ArticlePLoS neglected tropical diseases2017
Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases.
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 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Systematic Review of Survival Analysis in Leprosy Studies-Including the Following Outcomes: Relapse, Impairment of Nerve Function, Reactions and Physical Disability.International journal of environmental research and public health · 2022Pooled it
- Dynamics of Th1/Th17 responses and antimicrobial pathways in leprosy skin lesions.The Journal of clinical investigation · 2025Article
- Leprosy.Nature reviews. Disease primers · 2024Review
- Nanopore sequencing for smear-negative pulmonary tuberculosis-a multicentre prospective study in China.Annals of clinical microbiology and antimicrobials · 2024Article
- Genetic diversity of Mycobacterium leprae: Need to move towards genome-wide approaches.The Indian journal of medical research · 2024Review
- Shared challenges to the control of complex intracellular neglected pathogens.Frontiers in public health · 2024Review
- Diagnostic value of a nanopore sequencing assay of bronchoalveolar lavage fluid in pulmonary tuberculosis.BMC pulmonary medicine · 2023Article
- Modern Solutions for Ancient Pathogens: Direct Pathogen Sequencing for Diagnosis of Lepromatous Leprosy and Cerebral Coenurosis.Open forum infectious diseases · 2022Article
- Mycobacterium leprae induces Schwann cell proliferation and migration in a denervated milieu following intracutaneous excision axotomy in nine-banded armadillos.Experimental neurology · 2022Article
- Rapid Diagnosis ofFrontiers in medicine · 2022Article
- Low risk of relapse and deformity among leprosy patients who completed multi-drug therapy regimen from 2005 to 2010: A cohort study from four districts in South India.PLoS neglected tropical diseases · 2021Article
- Treatment and Evaluation Advances in Leprosy Neuropathy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
- Leprosy in wild chimpanzees.Nature · 2021Article
- Low rate of relapse after twelve-dose multidrug therapy for hansen's disease: A 20-year cohort study in a brazilian reference center.PLoS neglected tropical diseases · 2021Observational
- Common Adaptive Strategies Underlie Within-Host Evolution of Bacterial Pathogens.Molecular biology and evolution · 2021Article
- Relapse in leprosy and drug resistance assessment in a tertiary hospital of the state of Espírito Santo, Brazil.Revista da Sociedade Brasileira de Medicina Tropical · 2021Observational
- Evolutionary history ofPhilosophical transactions of the Royal Society of London. Series B, Biological sciences · 2020Article
- Multi-omic detection ofPhilosophical transactions of the Royal Society of London. Series B, Biological sciences · 2020Article
- Underlying mechanisms of leprosy recurrence in the Western Amazon: a retrospective cohort study.BMC infectious diseases · 2019Article
- Report of a Leprosy case in Singapore: an age-old disease not to be forgotten in developed countries with low-prevalence settings.Access microbiology · 2019Article
Corrections and comments
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Authors and funding
23 authors at 10 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monitor recurrent cases for drug resistance and to distinguish between relapse and reinfection as a means of assessing therapeutic efficacy. All three objectives can be reached with single nucleotide resolution using next generation sequencing and bioinformatics analysis of Mycobacterium leprae DNA present in human skin. METHODOLOGY: DNA was isolated by means of optimized extraction and enrichment methods from samples from three recurrent cases in leprosy patients participating in an open-label, randomized, controlled clinical trial of uniform MDT in Brazil (U-MDT/CT-BR). Genome-wide sequencing of M. leprae was performed and the resultant sequence assemblies analyzed in silico. PRINCIPAL
findingsIn all three cases, no mutations responsible for resistance to rifampicin, dapsone and ofloxacin were found, thus eliminating drug resistance as a possible cause of disease recurrence. However, sequence differences were detected between the strains from the first and second disease episodes in all three patients. In one case, clear evidence was obtained for reinfection with an unrelated strain whereas in the other two cases, relapse appeared more probable. CONCLUSIONS/SIGNIFICANCE: This is the first report of using M. leprae whole genome sequencing to reveal that treated and cured leprosy patients who remain in endemic areas can be reinfected by another strain. Next generation sequencing can be applied reliably to M. leprae DNA extracted from biopsies to discriminate between cases of relapse and reinfection, thereby providing a powerful tool for evaluating different outcomes of therapeutic regimens and for following disease transmission.
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