Evidence map›Paper›PMID 28570560›Full record

ArticlePLoS neglected tropical diseases2017

qPCR-High resolution melt analysis for drug susceptibility testing of Mycobacterium leprae directly from clinical specimens of leprosy patients.

Sergio Araujo, Luiz Ricardo Goulart, Richard W Truman, Isabela Maria B Goulart, Varalakshmi Vissa, Wei Li, Masanori Matsuoka, Philip Suffys, Amanda B Fontes, Patricia S Rosa and 2 more

Abstract readEvaluation Study
In one paragraph

Article in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Decoding leprosy: immune response, clinical manifestations and emerging diagnostic approaches.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2025
    Review
  4. Unraveling Drug Resistance inInternational journal of microbiology · 2025
    Review
  5. Article
  6. Frontiers in microbiology · 2021
    Review
  7. Case Report: Multidrug-ResistantThe American journal of tropical medicine and hygiene · 2020
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sergio AraujoNational Reference Center for Sanitary Dermatology and Leprosy, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.ORCID http://orcid.org/0000-0001-8666-4948
Luiz Ricardo GoulartNational Reference Center for Sanitary Dermatology and Leprosy, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
Richard W TrumanDivision National Hansen's Disease Programs (NHDP), Healthcare Systems Bureau (HSB), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (DHHS), Baton Rouge, Louisiana, United States of America.
Isabela Maria B GoulartNational Reference Center for Sanitary Dermatology and Leprosy, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
Varalakshmi VissaGood Samaritan Society, Fort Collins, Colorado, United States of America.
Wei LiDepartment of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America.
Masanori MatsuokaLeprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
Philip SuffysFundação Oswaldo Cruz, Laboratory of Molecular Biology applied to Mycobacteria, Rio de Janeiro, Rio de Janeiro, Brazil.
Amanda B FontesFundação Oswaldo Cruz, Laboratory of Molecular Biology applied to Mycobacteria, Rio de Janeiro, Rio de Janeiro, Brazil.
Patricia S RosaInstituto Lauro de Souza Lima, Department of Biology, Bauru, São Paulo, Brazil.
David M ScollardDivision National Hansen's Disease Programs (NHDP), Healthcare Systems Bureau (HSB), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (DHHS), Baton Rouge, Louisiana, United States of America.
Diana L WilliamsDivision National Hansen's Disease Programs (NHDP), Healthcare Systems Bureau (HSB), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (DHHS), Baton Rouge, Louisiana, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReal-Time PCR-High Resolution Melting (qPCR-HRM) analysis has been recently described for rapid drug susceptibility testing (DST) of Mycobacterium leprae. The purpose of the current study was to further evaluate the validity, reliability, and accuracy of this assay for M. leprae DST in clinical specimens. METHODOLOGY/PRINCIPAL

findingsThe specificity and sensitivity for determining the presence and susceptibility of M. leprae to dapsone based on the folP1 drug resistance determining region (DRDR), rifampin (rpoB DRDR) and ofloxacin (gyrA DRDR) was evaluated using 211 clinical specimens from leprosy patients, including 156 multibacillary (MB) and 55 paucibacillary (PB) cases. When comparing the results of qPCR-HRM DST and PCR/direct DNA sequencing, 100% concordance was obtained. The effects of in-house phenol/chloroform extraction versus column-based DNA purification protocols, and that of storage and fixation protocols of specimens for qPCR-HRM DST, were also evaluated. qPCR-HRM results for all DRDR gene assays (folP1, rpoB, and gyrA) were obtained from both MB (154/156; 98.7%) and PB (35/55; 63.3%) patients. All PCR negative specimens were from patients with low numbers of bacilli enumerated by an M. leprae-specific qPCR. We observed that frozen and formalin-fixed paraffin embedded (FFPE) tissues or archival Fite's stained slides were suitable for HRM analysis. Among 20 mycobacterial and other skin bacterial species tested, only M. lepromatosis, highly related to M. leprae, generated amplicons in the qPCR-HRM DST assay for folP1 and rpoB DRDR targets. Both DNA purification protocols tested were efficient in recovering DNA suitable for HRM analysis. However, 3% of clinical specimens purified using the phenol/chloroform DNA purification protocol gave false drug resistant data. DNA obtained from freshly frozen (n = 172), formalin-fixed paraffin embedded (FFPE) tissues (n = 36) or archival Fite's stained slides (n = 3) were suitable for qPCR-HRM DST analysis. The HRM-based assay was also able to identify mixed infections of susceptible and resistant M. leprae. However, to avoid false positives we recommend that clinical specimens be tested for the presence of the M. leprae using the qPCR-RLEP assay prior to being tested in the qPCR-HRM DST and that all specimens demonstrating drug resistant profiles in this assay be subjected to DNA sequencing. CONCLUSION/SIGNIFICANCE: Taken together these results further demonstrate the utility of qPCR-HRM DST as an inexpensive screening tool for large-scale drug resistance surveillance in leprosy.

Indexed as

Bacterial ProteinsDapsoneDNA, BacterialDrug Resistance, BacterialHumansLeprostatic AgentsLeprosyMicrobial Sensitivity TestsMycobacterium lepraeOfloxacinReal-Time Polymerase Chain ReactionReproducibility of ResultsRifampinSensitivity and SpecificitySequence Analysis, DNASkinBacterial ProteinsDapsoneDNA, BacterialLeprostatic AgentsOfloxacinRifampin

Identifiers

PMID28570560
PMCPMC5453413

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.