Mycobacterium ulcerans reservoirs : development of new laboratory techniques

L'ulcère de Buruli est une maladie infectieuse tropicale présente dans des foyers endémiques. Cette infection essentiellement cutanée est causée par Mycobacterium ulcerans. M. ulcerans est un pathogène opportuniste dont le réservoir est environnemental. Notre revue de la littérature a répertorié les sources environnementales potentielles de cette mycobactérie. Seulement cinq souches de M. ulcerans ont été isolées à partir de prélèvements de l’environnement. Il existe une corrélation inverse entre réchauffement climatique et incidence de l’ulcère de Buruli, peut-être liée à la sensibilité intrinsèque de M. ulcerans aux variations de température, ou bien à des modifications de son écosystème. Dans la perspective d’améliorer les protocoles d’isolement de M. ulcerans à partir de l’environnement, nous avons entrepris une analyse phénotypique à haut débit des substrats carbonés métabolisés par M. ulcerans et le profil obtenu nous a orientés après une recherche bibliographique des principales sources environnementales de ces substrats, vers des interactions plus spécifiques de M. ulcerans avec les bactéries, algues, mollusques et champignons. Les résultats de ce premier travail ont servi de base pour la mise au point de milieux de culture innovants qui nous ont permis d’isoler pour la première fois, une microcolonie de M. ulcerans à partir de fèces d’agouti. Nous avons mis au point une méthode de lecture automatisée des échantillons colorés par la méthode de Ziehl-Neelsen. Notre travail de thèse a produit des protocoles qui ont pour objectif d’être mis en œuvre dans les pays d’endémie, pour préciser les sources et modes de transmission de M. ulcerans aux populations.Buruli ulcer is a tropical infectious disease present in endemic foci/This mainly cutaneous infection is caused by Mycobacterium ulcerans. M. ulcerans is an opportunistic pathogen from the environment. Our literature review has listed the potential environmental sources of this mycobacterium.. However, only five strains of M. ulcerans have been isolated from environmental samples. There is an inverse correlation between global warming and incidence of Buruli ulcer, possibly related to the intrinsic sensitivity of M. ulcerans to temperature, or to changes in its ecosystem. In order to improve the isolation protocols of M. ulcerans from the environment, we conducted a high-throughput phenotypic analysis of the carbon substrates metabolized by M. ulcerans and the profile obtained oriented us afterwards a bibliographic search of the main environmental sources of these substrates, towards more specific interactions of M. ulcerans with other bacteria, algae, molluscs and fungi. The results of this first work served as a basis for the development of innovative culture media which, allowed us to isolate for the first time a microcolony of M. ulcerans from feces of agouti. We also developed a method for automated reading of samples stained by Ziehl-Neelsen staining. Our thesis work has produced protocols that are intended to be implemented in African endemic countries, in order to clarify the sources and modes of transmission of M. ulcerans to populations

Variations in temperatures and the incidence of Buruli ulcer in Africa

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A protocol for culturing environmental strains of the Buruli ulcer agent, Mycobacterium ulcerans

International audienceContaminations and fastidiousness of M. ulcerans may have both hamper isolation of strains from environmental sources. We aimed to optimize decontamination and culture of environmental samples to circumvent both limitations. Three strains of M. ulcerans cultured onto Middlebrook 7H10 at 30 degrees C for 20 days yielded a significantly higher number of colonies in micro-aerophilic atmosphere compared to ambient atmosphere, 5% CO2 and anaerobic atmosphere. In a second step, we observed that M. ulcerans genome uniquely encoded chitinase, fucosidase and A-D-GlcNAc-diphosphoryl polyprenol A-3-L-rhamnosyl transferase giving M. ulcerans the potential to metabolize chitine, fucose and N-acetyl galactosamine (NAG), respectively. A significant growth-promoting effect of 0.2 mg/mL chitin (p < 0.05), 0.01 mg/mL N-acetyl galactosamine (p < 0.05), 0.01 mg/mL fucose (p < 0.05) was observed with M. ulcerans indicating that NAG alone or combined with fucose and chitin could complement Middlebrook 7H10. Finally, the protocol combining 1% chlorhexidine decontamination with micro-aerophilic incubation on Middlebrook 7H10 medium containing chitin (0.2%), NAG (0.01%) and fucose (0.01%) medium and auto-fluorescence detection of colonies allowed for the isolation of one mycolactone-encoding strain from Thryonomys swinderianus (aulacode) feces specimens collected near the Kossou Dam, Cote d'Ivoire. We propose that incubation of chlorhexidine-decontaminated environmental specimens on Middlebrook 7H10-enriched medium under micro-aerophilic atmosphere at 30 degrees C may be used for the tentative isolation of M. ulcerans strains from potential environmental sources

High-Throughput Carbon Substrate Profiling of Mycobacterium ulcerans Suggests Potential Environmental Reservoirs

International audienceBackground Mycobacterium ulcerans is a close derivative of Mycobacterium marinum and the agent of Buruli ulcer in some tropical countries. Epidemiological and environmental studies pointed towards stagnant water ecosystems as potential sources of M. ulcerans, yet the ultimate reservoirs remain elusive. We hypothesized that carbon substrate determination may help elucidating the spectrum of potential reservoirs. Methodology/Principal findings In a first step, high-throughput phenotype microarray Biolog was used to profile carbon substrates in one M. marinum and five M. ulcerans strains. A total of 131/190 (69%) carbon substrates were metabolized by at least one M. ulcerans strain, including 28/190 (15%) carbon substrates metabolized by all five M. ulcerans strains of which 21 substrates were also metabolized by M. marinum. In a second step, 131 carbon substrates were investigated, through a bibliographical search, for their known environmental sources including plants, fruits and vegetables, bacteria, algae, fungi, nematodes, mollusks, mammals, insects and the inanimate environment. This analysis yielded significant association of M. ulcerans with bacteria (p = 0.000), fungi (p = 0.001), algae (p = 0.003) and mollusks (p = 0.007). In a third step, the Medline database was cross-searched for bacteria, fungi, mollusks and algae as potential sources of carbon substrates metabolized by all tested M. ulcerans; it indicated that 57% of M. ulcerans substrates were associated with bacteria, 18% with alga, 11% with mollusks and 7% with fungi. Conclusions This first report of high-throughput carbon substrate utilization by M. ulcerans would help designing media to isolate and grow this pathogen. Furthermore, the presented data suggest that potential M. ulcerans environmental reservoirs might be related to micro-habitats where bacteria, fungi, algae and mollusks are abundant. This should be followed by targeted investigations in Buruli ulcer endemic regions

Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans

International audienceBuruli ulcer is a noncontagious disabling cutaneous and subcutaneous mycobacteriosis reported by 33 countries in Africa, Asia, Oceania, and South America. The causative agent, Mycobacterium ulcerans, derives from Mycobacterium marinum by genomic reduction and acquisition of a plasmid-borne, nonribosomal cytotoxin mycolactone, the major virulence factor. M. ulcerans-specific sequences have been readily detected in aquatic environments in food chains involving small mammals. Skin contamination combined with any type of puncture, including insect bites, is the most plausible route of transmission, and skin temperature of <30 degrees C significantly correlates with the topography of lesions. After 30 years of emergence and increasing prevalence between 1970 and 2010, mainly in Africa, factors related to ongoing decreasing prevalence in the same countries remain unexplained. Rapid diagnosis, including laboratory confirmation at the point of care, is mandatory in order to reduce delays in effective treatment. Parenteral and potentially toxic streptomycinrifampin is to be replaced by oral clarithromycin or fluoroquinolone combined with rifampin. In the absence of proven effective primary prevention, avoiding skin contamination by means of clothing can be implemented in areas of endemicity. Buruli ulcer is a prototype of ecosystem pathology, illustrating the impact of human activities on the environment as a source for emerging tropical infectious diseases

Carbone substrates metabolized by at least one of the five tested <i>M</i>. <i>ulcerans</i> strains compared with carbon substrates metabolized by <i>Mycobacterium marinum</i> on Biolog PM1 & PM2 plates.

<p>Carbone substrates metabolized by at least one of the five tested <i>M</i>. <i>ulcerans</i> strains compared with carbon substrates metabolized by <i>Mycobacterium marinum</i> on Biolog PM1 & PM2 plates.</p

Confirming Autochthonous Buruli Ulcer Cases in Burkina Faso, West Africa

International audienceEnvironmental Mycobacterium ulcerans causes a disabling skin disease called Buruli ulcer. Recent studies completed the knowledge of the evolving geographic extension and epidemiology of Buruli ulcer in West Africa, where Côte d’Ivoire is reporting the highest number of cases. We report seven polymerase chain reaction-documented patients in Burkina Faso, a neighboring country of Côte d’Ivoire, where previously Buruli ulcer cases were confirmed primarily using clinical arguments

Cross-search of the Medline database (May, 2016) for fungi, mollusks and algae as potential sources of carbon substrates; and substrates metabolized by all tested <i>M</i>. <i>ulcerans</i> strains.

<p>The total number of hits for fungi, mollusks and algae is indicated into brackets. Each cell contains the number of cross-hits and green cells indicate the higher relative hit for each carbon source.</p

Recipe for 1x PM inoculating fluids from stock solutions.

<p>Recipe for 1x PM inoculating fluids from stock solutions.</p