@article{94098,
  keywords = {M. leprae, RLEP PCR, WGS, diagnosis, genotypes, leprosy, strain subtype, transmission},
  author = {Tió-Coma M and Avanzi C and Verhard E and Pierneef L and van Hooij A and Benjak A and Roy JC and Khatun M and Alam K and Corstjens P and Cole S and Richardus JH and Geluk A},
  title = {Genomic Characterization of Mycobacterium leprae to Explore Transmission Patterns Identifies New Subtype in Bangladesh.},
  abstract = {<p>, the causative agent of leprosy, is an unculturable bacterium with a considerably reduced genome (3.27 Mb) compared to homologues mycobacteria from the same ancestry. In 2001, the genome of  was first described and subsequently four genotypes (1-4) and 16 subtypes (A-P) were identified providing means to study global transmission patterns for leprosy. In order to understand the role of asymptomatic carriers we investigated  carriage as well as infection in leprosy patients ( = 60) and healthy household contacts (HHC;  = 250) from Bangladesh using molecular detection of the bacterial element RLEP in nasal swabs (NS) and slit skin smears (SSS). In parallel, to study  genotype distribution in Bangladesh we explored strain diversity by whole genome sequencing (WGS) and Sanger sequencing. In the studied cohort in Bangladesh,  DNA was detected in 33.3% of NS and 22.2% of SSS of patients with bacillary index of 0 whilst in HHC 18.0% of NS and 12.3% of SSS were positive. The majority of the  strains detected in this study belonged to genotype 1D (55%), followed by 1A (31%). Importantly, WGS allowed the identification of a new  genotype, designated 1B-Bangladesh (14%), which clustered separately between the 1A and 1B strains. Moreover, we established that the genotype previously designated 1C, is not an independent subtype but clusters within the 1D genotype. Intraindividual differences were present between the  strains obtained including mutations in hypermutated genes, suggesting mixed colonization/infection or in-host evolution. In summary, we observed that  is present in asymptomatic contacts of leprosy patients fueling the concept that these individuals contribute to the current intensity of transmission. Our data therefore emphasize the importance of sensitive and specific tools allowing post-exposure prophylaxis targeted at -infected or -colonized individuals.</p>},
  year = {2020},
  journal = {Frontiers in microbiology},
  volume = {11},
  pages = {1220},
  month = {01/2020},
  issn = {1664-302X},
  url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308449/pdf/fmicb-11-01220.pdf},
  doi = {10.3389/fmicb.2020.01220},
  language = {eng},
}