Resistance to dapsone and rifampin in Mycobacterium leprae isolated from leprosy patients of São Paulo State
DOI:
https://doi.org/10.47878/hi.2005.v30.35490Keywords:
Mycobacterium leprae, drug resistance, dapsone, rifampinAbstract
In 1981, reports of resistance to dapsone and rifampin led WHO to recommend multidrugtherapy in leprosy treatment. One of its main goals is preventing the selection of drug-resistant strains of mutant bactéria. Dapsone was the first drug which was experimentally proved to induce resistance; thisbecame possible only after the mouse foot pad inoculation technique was standardized, in 1960. There are some important criteria to suspect the existence of resistance, such as: relapses in multibacillary patients already treated or undergoing treatment or unsatisfactory clinicai response. Our study aimed at detection of dapsone and rifampin resistam strains among 40 treated patients with clinicai signs of relapse, from different cities of São Paulo State and its capital, employing the mouse footpad inoculation. We detected dapsone resistam bacilli in 11 cases. Among them, 5 showed total resistance, 1 intermediary resistance and 5 partial resistance. Rifampin resistant bacilli were detected in only two cases. We did not detect any case of multiple resistance. The high levei of resistance to dapsone is probably a consequence of many years of sulfone and sulfone derivative monotherapy. As for the rifampin, the drug was probably irregularly used in monotherapy; or the patient may have used it previously to treat another disease. The detection of resistant bacilli in patients who do not show any clinicai improvement, or relapse after treatment, is an important matter to be considered in the future prevention of new cases of resistance. The emergence of resistant strains, especially to rifampin, as well as its dissemination, may cause difficulties to the patients's treatment and jeopardize the leprosy control programs.
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