The genetic determinants of <i>Mycobacterium leprae</i> resistance to antimicrobial drugs

Abstract

The review is devoted to the appearance of resistance of a slowly developing disease leprosy to antimicrobial therapy (AMP), primarily recommended by the World Health Organization. The main danger of drug resistant leprosy is in the difficulty of identifying, since the causative agent of the disease is not cultivated on artificial media, and the methods for diagnosing drug resistance that are currently used take a long time. The drug resistance of the Mycobacterium leprae strain even to individual components of combination drug therapy result to the development of symptoms of the disease despite undergo anti-leprosy therapy, which in turn can cause the patient to become disabled. Currently, in the Russian Federation, there is no approved test for detecting Mycobacterium leprae DNA, and the determination of genetic determinants of resistance is carried out by sequencing genome regions determined by WHO recommendations: small gyrA, folP and rpoB genes loci. At the same time, modern studies in endemic regions reveal an increased level of Mycobacterium leprae strains resistant to individual components of combined drug therapy. The use of next generation sequencing (NGS) has made it possible to identify additional genetic determinants of leprosy resistance to the components of combination drug therapy. The current situation is relevant to antimicrobal drug resistance surveillance by using of quick identification systems for most frequent genetic resistance determinants of Mycobacterium leprae. The literature search was carried out using keywords in the Scopus, PubMed and RSCI databases.

Keywords

• anti-leprosy drug
• leprosy
• mycobacterium leprae
• genetic determinants of resistance
• drug resistance
• review