02578nas a2200385 4500000000100000008004100001653001200042653002700054653002100081653000800102653001400110653001800124653001600142653002500158653001700183100001500200700001400215700001200229700001200241700001200253700001400265700001500279700001000294700001400304700001400318700001300332700001300345700001100358700001500369245015300384856005100537300001200588490000700600520158500607 2018 d10aleprosy10aPaucibacillary leprosy10aPB leprosy cases10aAFB10aM. leprae10aReal Time PCR10aBI negative10a16S rRNA gene target10aZ-N staining1 aTurankar R1 aLavania M1 aSingh I1 aSingh V1 aAhuja M1 aPathak VK1 aJakhmola P1 aDas L1 aDarlong J1 aHembrom U1 aRamesh V1 aKhanna N1 aJohn A1 aSengupta U00aPaucibacillary Leprosy: Reappraisal using Ziehl-Neelsen staining of slit skin smears and 16S rRNA Real Time Polymerase Chain Reaction of nasal swabs uhttps://leprosyreview.org/article/89/3/27-2279 a272-2790 v893 a

Background: Leprosy is diagnosed by cardinal signs. Classification of paucibacillary (PB) and multibacillary (MB) leprosy is based on the number of skin lesions and nerve involvement. Objective: The study was conducted to determine the role played by acid fast bacilli (AFB) positivity of slit skin smear (SSS) in clinical classification. Methodology: SSSs and nasal swab smears (NSSs) were stained by Ziehl-Neelsen staining. RNAs was extracted from 120 NSSs. NSSs and SSSs were examined by microscopy and M. leprae viability in NSS was determined by real time polymerase chain reaction (RT-PCR). NSSs from 50 healthy individuals were used as controls. Results: Group-A PB cases, classified simply by presenting with ,5 patches, showed the presence of AFB in NSSs (7·5%) and SSSs (15%). Group-B PB cases, classified on the basis of a negative skin smear were AFB negative. Control group NSSs were AFB negative. RT-PCR of NSSs of PB cases of Group A and Group B were 65% and 87% positive for viable M. leprae respectively. All NSSs were positive for 16S rRNA gene with variable copy numbers. It was noted that 3 SSSs negative AFB cases from Group-A were positive for AFB in NSS. It was also observed that 6 SSSs positive AFB (Group-A) cases were negative for AFB in NSS. It was interesting to note that none of the patients in Group-A was AFB positive in both NSS and SSS. However, all of these patients were positive for 16S rRNA qPCR in NSSs. Conclusion: Our findings strongly suggest immediate inclusion of AFB staining of SSS for classification of leprosy.