Drug resistance in leprosy: An update following 70 years of chemotherapy - 30/07/22
Highlights |
• | Antimicrobial resistance is found in Mycobacterium leprae, causative agent of leprosy. |
• | History of chemotherapy can explain the current rate of drug resistance. |
• | Molecular methods are the standard methods to detect drug resistance in leprosy. |
• | Signs of positive selection in new genes are reported. |
• | New drugs are under investigation to overcome resistance. |
Abstract |
Leprosy is one of the oldest infectious diseases, reported for more than 2000years. Leprosy elimination goal as a public health problem set by the World Health Organization, aiming for a global prevalence rate<1 patient in a population of 10,000, was achieved in 2000 mainly thanks to the worldwide use of leprosy drugs starting in the 1980s and their access at no cost for patients since 1995. However, around 200,000 new cases are still reported each year, particularly in India, Brazil, and Indonesia. As with other bacteria of medical interest, antimicrobial resistance is observed in Mycobacterium leprae strains in several parts of the world, despite multidrug therapy being the recommended standard leprosy treatment to avoid resistance selection since 1982. Therefore, identifying and monitoring resistance is necessary. We provide an overview of the historical facts that led to the current drug resistance situation, the antibiotics effective against M. leprae, their mechanisms of action and resistance, and resistance detection methods. We also discuss therapeutic management of the resistant cases, new genes with potential roles in drug resistance and bacterial adaptation, new drugs under investigation, and the risk for resistance selection with the chemoprophylaxis measures.
Le texte complet de cet article est disponible en PDF.Keywords : Drug resistance, Leprosy, Mycobacterium leprae, Chemotherapy, Molecular biology
Plan
Vol 52 - N° 5
P. 243-251 - août 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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