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Molecular Detection of Dapsone and Rifampicin Resistance on Mycobacterium leprae from Leprosy Patients in East Java DINAR ADRIATY; RATNA WAHYUNI; CITA ROSITA S. PRAKOESWA; NI PUTU SUSARI; INDROPO AGUSNI; SHINZO IZUMI
Microbiology Indonesia Vol. 3 No. 3 (2009): December 2009
Publisher : Indonesian Society for microbiology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (11.892 KB) | DOI: 10.5454/mi.3.3.4

Abstract

The drug resistant problem of Mycobacterium leprae has been developing since the last decade and this has become a leprosy elimination problem in several countries, including Indonesia. Using biological on molecular methods, it is now possible to test for drug resistant cases in relatively simple and less time consuming ways. The purpose of the study is to analyze theprevalence of drug resistance M. leprae to dapsone and rifampicin in East Java based on the etection of mutations in the folP and rpoB genes. All samples were obtained from multibacillary leprosy patients in East Java, who have admitted to the Dr Sutomo Hospital Surabaya in 2003-2005. Isolates were analyzed by PCR, and the presence of nucleotide sequence of the folP and rpoB genes from M. leprae were confirmed by direct sequencing. Of 94 specimens which were collected, all were analyzed for their folP and rpoB genome. From 94 isolates, 70 showed a positive result by the folP1-folPR test and 77 out of 94 isolates showed positive by the rpoBF-rpoBR test. From 70 isolates for folP gene examination, there were 3 isolates which had mutation in the amino acid at codon 53; 2 cases Threonin (ACC) became Alanin (GCC) and 1 case Threonin (ACC) became Arginin (AGA). These mutations are responsible to dapsone resistance. For the rpoB gene, no mutation was found. The result suggested that 3 isolates (4.3%), 1 from a new case and 2 from relapse cases in this experiment, were resistant to dapsone and all isolates (100%) were susceptible to rifampicin.
Histoid Leprosy Umi Rinasari; Sawitri Sawitri; M. Yulianto Listiawan; Cita Rosita Prakoeswa; Indropo Agusni; Rachmat Santoso; Shinzo Izumi
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 1 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (210.114 KB) | DOI: 10.20473/ijtid.v1i1.3719

Abstract

Histoid Leprosy is a variant of lepromatous leprosy with characteristic clinical and histopathological features. Usually it is occured in lepromatous patients who relaps after dapsone monotherapy, in those with dapsone resistance , sometimes even after multidrug treatment, or at times, de novo with characteristic clinical and histopathological features. A 36 years old male, originated from Papua, visited to the skin outpatient clinic with translucent shiny nodules on the left elbow and thumb for the last 18 months. The nodules were multiple, painless and firm. There were nasal congestion, tickening of ear lobes and loss of eye brows. Patient did not have any history of previous antileprotic treatment. Routine blood examination was normal. Bacteriological examination of slit skin smear revealed acid-fast bacilli of Bacterial Index 4+ and Morfologic Index 10%. Histopathology of skin suggested lepromatous leprosy of histoid type with characteristic interlacing bundles of spindle shaped cells. Anti-PGL1 antibody (ELISA) revealed high titer of IgM (>5.300 u/ml) and also IgG anti PGL-1 (>5.300 u/ml). Polymerase chain reaction examination test to detect M.leprae was positive and direct sequencing of M.leprae isolate shows no mutation, which means no resistancy to MDT treatment. Treatment with MDTWHO regiment give clinical improvements and the histoid lesions disappered after 3 months treatment.The histoid form of leprosy in this case developed without any prior treatment of anti leprotic drugs ( de novo ). Some theoretical aspects of the patho-mechanism of histoid leprosy are discussed.
TTC Repeats Variation of Mycobacterium leprae Isolates for Analysis of Leprosy Transmission in Leprosy Endemic Area in East Java, INDONESIA Dinar Adriaty; Ratna Wahyuni; Iswahyudi Iswahyudi; Indropo Agusni; Shinzo Izumi
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 1 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1494.939 KB) | DOI: 10.20473/ijtid.v1i1.3722

Abstract

East Java province still has some pocket of leprosy endemic areas. In order to solve the problem, molecular typing will make it feasible to study the transmission pattern of Mycobacterium leprae in leprosy endemic area. The present study is to analyze the presence of M.leprae DNA in the environment and to study variation number of TTC repeats and their distribution. Poteran Island is located in Madura, East Java and was chosen because this island has a high prevalence of leprosy and remains stable for the last five years. All samples were analyzed by PCR and the numbers of TTC repeats were confirmed by direct sequencing. Of all collected samples, 26.4% isolates of water resources (24); 61.9% nasal swabs (26); and 35.3% skin tissues (24) are positives. No statistically difference in the pattern distribution of TTC repeats between skin tissues of patients and nasal swab of households contact (p=0.594); also distribution of TTC repeats between skin tissues of leprosy patients and those of water resources (p=0.441); and distribution of TTC repeats between nasal swab of households contact with water resources (p=0.906). It means that the transmission of M.leprae in leprosy endemic area has closely related in 3 aspects: agent, host & environment.