae and the mutational profile of the target genes. In this paper, we limited the study period to May 2022 and searched PubMed, Web of Science (WOS), Scopus, and Embase databases for identified studies. Two independent reviewers extracted the study data. Mutation and drug-resistance rates were estimated in Stata 16.0. The results demonstrated that the drug-resistance rate was 10.18% (95% CI: 7.85–12.51). Subgroup analysis showed the highest resistance rate was in the Western Pacific region (17.05%, 95% CI:1.80 to 13.78), and it was higher after 2009 than before [(11.39%, 7.46–15.33) vs. 6.59% (3.66–9.53)]. We can conclude that the rate among new cases (7.25%, 95% CI: 4.65–9.84) was lower than the relapsed (14.26%, 95 CI%: 9.82–18.71). Mutation rates of Folp1, RpoB and GyrA were 4.40% (95% CI: 3.02–5.77), 3.66% (95% CI: 2.41–4.90) and 1.28% (95% CI: 0.87–1.71) respectively, while the rate for polygenes mutation was 1.73% (0.83–2.63). For further analysis, we used 368 drug-resistant strains as research subjects and found that codons (Ser, Pro, Ala) on RpoB, Folp1 and GyrA are the most common mutation sites in the determining region (DRDR). In addition, the most common substitution patterns of Folp1, RpoB, and GyrA are Pro→Leu, Ser→Leu, and Ala→Val. This study found that a higher proportion of patients has developed resistance to these drugs, and the rate has increased since 2009, which continue to pose a challenge to clinicians. In addition, the amino acid alterations in the sequence of the DRDR regions and the substitution patterns mentioned in the study also provide new ideas for clinical treatment options.

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Section: Discussionsupporting

confidence: 93%

Drug Resistance (Dapsone, Rifampicin, Ofloxacin) and Resistance-Related Gene Mutation Features in Leprosy Patients: A Systematic Review and Meta-Analysis

Li,

Yang

et al. 2022

IJMS

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“…This shows that when the duration from infection to onset is long, it becomes more challenging to trace the point or source of transmission. This is corroborated by recent reports of autochthonous cases in Europe and the Americas ( Beauvillain et al, 2021 ; Naidu et al, 2021 ; Rendini and Levis, 2017 ). In contrast, earlier studies report that being a family contact of a patient plays an increasingly important role in disease transmission when closer to elimination ( Koba et al, 2009 ).…”

Section: Discussionsupporting

confidence: 85%

Hansen's disease (leprosy) in Japan, 1947-2020: an epidemiologic study during the declining phase to elimination

Yotsu

Miyamoto²,

Mori³

et al. 2022

International Journal of Infectious Diseases

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“…In 2020, 127,396 new cases of leprosy were reported in 127 countries, including 74% in India, Brazil, and Indonesia [ 4 ]. Leprosy in Europe has become rare as of the second half of the 20th century, and the most recent cases were primarily imported from endemic regions [ 5 , 6 ]. Up to the 1980s, Italy only had autochthonous leprosy cases in distinct, endemic areas (Northern Tuscany, Eastern Sicily, Calabria, Puglia, and Liguria) [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Leprosy in an Adopted Woman Diagnosed by Molecular Tools: A Case Report from a Non-Endemic Area

et al. 2023

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Coupled with its rarity in non-endemic areas, the clinical heterogeneity of leprosy makes diagnosis very challenging. We report a diagnosis of multibacillary leprosy in a 22-year-old Indian woman, adopted at the age of 10 and living in Italy. The patient presented with painful skin lesions on the face, trunk, and lower and upper extremities, associated with dysesthesia and a motor deficit in her left leg following corticosteroid therapy interruption. Histopathology results from the skin lesions suggested leprosy, but no acid-fast bacilli were identified. Molecular biology in a center specializing in tropical diseases confirmed the diagnosis, allowing prompt and adequate treatment. Genotype analysis allowed the identification of a genotype 1D of M. leprae, facilitating the epidemiological investigation of the plausible infection origin. No resistances to rifampicin, dapsone, or ofloxacin were detected. Leprosy will continue to exist in high-income nations, and the incidence may rise over time due to increasing migration and globalization. CARE guidelines were followed.

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Autochthonous leprosy in Europe: a case report and literature review

Cited by 5 publications

References 15 publications

Drug Resistance (Dapsone, Rifampicin, Ofloxacin) and Resistance-Related Gene Mutation Features in Leprosy Patients: A Systematic Review and Meta-Analysis

Drug Resistance (Dapsone, Rifampicin, Ofloxacin) and Resistance-Related Gene Mutation Features in Leprosy Patients: A Systematic Review and Meta-Analysis

Hansen's disease (leprosy) in Japan, 1947-2020: an epidemiologic study during the declining phase to elimination

Leprosy in an Adopted Woman Diagnosed by Molecular Tools: A Case Report from a Non-Endemic Area

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