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Volume 24, Number 8—August 2018
Research Letter

Dapsone Resistance in Leprosy Patients Originally from American Samoa, United States, 2010–2012

Diana L. WilliamsComments to Author , Sergio Araujo, Barbara M. Stryjewska, and David Scollard
Author affiliations: Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA (D.L. Williams); Centro de Referência Nacional em Hanseníase/Dermatológica Sanitária, Uberlândia, Brazil (S. Araujo); National Hansen’s Disease Programs, Baton Rouge, Louisiana, USA (D.L. Williams, S. Araujo, B.M. Stryjewska, D. Scollard)

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Table

Drug resistance in leprosy patients with and without origins in American Samoa, USA, 2012–2015*

Sample no. Clinical classification† Drug susceptibility‡
 DRDR sequence
 Location§
Dapsone Rifampin folP1 rpoB
US patients of American Samoa origin
NHDP1 BL No Yes T53I Wild type Louisiana, USA
NHDP2 LL Yes Yes Wild type Wild type Hawaii, USA
NHDP3 LL No Yes P55R Wild type Washington, USA
NHDP4 LL Yes Yes Wild type Wild type Massachusetts, USA
NHDP5 (9) BL No No T53A S456L Hawaii, USA
NHDP6 (8)
 LL
 No
 Yes
P55L
 Wild type
 California, USA
US patients not of American Samoa origin
NHDP7 BL Yes Yes Wild type Wild type Africa
NHDP8 LL Yes Yes Wild type Wild type Burma
NHDP9 LL Yes Yes Wild type Wild type Micronesia
NHDP10 LL Yes Yes Wild type Wild type Micronesia
NHDP11 LL-BL Yes Yes Wild type Wild type Micronesia
NHDP12 BL Yes Yes Wild type Wild type Micronesia
NHDP13 LL Yes Yes Wild type Wild type Pacific Islands
NHDP14 LL Yes Yes Wild type Wild type Pacific Islands
NHDP15 LL Yes Yes Wild type Wild type Marshall Islands
NHDP16 BL Yes Yes Wild type Wild type Marshall Islands
NHDP17 BL Yes Yes Wild type Wild type Marshall Islands
NHDP18 BL Yes Yes Wild type Wild type The Philippines
NHDP19 LL Yes Yes Wild type Wild type The Philippines
NHDP20 BL Yes Yes Wild type Wild type Alaska, USA
NHDP21 LL Yes Yes Wild type Wild type Alaska, USA
NHDP22 LL Yes Yes Wild type Wild type Florida, USA
NHDP23 LL Yes Yes Wild type Wild type Florida, USA
NHDP24 LL Yes Yes Wild type Wild type Florida, USA
NHDP25 LL-BL Yes Yes Wild type Wild type Louisiana, USA
NHDP26 LL Yes Yes Wild type Wild type Louisiana, USA

*BL, borderline leprosy; DRDR, drug resistance–determining region; LL, lepromatous leprosy; NHDP, National Hansen’s Disease Programs.
†Classification according to the Ridley-Jopling scale.
‡Molecular drug susceptibility testing done according to the World Health Organization guidelines (6). A susceptible Mycobacterium leprae isolate had no mutations in the DRDR of folP1 or rpoB (i.e., the isolate was wild type). A drug-resistant M. leprae isolate had a mutation in the DRDR of the folP1 or rpoB gene (4,5).
§Location for patients of American Samoa origin refers to the US state where the leprosy diagnosis was made. Location for patients not of American Samoa origin refers to their location of origin.

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References
  1. World Health Organization Study Group on Leprosy for Control Programmes. Chemotherapy of leprosy for control programmes: report of a WHO study group [meeting held in Geneva from 12 to 16 October 1981]. Geneva: World Health Organization; 1982 [cited 2018 Jan 8]. http://www.who.int/iris/handle/10665/38984
  2. Cambau  E, Perani  E, Guillemin  I, Jamet  P, Ji  B. Multidrug-resistance to dapsone, rifampicin, and ofloxacin in Mycobacterium leprae. Lancet. 1997;349:103–4. DOIPubMedGoogle Scholar
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  5. Benjak  A, Avanzi  C, Singh  P, Loiseau  C, Girma  S, Busso  P, et al. Phylogenomics and antimicrobial resistance of the leprosy bacillus Mycobacterium leprae. Nat Commun. 2018;9:352. DOIPubMedGoogle Scholar
  6. World Health Organization. Guidelines for global surveillance of drug resistance in leprosy. New Delhi (India): The Organization; 2009 [cited 2018 Jan 8]. http://www.searo.who.int/entity/global_leprosy_programme/publications/guide_surv_drug_res_2009.pdf
  7. World Health Organization. Surveillance of drug resistance in leprosy: 2010. Wkly Epidemiol Rec. 2011;86:237–40.PubMedGoogle Scholar
  8. Williams  DL, Lewis  C, Sandoval  FG, Robbins  N, Keas  S, Gillis  TP, et al. Drug resistance in patients with leprosy in the United States. Clin Infect Dis. 2014;58:72–3. DOIPubMedGoogle Scholar
  9. Williams  DL, Hagino  T, Sharma  R, Scollard  D. Primary multidrug-resistant leprosy, United States. Emerg Infect Dis. 2013;19:179–81. DOIPubMedGoogle Scholar
  10. World Health Organization. Epidemiological review of leprosy in the WHO Western Pacific Region, 2000. Manila (Philippines): The Organization; 2002 [cited 2018 Jan 8]. http://www.wpro.who.int/leprosy/documents/leprosy_review_2000.pdf p.3

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Page created: July 18, 2018
Page updated: July 18, 2018
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