Late Onset of the Serological Response against the 18 kDa Small Heat Shock Protein of Mycobacterium ulcerans in Children

Röltgen, Katharina; Bratschi, Martin W.; Ross, Amanda; Aboagye, Samuel Yaw; Ampah, Kobina Assan; Bolz, Miriam; Andreoli, Arianna; Pritchard, James; Minyem, Jacques C.; Noumen, Djeunga; Koka, Eric; Boock, Alphonse Um; Yeboah-Manu, Dorothy; Pluschke, Gerd

doi:10.1371/journal.pntd.0002904

Cited by 32 publications

(37 citation statements)

References 21 publications

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“…All of the studied communities along the Offin River basin were designated endemic; the communities included Ntobroso and Achiase in the Atwima district, upstream and midstream of the river, respectively, and Mfantsiman in the Upper Denkyira district, downstream of the river. Extensive seroepidemiological studies (34)(35)(36) conducted in these communities indicated high levels of serological evidence of exposure of community members to M. ulcerans 18-kDa small heat shock protein (hsp) (33), irrespective of the disease burden.…”

Section: Methodsmentioning

confidence: 99%

Isolation of Nontuberculous Mycobacteria from the Environment of Ghanian Communities Where Buruli Ulcer Is Endemic

Aboagye

Ampah

Nakobu

et al. 2016

Appl Environ Microbiol

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This study aimed to isolate nontuberculous mycobacterial species from environmental samples obtained from some selected communities in Ghana. To optimize decontamination, spiked environmental samples were used to evaluate four decontamination solutions and supplemented media, after which the best decontamination solution and media were used for the actual analysis. The isolates obtained were identified on the basis of specific genetic sequences, including heat shock protein 65, IS2404, IS2606, rpoB, and the ketoreductase gene, as needed. Among the methods evaluated, decontamination with 1 M NaOH followed by 5% oxalic acid gave the highest rate of recovery of mycobacteria (50.0%) and the lowest rate of contamination (15.6%). The cultivation medium that supported the highest rate of recovery of mycobacteria was polymyxin B-amphotericin B-nalidixic acidtrimethoprim-azlocillin-supplemented medium (34.4%), followed by isoniazid-supplemented medium (28.1%). Among the 139 samples cultivated in the main analysis, 58 (41.7%) yielded mycobacterial growth, 70 (50.4%) had no growth, and 11 (7.9%) had all inoculated tubes contaminated. A total of 25 different mycobacterial species were identified. Fifteen species (60%) were slowly growing (e.g., Mycobacterium ulcerans, Mycobacterium avium, Mycobacterium mantenii, and Mycobacterium malmoense), and 10 (40%) were rapidly growing (e.g., Mycobacterium chelonae, Mycobacterium fortuitum, and Mycobacterium abscessus). The occurrence of mycobacterial species in the various environmental samples analyzed was as follows: soil, 16 species (43.2%); vegetation, 14 species (38.0%); water, 3 species (8.0%); moss, 2 species (5.4%); snail, 1 species (2.7%); fungi, 1 species (2.7%). This study is the first to report on the isolation of M. ulcerans and other medically relevant nontuberculous mycobacteria from different environmental sources in Ghana. IMPORTANCEDiseases caused by mycobacterial species other than those that cause tuberculosis and leprosy are increasing. Control is difficult because the current understanding of how the organisms are spread and where they live in the environment is limited, although this information is needed to design preventive measures. Growing these organisms from the environment is also difficult, because the culture medium becomes overgrown with other bacteria that also live in the environment, such as in soil and water. We aimed to improve the methods for growing these organisms from environmental sources, such as soil and water samples, for better understanding of important mycobacterial ecology.

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Section: Methodsmentioning

confidence: 99%

Isolation of Nontuberculous Mycobacteria from the Environment of Ghanian Communities Where Buruli Ulcer Is Endemic

Aboagye

Ampah

Nakobu

et al. 2016

Appl Environ Microbiol

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“…In that vein, findings from our seroepidemiological studies, where we determined antibody titers against the 18-kDa-small heat shock protein of M. ulcerans in healthy individuals living in BU endemic areas of Cameroon and Ghana, suggested that children below the age of 5 years are considerably less exposed to the pathogen than older children. This indicates that exposure to M. ulcerans and thus infection with the pathogen might occur outside of the relatively small movement range of very young children and increases in older children with more direct environmental contacts further away from their homes [59]. Hence, in African, BU endemic settings infection through vectors commonly present in the limited movement radius of young children appears unlikely.…”

Section: Potential Vectorsmentioning

confidence: 99%

“…Another intriguing aspect of these seroepidemiological investigations in BU endemic regions is that exposure to M. ulcerans in many cases seems to lead to nonsymptomatic infections [59,60]. Factors accounting for this diverse outcome of infection may be manifold, as observed also for other mycobacterial diseases such as tuberculosis and leprosy.…”

Section: Potential Vectorsmentioning

confidence: 99%

Mycobacterium ulcerans Disease (Buruli Ulcer): Potential Reservoirs and Vectors

Röltgen

Pluschke

2015

Curr Clin Micro Rpt

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Mycobacterium ulcerans is an emerging pathogen causing the skin infection Buruli ulcer (BU), one of the most neglected tropical diseases. BU is characterized by the formation of chronic, necrotizing skin lesions. This pathology is mainly attributed to the cytotoxic and immunosuppressive activities of the unique polyketide-derived macrolide toxin mycolactone secreted by the pathogen. The disease has been reported from more than 30 countries worldwide, with an extremely focal geographic distribution within endemic countries and highest incidences in remote communities of West/ Central Africa and also certain coastal areas of Australia. While M. ulcerans has long been considered an environmental bacterium, recent findings from southeastern Australia, identifying possums as probable reservoirs of infection, indicate its zoonotic potential. The exact route of M. ulcerans transmission is unclear, although it is commonly assumed that infection takes place either through physical contact with environmental reservoirs via skin abrasions or through insect bites, while direct human-to-human transmission seems to be rare.

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“…90 In line with this observation, sero-epidemiological studies in Ghana and Cameroon have indicated that children below 5 years of age are considerably less exposed to M. ulcerans than older children. 91 Infection by M. ulcerans might thus occur outside the relatively small movement range of very young children. Exposure and the associated risk of developing BU disease appears to increase at an age when the children are having more intense environmental contacts, including direct exposure to water bodies peripheral to their homes.…”

Section: Age and Sexmentioning

confidence: 99%

“…Seroepidemiological studies in Ghana and Cameroon have shown that children are much earlier exposed to malaria parasites than to M. ulcerans, indicating that an involvement of insect vectors commonly found close to the households is highly unlikely. 91 Results of other studies have been compiled in a conceptual model, where M. ulcerans, present in the aquatic environment such as in detritus, mud, or plant biofilms, is concentrated by water-filtering organisms 70,113 and subsequently passed on to predatory aquatic vertebrates and invertebrates feeding on this prey. Infection from potential environmental reservoirs may take place via puncture wounds or lacerations after contact with concentrated M. ulcerans sources or via invertebrate vectors, such as aquatic insects.…”

Section: Hypotheses On the Mode(s) Of M Ulcerans Transmissionmentioning

confidence: 99%

Epidemiology and disease burden of Buruli ulcer: a review

Röltgen¹,

Pluschke

2015

RRTM

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Buruli ulcer (BU) is a neglected tropical skin disease caused by Mycobacterium ulcerans. Infection foci occur mainly in remote, rural areas of Central and West Africa, but also in Australia and Papua New Guinea. In addition, infections caused by M. ulcerans strains of a different lineage are sporadically reported from scattered foci in Asia and the Americas. While in the past decade more than 42,000 BU cases have been reported worldwide, an assessment of the actual global disease burden is complicated by the remoteness of affected populations and a lack of data on the incidence of BU in a number of countries, from which cases have been historically reported. Moreover, as BU patients present with diverse clinical manifestations ranging from relatively unspecific nodules, plaques, or edema to necrotic, ulcerative lesions, differential diagnosis is manifold and thus clinical misclassification may occur. Since to date reservoirs and transmission pathways of M. ulcerans remain equivocal, early diagnosis and treatment of patients are key determinants to control the disease. Particularly in view of the apparent decline in BU incidence in regions of West Africa, awareness and knowledge of BU in endemic regions must be retained to ensure a continuous monitoring and control. An integrated approach for the control of tropical skin diseases should be considered to cope with this difficult task. This review article aims at providing an overview of the current global burden of BU and summarizes the state of knowledge on the various epidemiological aspects of this enigmatic disease.

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Late Onset of the Serological Response against the 18 kDa Small Heat Shock Protein of Mycobacterium ulcerans in Children

Cited by 32 publications

References 21 publications

Isolation of Nontuberculous Mycobacteria from the Environment of Ghanian Communities Where Buruli Ulcer Is Endemic

Isolation of Nontuberculous Mycobacteria from the Environment of Ghanian Communities Where Buruli Ulcer Is Endemic

Mycobacterium ulcerans Disease (Buruli Ulcer): Potential Reservoirs and Vectors

Epidemiology and disease burden of Buruli ulcer: a review

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