@article {13, title = {A comparison of DNA extraction procedures for the detection of Mycobacterium ulcerans, the causative agent of Buruli ulcer, in clinical and environmental specimens.}, journal = {J Microbiol Methods}, volume = {76}, year = {2009}, month = {2009 Feb}, pages = {152-8}, abstract = {

Mycobacterium ulcerans is the causative agent of Buruli ulcer, the third most common mycobacterial disease in humans after tuberculosis and leprosy. Although the disease is associated with aquatic ecosystems, cultivation of the bacillus from the environment is difficult to achieve. Therefore, at the moment, research is based on the detection by PCR of the insertion sequence IS2404 present in M. ulcerans and some closely related mycobacteria. In the present study, we compared four DNA extraction methods for detection of M. ulcerans DNA, namely the one tube cell lysis and DNA extraction procedure (OT), the FastPrep procedure (FP), the modified Boom procedure (MB), and the Maxwell 16 Procedure (M16). The methods were performed on serial dilutions of M. ulcerans, followed by PCR analysis with different PCR targets in M. ulcerans to determine the detection limit (DL) of each method. The purity of the extracted DNA and the time and effort needed were compared as well. All methods were performed on environmental specimens and the two best methods (MB and M16) were tested on clinical specimens for detection of M. ulcerans DNA. When comparing the DLs of the DNA extraction methods, the MB and M16 had a significantly lower DL than the OT and FP. For the different PCR targets, IS2404 showed a significantly lower DL than mlsA, MIRU1, MIRU5 and VNTR6. The FP and M16 were considerably faster than the MB and OT, while the purity of the DNA extracted with the MB was significantly higher than the DNA extracted with the other methods. The MB performed best on the environmental and clinical specimens. This comparative study shows that the modified Boom procedure, although lengthy, provides a better method of DNA extraction than the other methods tested for detection and identification of M. ulcerans in both clinical and environmental specimens.

}, keywords = {Animals, Buruli Ulcer, DNA Transposable Elements, DNA, Bacterial, DNA, Plant, Environmental Monitoring, Humans, Mycobacterium ulcerans, Polymerase Chain Reaction, Reagent Kits, Diagnostic, Sensitivity and Specificity, Soil Microbiology, Water Microbiology}, issn = {0167-7012}, doi = {10.1016/j.mimet.2008.10.002}, author = {Durnez, Lies and Stragier, Pieter and Roebben, Karen and Ablordey, Anthony and Leirs, Herwig and Portaels, Fran{\c c}oise} } @article {14, title = {Persistence of Mycobacterium ulcerans disease (Buruli Ulcer) in the historical focus of Kasongo Territory, the Democratic Republic of Congo.}, journal = {Am J Trop Med Hyg}, volume = {81}, year = {2009}, month = {2009 Nov}, pages = {888-94}, abstract = {

Fifty years after the last report of Mycobacterium ulcerans infections (Buruli ulcer [BU]) in Kasongo Territory, Maniema Province, Democratic Republic of Congo (DRC), we conducted a small-scale cross-sectional survey to assess if this historical BU focus was still active and if so to explore the disease epidemiology. Seventy-five active and inactive BU cases were identified on clinical grounds of which two of 28 BU active cases were laboratory confirmed. We used a modified BU02 form to reconstruct the local disease dynamics and we believe that the horrific conflict in eastern DRC and exceptional flooding were the most likely causes of the re-emergence of the disease. There is a need in the DRC to decentralize and integrate surveillance and control activities at local level to increase the effectiveness of patient management.

}, keywords = {Adolescent, Adult, Age Distribution, Aged, Buruli Ulcer, Child, Democratic Republic of the Congo, Female, Humans, Male, Middle Aged, Mycobacterium ulcerans, Sex Characteristics, Young Adult}, issn = {1476-1645}, doi = {10.4269/ajtmh.2009.09-0049}, author = {Suykerbuyk, Patrick and Wambacq, Julie and Phanzu, Delphin M and Haruna, Hemedi and Nakazawa, Yoshinori and Ooms, Kristien and Kamango, Kalambo and Stragier, Pieter and Singa, Jackie N and Ekwanzala, Florent and De Herdt, Eric and De Maeyer, Philippe and Kestens, Luc and Portaels, Fran{\c c}oise} } @article {15, title = {Buruli ulcer in United Kingdom tourist returning from Latin America.}, journal = {Emerg Infect Dis}, volume = {15}, year = {2009}, month = {2009 Nov}, pages = {1827-9}, abstract = {

We report a case of Buruli ulcer in a tourist from the United Kingdom. The disease was almost certainly acquired in Brazil, where only 1 case had previously been reported. The delay in diagnosis highlights the need for physicians to be aware of the disease and its epidemiology.

}, keywords = {Adult, Anti-Bacterial Agents, Brazil, Buruli Ulcer, Communicable Diseases, Emerging, Great Britain, Humans, Latin America, Male, Mycobacterium ulcerans, Skin Transplantation, Travel}, issn = {1080-6059}, doi = {10.3201/eid1511.090460}, author = {McGann, Hugh and Stragier, Pieter and Portaels, Fran{\c c}oise and Gascoyne Binzi, Deborah and Collyns, Timothy and Lucas, Sebastian and Mawer, Damian} } @article {11, title = {[Follow-up of the first case of Mycobacterium ulcerans infection documented by PCR, genotyping and culture in the Republic of Congo-Brazzaville].}, journal = {Med Trop (Mars)}, volume = {68}, year = {2008}, month = {2008 Apr}, pages = {137-43}, abstract = {

This article presents follow-up data from the first patient in whom Mycobacterium ulcerans infection (MUI) was documented by PCR, genotyping and culture in the Republic of Congo-Brazzaville. Findings show the importance of regular clinical and microbiological evaluation for the disseminated form of the disease. The patient was probably infected in Pointe Noire where MUI has been described but never documented. Culture of specimens collected before antibiotic treatment showed that the bacterium was sensitive to the antibiotics being administered (streptomycin and rifampin) and was identical to isolates from Atlantic-coast regions of West Africa where MUI is endemic. The patient was treated with streptomycin and rifampin for 12 weeks in association with surgery. During treatment clinical examination was performed every day and microbiological analysis every two weeks. The duration of follow-up from the end of specific antibiotic treatment was 26 months. Medical treatment failed to prevent bone involvement and fistulae that were treated by surgery. However medical treatment may have limited dissemination of the disease. Serial microbiological evaluation was useful to detect bone involvement in this patient, but persistent positive gene amplification is not a proof of active disease. This study confirms that MUI is still endemic in the region of Pointe Noire. This finding underlines the need to optimize epidemiologic surveillance, laboratory diagnostic capabilities, and therapeutic management in the Republic of Congo-Brazzaville.

}, keywords = {Adult, Anti-Bacterial Agents, Biopsy, Buruli Ulcer, Congo, DNA, Bacterial, Follow-Up Studies, Genotype, Humans, Male, Mycobacterium ulcerans, Polymerase Chain Reaction, Skin}, issn = {0025-682X}, author = {Kibadi, K and Stragier, P and Muyembe-Tamfum, J J and Pedrosa, J and Portaels, F} }