Response to treatment in a prospective cohort of patients with large ulcerated lesions suspected to be Buruli Ulcer (Mycobacterium ulcerans disease).

PLoS Neglected Tropical Diseases
Kapay KibadiFrançoise Portaels

Abstract

The World Health Organization (WHO) advises treatment of Mycobacterium ulcerans disease, also called "Buruli ulcer" (BU), with a combination of the antibiotics rifampicin and streptomycin (R+S), whether followed by surgery or not. In endemic areas, a clinical case definition is recommended. We evaluated the effectiveness of this strategy in a series of patients with large ulcers of > or =10 cm in longest diameter in a rural health zone of the Democratic Republic of Congo (DRC). A cohort of 92 patients with large ulcerated lesions suspected to be BU was enrolled between October 2006 and September 2007 and treated according to WHO recommendations. The following microbiologic data were obtained: Ziehl-Neelsen (ZN) stained smear, culture and PCR. Histopathology was performed on a sub-sample. Directly observed treatment with R+S was administered daily for 12 weeks and surgery was performed after 4 weeks. Patients were followed up for two years after treatment. Out of 92 treated patients, 61 tested positive for M. ulcerans by PCR. PCR negative patients had better clinical improvement than PCR positive patients after 4 weeks of antibiotics (54.8% versus 14.8%). For PCR positive patients, the outcome after 4 weeks of antibiotic treatme...Continue Reading

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Citations

Nov 17, 2010·Antimicrobial Agents and Chemotherapy·Tianyu ZhangEric L Nuermberger
Jan 30, 2013·PLoS Neglected Tropical Diseases·Marcus BeissnerGisela Bretzel
Dec 25, 2013·PLoS Neglected Tropical Diseases·Tianyu ZhangEric L Nuermberger
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Methods Mentioned

BETA
PCR
biopsy

Software Mentioned

SPSS

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