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Dihydropteroate synthase mutations in the folP1 gene predict dapsone resistance in relapsed cases of leprosy

Emmanuelle Cambau1, Laetitia Carthagena, Aurélie Chauffour

  • 1Laboratoire de Bacteriologie-Hygiene, Centre National de Reference pour la Resistance des Mycobacteries aux Antituberculeux, Faculte de Medecine Pitie-Salpetriere, Universite Paris, Paris, France.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 16, 2005
PubMed

Insights

Molecular detection identified mutations in the folP1 gene linked to dapsone resistance in Mycobacterium leprae. This finding suggests fluoroquinolones as an alternative treatment for dapsone-resistant leprosy.

Area of Science:

  • Microbiology
  • Genetics
  • Pharmacology

Background:

  • Dapsone is a primary treatment for leprosy.
  • Emerging dapsone resistance in Mycobacterium leprae poses a treatment challenge.
  • Accurate detection of resistance is crucial for effective therapy.

Purpose of the Study:

  • To compare molecular detection with the mouse footpad test for identifying dapsone resistance in Mycobacterium leprae.
  • To investigate the association between folP1 gene mutations and dapsone resistance levels.

Main Methods:

  • Tested 38 Mycobacterium leprae strains using both molecular detection and mouse footpad inoculation.
  • Analyzed mutations in the folP1 gene at codons 53 and 55.

Main Results:

  • folP1 gene mutations were detected in strains with high, intermediate, and low-level dapsone resistance.
  • No folP1 mutations were found in dapsone-susceptible strains.
  • Molecular detection correlated with resistance levels.

Conclusions:

  • Molecular detection of folP1 mutations is a reliable method for identifying dapsone resistance in Mycobacterium leprae.
  • The presence of folP1 mutations indicates potential treatment failure with dapsone.
  • Fluoroquinolones may be a suitable alternative therapy for infections with dapsone-resistant Mycobacterium leprae strains carrying folP1 mutations.

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