PMID- 27558564
OWN - NLM
STAT- MEDLINE
DCOM- 20171030
LR  - 20171030
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 63
IP  - 11
DP  - 2016 Dec 1
TI  - Molecular Evidence for the Aerial Route of Infection of Mycobacterium leprae and 
      the Role of Asymptomatic Carriers in the Persistence of Leprosy.
PG  - 1412-1420
AB  - BACKGROUND:  Leprosy persists as a public health problem. The chain of 
      transmission and mechanism of infection are not completely understood. In the 
      current study, we investigated the route of infection and of disease onset, from 
      airway exposure, colonization, and bloodstream dissemination. METHODS: 
       Mycobacterium leprae DNA was detected through quantitative polymerase chain 
      reaction in nasal vestibule, nasal turbinate mucosa, and peripheral blood 
      samples, along with anti-phenolic glycolipid I serology and skin tests from the 
      same individual, from 113 leprosy patients and 104 household contacts of patients 
      (HHCs). Bivariate statistics and multiple correspondence analysis were employed. 
      RESULTS:  The rates of DNA positivity among patients were 66.4% (75 of 113) for 
      nasal swab samples, 71.7% (81 of 113) for nasal turbinate biopsy samples, 19.5% 
      (22 of 113) for blood samples, with seropositivity of 62.8% (71 of 113 samples) 
      and with increasing incidences toward the multibacillary pole of the clinical 
      spectrum. Positivity among HHCs were as follows: 49% (51 of 104) for nasal swab 
      samples, 53.8% (56 of 104) for nasal biopsy samples, 6.7% (7 of 104) for blood 
      samples, and 18.3% (19 of 104 samples) for anti-phenolic glycolipid I serology. 
      During the follow-up of 5-7 years, out of 104 HHCs, 7 developed leprosy (6.7%). 
      Risk for the disease outcome was estimated by comparing results in HHCs who 
      develop leprosy with those not affected. Neither nasal passage nor mucosa 
      positivity was determinant of later disease onset; however, blood presence 
      increased the risk for disease development (relative risk/positive likelihood 
      ratio, 5.54; 95% confidence interval, 1.30-23.62), as did seropositivity 
      (positive likelihood ratio, 3.69 [1.67-8.16]; relative risk, 5.97 [1.45-24.5]). 
      CONCLUSIONS:  Our findings strongly suggest that the aerosol route of infection 
      and transmission is predominant and that HHCs contribute to the infection risk to 
      themselves and probably to others.
CI  - (c) The Author 2016. Published by Oxford University Press for the Infectious 
      Diseases Society of America. All rights reserved. For permissions, e-mail 
      journals.permissions@oup.com.
FAU - Araujo, Sergio
AU  - Araujo S
AD  - National Reference Center for Sanitary Dermatology and Leprosy, Clinics Hospital.
AD  - Postgraduate Program in Health Sciences, School of Medicine.
FAU - Freitas, Larissa Oliveira
AU  - Freitas LO
AD  - National Reference Center for Sanitary Dermatology and Leprosy, Clinics Hospital.
FAU - Goulart, Luiz Ricardo
AU  - Goulart LR
AD  - National Reference Center for Sanitary Dermatology and Leprosy, Clinics Hospital.
AD  - Postgraduate Program in Health Sciences, School of Medicine.
AD  - Institute of Biochemistry and Genetics, Federal University of Uberlandia, Minas 
      Gerais, Brazil.
AD  - Department of Medical Microbiology and Immunology, University of California, 
      Davis.
FAU - Goulart, Isabela Maria Bernardes
AU  - Goulart IM
AD  - National Reference Center for Sanitary Dermatology and Leprosy, Clinics Hospital.
AD  - Postgraduate Program in Health Sciences, School of Medicine.
LA  - eng
PT  - Journal Article
DEP - 20160823
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (Aerosols)
RN  - 0 (Antibodies, Bacterial)
RN  - 0 (Antigens, Bacterial)
RN  - 0 (DNA, Bacterial)
RN  - 0 (Glycolipids)
RN  - 0 (phenolic glycolipid I, Mycobacterium leprae)
SB  - IM
CIN - Clin Infect Dis. 2016 Dec 1;63(11):1421-1422. PMID: 27558566
MH  - Adolescent
MH  - Adult
MH  - Aerosols
MH  - Antibodies, Bacterial/blood
MH  - Antigens, Bacterial/immunology
MH  - *Asymptomatic Infections
MH  - Bacterial Load
MH  - Biopsy
MH  - Carrier State/epidemiology/*microbiology
MH  - DNA, Bacterial/genetics/isolation & purification
MH  - Family Characteristics
MH  - Female
MH  - Follow-Up Studies
MH  - Glycolipids/immunology
MH  - Humans
MH  - Leprosy/blood/epidemiology/*microbiology/*transmission
MH  - Male
MH  - Middle Aged
MH  - Mycobacterium leprae/genetics/immunology/*isolation & purification
MH  - Nasal Mucosa/*microbiology
MH  - Nose/microbiology
MH  - Polymerase Chain Reaction
OTO - NOTNLM
OT  - Epidemiology
OT  - Leprosy
OT  - Mycobacterium leprae
OT  - Quantitative Real-Time PCR
OT  - phenolic glycolipid I
EDAT- 2016/08/26 06:00
MHDA- 2017/10/31 06:00
CRDT- 2016/08/26 06:00
PHST- 2016/02/16 00:00 [received]
PHST- 2016/07/11 00:00 [accepted]
PHST- 2016/08/26 06:00 [pubmed]
PHST- 2017/10/31 06:00 [medline]
PHST- 2016/08/26 06:00 [entrez]
AID - ciw570 [pii]
AID - 10.1093/cid/ciw570 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2016 Dec 1;63(11):1412-1420. doi: 10.1093/cid/ciw570. Epub 2016 
      Aug 23.