@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} } @article {1, title = {Genetic diversity and population structure of Mycobacterium marinum: new insights into host and environmental specificities.}, journal = {J Clin Microbiol}, volume = {50}, year = {2012}, pages = {3627-34}, abstract = {

Mycobacterium marinum causes a systemic tuberculosis-like disease in fish and skin infections in humans that can spread to deeper structures, resulting in tenosynovitis, arthritis, and osteomyelitis. However, little information is available concerning (i) the intraspecific genetic diversity of M. marinum isolated from humans and animals; (ii) M. marinum genotype circulation in the different ecosystems, and (iii) the link between M. marinum genetic diversity and hosts (humans and fish). Here, we conducted a genetic study on 89 M. marinum isolates from humans (n = 68) and fish (n = 21) by using mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) typing. The results show that the M. marinum population is genetically structured not only according to the host but also according to the ecosystem as well as to tissue tropism in humans. This suggests the existence of different genetic pools in the function of the biological and ecological compartments. Moreover, the presence of only certain M. marinum genotypes in humans suggests a different zoonotic potential of the M. marinum genotypes. Considering that the infection is linked to aquarium activity, a significant genetic difference was also detected when the human tissue tropism of M. marinum was taken into consideration, with a higher genetic polymorphism in strains isolated from patients with cutaneous forms than from individuals with deeper-structure infection. It appears that only few genotypes can produce deeper infections in humans, suggesting that the immune system might play a filtering role.

}, keywords = {Adolescent, Adult, Aged, Animals, Biota, Child, Child, Preschool, DNA, Bacterial, Female, Fish Diseases, Fishes, Genetic Variation, Genotype, Humans, Interspersed Repetitive Sequences, Male, Middle Aged, Molecular Typing, Mycobacterium Infections, Nontuberculous, Mycobacterium marinum, Young Adult}, issn = {1098-660X}, doi = {10.1128/JCM.01274-12}, author = {Broutin, Vincent and Ba{\~n}uls, Anne-Laure and Aubry, Alexandra and Keck, Nicolas and Choisy, Marc and Bernardet, Jean-Fran{\c c}ois and Michel, Christian and Raymond, Jean-Christophe and Libert, C{\'e}dric and Barnaud, Antoine and Stragier, Pieter and Portaels, Fran{\c c}oise and Terru, Dominique and Belon, Claudine and Dereure, Olivier and Gutierrez, Cristina and Boschiroli, Maria-Laura and Van De Perre, Philippe and Cambau, Emmanuelle and Godreuil, Sylvain} }