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Streptococcus dysgalactiae subsp.-equisimilis as an emerging secondary pathogen in leprosy foot ulcers
Kumar Ebineshan1, Michael Sukumar Pallapati1, Aparna Srikantam2
1Department of Microbiology, LEPRA - Society, Blue Peter Public Health and Research Center, Hyderabad, India.
Background And Objectives:
Leprosy foot ulcers (LFU) tend to become chronic due to secondary bacterial infections, leading to subsequent disfigurement and disability. Treatment modality for infected plantar ulcers thus so far is majorly based on conventional approach of empirical antibacterial therapy. However, this approach tends to overlook unconventional pathogens which are likely to be present in the LFU.
Materials And Methods:
Twenty-six leprosy patients (17 males and 9 females) who had completed multidrug therapy (MDT) and those are suffering from foot ulcer were included. Using sterile cotton swabs, two wound swabs were collected, of these; one for bacterial culture and another for NGS (Next Generation Sequencing).
Results:
Out of 26 samples tested on conventional bacterial culture, Streptococcus spp. (50%) was predominant organism. On NGS, 09/26 (34.61%) showed Streptococcus-dysgalactiae-subsp.-equisimilis-GGS 12 as the most abundant single organism, along with some unknown and unclassified organisms; 03/26 (11.5%) were Arcanobacterium-haemolyticum-DSM-20595 alone and 02/26 (7.69%) were Streptococcus-pyogenes alone.Acombination of Arcanobacterium-haemolyticum-DSM-20595 and Streptococcus-dysgalactiae-subsp.-equisimilis-GGS 124 was found in nine (34.61%) specimens.
Conclusion:
Polymicrobial infection with conventional and unconventional pathogenic bacteria is another notable finding suggesting appropriate interventions. The study findings also reiterate the need for understanding the polymicrobial infections and their role in the clinical progression of the LFU.
Insights
Leprosy foot ulcers often have polymicrobial infections, including uncommon bacteria. Next-generation sequencing reveals a broader range of pathogens than traditional methods, highlighting the need for advanced diagnostics in LFU treatment.
Area of Science:
- Microbiology
- Infectious Diseases
- Dermatology
Background:
- Leprosy foot ulcers (LFU) frequently develop chronic infections due to secondary bacterial contamination.
- Current treatments for LFU primarily rely on empirical antibacterial therapy, which may miss unconventional pathogens.
- Chronic LFU can lead to disfigurement and disability.
Purpose of the Study:
- To investigate the polymicrobial etiology of leprosy foot ulcers.
- To compare conventional bacterial culture with Next-Generation Sequencing (NGS) for identifying pathogens in LFU.
- To highlight the role of unconventional bacteria in LFU pathogenesis.
Main Methods:
- Twenty-six leprosy patients with foot ulcers were recruited.
- Two wound swabs were collected from each patient: one for bacterial culture and one for NGS.
- Bacterial identification was performed using standard culture techniques and advanced NGS.
Main Results:
- Conventional culture identified *Streptococcus* spp. as the predominant organism (50%).
- NGS revealed *Streptococcus dysgalactiae subsp. equisimilis* (34.61%) as the most abundant single organism in several cases.
- *Arcanobacterium haemolyticum* and *Streptococcus pyogenes* were also identified, with mixed infections common.
Conclusions:
- LFU exhibit polymicrobial infections involving both conventional and unconventional bacterial pathogens.
- Understanding the complex microbial communities in LFU is crucial for developing effective treatment strategies.
- NGS offers a more comprehensive approach to identifying pathogens in LFU compared to traditional methods.
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