[Contribution of gene amplification in Mycobacterium ulcerans detection in exudates and cutaneous biopsies in Côte...

Mycobacterium ulcerans skin ulceration is a major issue of public health in Côte d'Ivoire. The diagnosis of M. ulcerans infection is hampered by the slow growth of the bacterium in culture, implying a delay of several weeks before a specific diagnosis can be obtained. In Côte d'Ivoire the diagnosis of Buruli ulcer is almost based on clinical features. During the last decade, many studies have demonstrated the extremely high capacity of PCR for rapidly and specifically detecting bacteria and genes of interest. That ability has revealed PCR as a powerful tool in clinical microbiology studies. In this study we evaluated the M. ulcerans detection in specimens of exudates and biopsies collected from patients clinically suspected of Buruli ulcer and treated in "Raoul Follereau" centre of Manikro in the North-central region of Côte d'Ivoire. The microscopic research of BAAR in 185 swabs loaded with skin lesions collected from these patients showed a positive rate of 14.6%. The PCR detection in 48 h or 72 h of the M. ulcerans IS2404 and IS2606 in the swabs and in the 26 biopsies, from these patients, showed positive rates of 15.7% and 84.6% respectively and in the same samples. These results obtained with PCR detection of M. ulcerans insertions sequences suggest that this technique performed with exudates and biopsy can be used to confirm a routine specific diagnosis of M. ulcerans and early screening of Buruli ulcer in Côte d'Ivoire.