Articles

Found 7 Documents
Search

Molecular Detection of Dapsone and Rifampicin Resistance on Mycobacterium leprae from Leprosy Patients in East Java ADRIATY, DINAR; WAHYUNI, RATNA; PRAKOESWA, CITA ROSITA S.; SUSARI, NI PUTU; AGUSNI, INDROPO; IZUMI, SHINZO
Microbiology Indonesia Vol 3, No 3 (2009): December 2009
Publisher : Indonesian Society for microbiology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The drug resistant problem of Mycobacterium leprae has been developing since the last decade and this has become a leprosy elimination problem in several countries, including Indonesia. Using biological on molecular methods, it is now possible to test for drug resistant cases in relatively simple and less time consuming ways. The purpose of the study is to analyze theprevalence of drug resistance M. leprae to dapsone and rifampicin in East Java based on the  etection of mutations in the folP and rpoB genes. All samples were obtained from multibacillary leprosy patients in East Java, who have admitted to the Dr Sutomo Hospital Surabaya in 2003-2005. Isolates were analyzed by PCR, and the presence of nucleotide sequence of the folP and rpoB genes from M. leprae were confirmed by direct sequencing. Of 94 specimens which were collected, all were analyzed for their folP and rpoB genome. From 94 isolates, 70 showed a positive result by the folP1-folPR test and 77 out of 94 isolates showed positive by the rpoBF-rpoBR test. From 70 isolates for folP gene examination, there were 3 isolates which had mutation in the amino acid at codon 53; 2 cases Threonin (ACC) became Alanin (GCC) and 1 case Threonin (ACC) became Arginin (AGA). These mutations are responsible to dapsone resistance. For the rpoB gene, no mutation was found. The result suggested that 3 isolates (4.3%), 1 from a new case and 2 from relapse cases in this experiment, were resistant to dapsone and all isolates (100%) were susceptible to rifampicin.
DAPSONE RESISTANCE IN A Mycobacterium leprae ISOLATE WITH TWO POINT MUTATIONS IN folP GENE FROM A LEPROSY PATIENT Ardiaty, Dinar; Wahyuni, Ratna; Prakoeswa, Cita; Abdullah, Rasyidin; Agusni, Indropo; Izumi, Shinzo
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 2 (2012)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (713.052 KB)

Abstract

Drug resistance in leprosy is important for Leprosy Control Program, since the WHO-Multidrug regiment (MDT) has been used for global treatment of leprosy for more than two decades already. A Dapsone resistance case in a Multibacillary (MB) leprosy case is reported. The patient was diagnosed and treated in Tajuddin Chalid Hospital Makassar, South Sulawesi. Previously he was treated in a health center at South Sulawesi and was given a treatment for one year, before referred to the hospital. The leprosy skin lesions are still active with erythematous skin lesions and thickened ear lobe. Bacteriological examination was positive for Acid Fast Bacilli, the Bacterial Index was 3+ and the Morphological Index was 1%. The specimens of M.leprae isolation was sent to the Institute of Tropical Disease Surabaya for drug resistance study. Using the Lp1-2 and Lp3-4 nested primers, PCR test was positive for M.leprae.Sequencing result for folP gene showed a double mutation at codon 53 (ACC / Threonin ) which become (AGG / Arginine). Simultaneous mutation at two nucleotides at one codon has never been reported in Indonesia before and this phenomenon is important for leprosy control policy.
DAPSONE RESISTANCE IN A Mycobacterium leprae ISOLATE WITH TWO POINT MUTATIONS IN folP GENE FROM A LEPROSY PATIENT Ardiaty, Dinar; Wahyuni, Ratna; Prakoeswa, Cita; Abdullah, Rasyidin; Agusni, Indropo; Izumi, Shinzo
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 2 (2012)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (713.052 KB) | DOI: 10.20473/ijtid.v3i2.218

Abstract

Drug resistance in leprosy is important for Leprosy Control Program, since the WHO-Multidrug regiment (MDT) has been used for global treatment of leprosy for more than two decades already. A Dapsone resistance case in a Multibacillary (MB) leprosy case is reported. The patient was diagnosed and treated in Tajuddin Chalid Hospital Makassar, South Sulawesi. Previously he was treated in a health center at South Sulawesi and was given a treatment for one year, before referred to the hospital. The leprosy skin lesions are still active with erythematous skin lesions and thickened ear lobe. Bacteriological examination was positive for Acid Fast Bacilli, the Bacterial Index was 3+ and the Morphological Index was 1%. The specimens of M.leprae isolation was sent to the Institute of Tropical Disease Surabaya for drug resistance study. Using the Lp1-2 and Lp3-4 nested primers, PCR test was positive for M.leprae.Sequencing result for folP gene showed a double mutation at codon 53 (ACC / Threonin ) which become (AGG / Arginine). Simultaneous mutation at two nucleotides at one codon has never been reported in Indonesia before and this phenomenon is important for leprosy control policy.
Histoid Leprosy Rinasari, Umi; Sawitri, Sawitri; Listiawan, M. Yulianto; Prakoeswa, Cita Rosita; Agusni, Indropo; Santoso, Rachmat; Izumi, Shinzo
Indonesian Journal of Tropical and Infectious Disease Vol 1, No 1 (2010)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (210.114 KB) | DOI: 10.20473/ijtid.v1i1.3719

Abstract

Histoid Leprosy is a variant of lepromatous leprosy with characteristic clinical and histopathological features. Usually it is occured in lepromatous patients who relaps after dapsone monotherapy, in those with dapsone resistance , sometimes even after multidrug treatment, or at times, de novo with characteristic clinical and histopathological features. A 36 years old male, originated from Papua, visited to the skin outpatient clinic with translucent shiny nodules on the left elbow and thumb for the last 18 months. The nodules were multiple, painless and firm. There were nasal congestion, tickening of ear lobes and loss of eye brows. Patient did not have any history of previous antileprotic treatment. Routine blood examination was normal. Bacteriological examination of slit skin smear revealed acid-fast bacilli of Bacterial Index 4+ and Morfologic Index 10%. Histopathology of skin suggested lepromatous leprosy of histoid type with characteristic interlacing bundles of spindle shaped cells. Anti-PGL1 antibody (ELISA) revealed high titer of IgM (>5.300 u/ml) and also IgG anti PGL-1 (>5.300 u/ml). Polymerase chain reaction examination test to detect M.leprae was positive and direct sequencing of M.leprae isolate shows no mutation, which means no resistancy to MDT treatment. Treatment with MDTWHO regiment give clinical improvements and the histoid lesions disappered after 3 months treatment.The histoid form of leprosy in this case developed without any prior treatment of anti leprotic drugs ( de novo ). Some theoretical aspects of the patho-mechanism of histoid leprosy are discussed.
EVALUATION OF ANTI PCL-1 ANTIBODY TITER IN A GROUP OF HEALTHY SCHOOL CHILDREN WHO LIVE IN LEPROSY ENDEMIC AREA FROM 2007–2010 putri, rachmah diana; amiruddin, M. dali; tabri, farida; Adriaty, Dinar; Wahyuni, ratna; iswahyudi, iswahyudi; agusni, indropo; izumi, shinzo
Indonesian Journal of Tropical and Infectious Disease Vol 1, No 3 (2010)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (583.13 KB) | DOI: 10.20473/ijtid.v1i3.2184

Abstract

The “Iceberg phenomene” has been used to explain this situation which indicate that these new leprosy cases is originated from Subclinical Leprosy. Fifty eight healthy school children who live in Jeneponto Regency, a leprosy endemic area in South Sulawesi were recruited. The first examination was performed in 2007 and sera samples were kept in deep freeze refrigerator. In 2010 these children were re-examined for clinical leprosy and sera were collected again. ELISA study was performed simultaneously to these 58 pairs of sera (2007 & 2010) for measuring the titer of IgM anti PGL-1 antibody (ELISA) and the level 605u/ml was regarded as cut off value. After three years evaluation, none of these children showed any clinical signs of leprosy, but 20 of 22 ( 90.9%) children were remained sero-positive and only 2 (9.1%) became sero-negatives. In other sites, 5 children that previously sero-negatives became sero-positives after 3 years. Eight of 10 (80%) children who showed sero (+) with high titer (>1.000u/ml) in 2007, were also remained in high titer. The mean titer of 2007 was 627.8 u/ml, and after3 years became 723.9 u/ml (p<0.05). Although there is no progression from Subclinical to Manifest Leprosy cases among these children, the number of sero (+) cases were increased and the mean titer of IgM anti PGL-1 antibody was significantly increased.. The majority who previously showed high anti PGL-1 antibody titer, remained in high level. This study support the “iceberg phenomene” theory in Leprosy.
Mycobacterium leprae in Daily Water Resources of Inhabitants Who Live in Leprosy Endemic Area of East Java Wahyuni, Ratna; Adriaty, Dinar; iswahyudi, iswahyudi; Prakoeswa, Cita Rosita S.; Agusni, Indropo; izumi, shinzo
Indonesian Journal of Tropical and Infectious Disease Vol 1, No 2 (2010)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1204.754 KB) | DOI: 10.20473/ijtid.v1i2.2164

Abstract

Leprosy still a health problem in Indonesia, where many leprosy pocket areas still persists, especially in the eastern part of the country. Although the program of WHO – Multidrug Therapy (MDT) regiment has been conducted elsewhere since 1980s, only the prevalence can be reduced but not the incidence of new leprosy cases. Theoretically after the source of leprosy (the infectious leprosy cases) has been treated, no more transmission of the disease and should be no more new leprosy cases will be found. To explain this phenomenon, the non-human resource of M.leprae became a new topic of debates, especially the existence of bacteria in the environment. A field study of the existence of M.leprae in the environment of leprosy endemic area had been conducted in a leprosy endemic area of the northern part of East Java. The aim of the study is to find any correlation of the existence of these bacteria in the environment with the presence of leprosy patients who live in that area, in order to study its role in the transmission of the disease. Ninety water samples from wells in the house of inhabitants who live in one endemic sub district were collected. The owner of the well was interviewed whether any leprosy patients who routinely use the water for their daily life activities. Water samples were examined by Polymerase Chain Reaction (PCR) method to detect M.leprae DNA, using the LpF-LpR and Lp3-Lp4 nested primers (99bp). The PCR results showed positive band for M.leprae in 22 out of 90 (24%) water samples. Water samples from wells that used by leprosy patients showed positive PCR in 11/48 (23%), while 11 out of 42 (26%) water samples from wells that never been used by leprosy cases showed positive result. Statistically there was no difference (p>0.05) in the positivity of M.leprae between the two groups. It was concluded that the existence of M.leprae in the daily water resource was not correlated with the present of leprosy cases in the area. Possible symbiosis between protozoan and mycobacterium in the environment were discussed.
TTC Repeats Variation of Mycobacterium leprae Isolates for Analysis of Leprosy Transmission in Leprosy Endemic Area in East Java, INDONESIA Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi; Agusni, Indropo; Izumi, Shinzo
Indonesian Journal of Tropical and Infectious Disease Vol 1, No 1 (2010)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1494.939 KB) | DOI: 10.20473/ijtid.v1i1.3722

Abstract

East Java province still has some pocket of leprosy endemic areas. In order to solve the problem, molecular typing will make it feasible to study the transmission pattern of Mycobacterium leprae in leprosy endemic area. The present study is to analyze the presence of M.leprae DNA in the environment and to study variation number of TTC repeats and their distribution. Poteran Island is located in Madura, East Java and was chosen because this island has a high prevalence of leprosy and remains stable for the last five years. All samples were analyzed by PCR and the numbers of TTC repeats were confirmed by direct sequencing. Of all collected samples, 26.4% isolates of water resources (24); 61.9% nasal swabs (26); and 35.3% skin tissues (24) are positives. No statistically difference in the pattern distribution of TTC repeats between skin tissues of patients and nasal swab of households contact (p=0.594); also distribution of TTC repeats between skin tissues of leprosy patients and those of water resources (p=0.441); and distribution of TTC repeats between nasal swab of households contact with water resources (p=0.906). It means that the transmission of M.leprae in leprosy endemic area has closely related in 3 aspects: agent, host & environment.