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Are viable Mycobacterium leprae present in lepromatous patients after completion of 12 months' and 24 months' multi-drug therapy?
Indian J Lepr. 2004 Jul-Sep; 76(3):199-206.IJ

Abstract

A study was carried out to determine whether or not viable bacilli persist in MB patients treated with 12-month and 24-month multidrug therapy (MDT). In the first group, 60 untreated lepromatous patients who had an initial average bacterial index (BI) of 3+ or more were enrolled. At the completion of 12 months of MDT, skin biopsies were obtained and M. leprae concentrate was inoculated into the footpads of five thymectomized and irradiated (T900r) mice. Rees technique was used for the mouse footpad (MFP) experiment. Harvesting was done it the 6th, 9th and 12th months. Out of the 60 biopsies inoculated into mouse footpads to check the viability of bacilli, 2 skin biopsies (3.3%) showed significant growth and 10 (16%) showed equivocal growth. 27 patients also had nerve biopsies tested for growth in MFP studies. None of the inoculated nerve biopsies showed significant multiplication in the MFP experiments. However, 4 biopsies (14%) showed equivocal growth. In the second group, 20 patients had skin biopsies and 10 had nerve biopsies done at the end of 24 doses of MDT in order to test the viability of bacilli; none of the skin or nerve biopsies from these patients showed any growth. This study showed that M. leprae present in the tissues after 24 doses of MDT are not viable and the drug schedule of 24 doses is adequate to treat leprosy patients, irrespective of their BI. However, a small (3.3%) percentage of the patients with a high BI harbour viable bacteria in the skin after 12 doses of treatment. Since a large majority of the patients (38 patients) who had a high initial BI responded well to the treatment, it is important to find out the reason for the lack of response in two patients. One of the reasons may be the presence of drug-resistant strains. It is important to follow up on these patients for a longer duration to ascertain whether or not they would relapse.

Authors+Show Affiliations

Department of Histopathology and Experimental Pathology, Schieffelin Leprosy Research and Training Centre, Karigiri 632 106, Vellore, Tamil Nadu, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15835604

Citation

Ebenezer, G J., et al. "Are Viable Mycobacterium Leprae Present in Lepromatous Patients After Completion of 12 Months' and 24 Months' Multi-drug Therapy?" Indian Journal of Leprosy, vol. 76, no. 3, 2004, pp. 199-206.
Ebenezer GJ, Daniel S, Norman G, et al. Are viable Mycobacterium leprae present in lepromatous patients after completion of 12 months' and 24 months' multi-drug therapy? Indian J Lepr. 2004;76(3):199-206.
Ebenezer, G. J., Daniel, S., Norman, G., Daniel, E., & Job, C. K. (2004). Are viable Mycobacterium leprae present in lepromatous patients after completion of 12 months' and 24 months' multi-drug therapy? Indian Journal of Leprosy, 76(3), 199-206.
Ebenezer GJ, et al. Are Viable Mycobacterium Leprae Present in Lepromatous Patients After Completion of 12 Months' and 24 Months' Multi-drug Therapy. Indian J Lepr. 2004 Jul-Sep;76(3):199-206. PubMed PMID: 15835604.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Are viable Mycobacterium leprae present in lepromatous patients after completion of 12 months' and 24 months' multi-drug therapy? AU - Ebenezer,G J, AU - Daniel,S, AU - Norman,G, AU - Daniel,E, AU - Job,C K, PY - 2005/4/20/pubmed PY - 2005/7/14/medline PY - 2005/4/20/entrez SP - 199 EP - 206 JF - Indian journal of leprosy JO - Indian J Lepr VL - 76 IS - 3 N2 - A study was carried out to determine whether or not viable bacilli persist in MB patients treated with 12-month and 24-month multidrug therapy (MDT). In the first group, 60 untreated lepromatous patients who had an initial average bacterial index (BI) of 3+ or more were enrolled. At the completion of 12 months of MDT, skin biopsies were obtained and M. leprae concentrate was inoculated into the footpads of five thymectomized and irradiated (T900r) mice. Rees technique was used for the mouse footpad (MFP) experiment. Harvesting was done it the 6th, 9th and 12th months. Out of the 60 biopsies inoculated into mouse footpads to check the viability of bacilli, 2 skin biopsies (3.3%) showed significant growth and 10 (16%) showed equivocal growth. 27 patients also had nerve biopsies tested for growth in MFP studies. None of the inoculated nerve biopsies showed significant multiplication in the MFP experiments. However, 4 biopsies (14%) showed equivocal growth. In the second group, 20 patients had skin biopsies and 10 had nerve biopsies done at the end of 24 doses of MDT in order to test the viability of bacilli; none of the skin or nerve biopsies from these patients showed any growth. This study showed that M. leprae present in the tissues after 24 doses of MDT are not viable and the drug schedule of 24 doses is adequate to treat leprosy patients, irrespective of their BI. However, a small (3.3%) percentage of the patients with a high BI harbour viable bacteria in the skin after 12 doses of treatment. Since a large majority of the patients (38 patients) who had a high initial BI responded well to the treatment, it is important to find out the reason for the lack of response in two patients. One of the reasons may be the presence of drug-resistant strains. It is important to follow up on these patients for a longer duration to ascertain whether or not they would relapse. SN - 0254-9395 UR - https://www.unboundmedicine.com/medline/citation/15835604/Are_viable_Mycobacterium_leprae_present_in_lepromatous_patients_after_completion_of_12_months'_and_24_months'_multi_drug_therapy L2 - https://medlineplus.gov/mycobacterialinfections.html DB - PRIME DP - Unbound Medicine ER -