Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis
Currently, four laboratory methods are available to diagnose Buruli ulcer, a neglected tropical skin disease caused by Mycobacterium ulcerans affecting mainly children in remote rural areas of West Africa. Only one of the four methods, direct microscopic examination of wound exudate for acid fast ba...
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Public Library of Science
2016
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890796/ |
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pubmed-48907962016-06-10 Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis Ruf, Marie-Thérèse Bolz, Miriam Vogel, Moritz Bayi, Pierre F. Bratschi, Martin W. Sopho, Ghislain Emmanuel Yeboah-Manu, Dorothy Um Boock, Alphonse Junghanss, Thomas Pluschke, Gerd Research Article Currently, four laboratory methods are available to diagnose Buruli ulcer, a neglected tropical skin disease caused by Mycobacterium ulcerans affecting mainly children in remote rural areas of West Africa. Only one of the four methods, direct microscopic examination of wound exudate for acid fast bacilli, is suitable as point-of-care test. The others, histopathology, culture and IS2404 quantitative PCR, require sophisticated laboratory infrastructure. However, in comparison to the current gold standard, IS2404 quantitative PCR, microscopic smear examination has limited sensitivity. Our results on the distribution of M. ulcerans in Buruli ulcer lesions emphasize that the sensitivity of Buruli ulcer laboratory diagnosis is dependent on optimal sampling procedures. Accurate histopathology crucially depends on tissue samples containing all three skin layers, including the subcutis in which the majority of the bacteria are found. For IS2404 quantitative PCR, culture and direct smear detection, the margin of ulcerative lesions should be sampled at several positions, since bacteria and bacterial DNA are unevenly distributed. With optimized sampling, well-trained laboratory personnel and good microscopy infrastructure, direct smear examination reached a sensitivity of 73%, as compared to IS2404 quantitative PCR. Public Library of Science 2016-06-02 /pmc/articles/PMC4890796/ /pubmed/27253422 http://dx.doi.org/10.1371/journal.pntd.0004767 Text en © 2016 Ruf et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Ruf, Marie-Thérèse Bolz, Miriam Vogel, Moritz Bayi, Pierre F. Bratschi, Martin W. Sopho, Ghislain Emmanuel Yeboah-Manu, Dorothy Um Boock, Alphonse Junghanss, Thomas Pluschke, Gerd |
| spellingShingle |
Ruf, Marie-Thérèse Bolz, Miriam Vogel, Moritz Bayi, Pierre F. Bratschi, Martin W. Sopho, Ghislain Emmanuel Yeboah-Manu, Dorothy Um Boock, Alphonse Junghanss, Thomas Pluschke, Gerd Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis |
| author_facet |
Ruf, Marie-Thérèse Bolz, Miriam Vogel, Moritz Bayi, Pierre F. Bratschi, Martin W. Sopho, Ghislain Emmanuel Yeboah-Manu, Dorothy Um Boock, Alphonse Junghanss, Thomas Pluschke, Gerd |
| author_sort |
Ruf, Marie-Thérèse |
| title |
Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis |
| title_short |
Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis |
| title_full |
Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis |
| title_fullStr |
Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis |
| title_full_unstemmed |
Spatial Distribution of Mycobacterium ulcerans in Buruli Ulcer Lesions: Implications for Laboratory Diagnosis |
| title_sort |
spatial distribution of mycobacterium ulcerans in buruli ulcer lesions: implications for laboratory diagnosis |
| description |
Currently, four laboratory methods are available to diagnose Buruli ulcer, a neglected tropical skin disease caused by Mycobacterium ulcerans affecting mainly children in remote rural areas of West Africa. Only one of the four methods, direct microscopic examination of wound exudate for acid fast bacilli, is suitable as point-of-care test. The others, histopathology, culture and IS2404 quantitative PCR, require sophisticated laboratory infrastructure. However, in comparison to the current gold standard, IS2404 quantitative PCR, microscopic smear examination has limited sensitivity. Our results on the distribution of M. ulcerans in Buruli ulcer lesions emphasize that the sensitivity of Buruli ulcer laboratory diagnosis is dependent on optimal sampling procedures. Accurate histopathology crucially depends on tissue samples containing all three skin layers, including the subcutis in which the majority of the bacteria are found. For IS2404 quantitative PCR, culture and direct smear detection, the margin of ulcerative lesions should be sampled at several positions, since bacteria and bacterial DNA are unevenly distributed. With optimized sampling, well-trained laboratory personnel and good microscopy infrastructure, direct smear examination reached a sensitivity of 73%, as compared to IS2404 quantitative PCR. |
| publisher |
Public Library of Science |
| publishDate |
2016 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890796/ |
| _version_ |
1613587909234917376 |