Mycobacterium leprae in the periodontium, saliva and skin smears of leprosy patients

Mycobacterium leprae no periodonto, saliva e raspados intradérmicos de sujeitos com hanseníase

ORIGINAL ARTICLE

Mycobacterium leprae in the periodontium, saliva and skin smears of leprosy patients

Mycobacterium leprae no periodonto, saliva e raspados intradérmicos de sujeitos com hanseníase

Ligia Fernandes Abdalla^I; João Hugo Abdalla Santos^II; Carolina Souza Cunha Collado^III; Maria da Graça Souza Cunha^IV; Felipe Gomes Naveca^V

^IMasters program in Tropical Pathology, Universidade Federal do Amazonas (UFAM), Manaus, AM, Brazil

^IIResidency in Infectious Diseases, Fundação de Medicina Tropical, Manaus, AM, Brazil

^IIIMedical School, Universidade Nilton Lins, Manaus, AM, Brazil

^IVGraduate Program in Medical Sciences, Fundação Alfredo da Matta (FUAM), Manaus, AM, Brazil

^VInstituto Leônidas e Maria Deane, Fiocruz/AM, Manaus, AM, Brazil

^{Correspondence}

ABSTRACT

PURPOSE: To verify the presence of M. leprae in the periodontium, saliva and skin slit smears of leprosy patients. To correlate bacteriological and molecular findings with clinical data and compare laboratory techniques.

METHODS: A cross-sectional study was designed to use bacteriological (baciloscopy) and molecular (PCR) parameters to detect M. leprae in exudates of the gingival sulcus/periodontium pocket, saliva and skin slit smears from multiple clinical forms of leprosy patients without previous treatment.

RESULTS: The study included 48 leprosy patients with 15 multibacillary (MB) cases and 33 paucibacillary (PB) cases. The diagnosis of MB was confirmed through bacteriological examination and PCR results from skin slit smears. A total of 16 (48.5%) PB patients were PCR positive only. Four PB patients with negative PCR skin smears were PCR positive for the periodontium and saliva, with 2 cases and 1 case, respectively. No periodontium or saliva samples had positive bacteriological results.

CONCLUSION: There was no correlation between periodontal disease and the presence of M. leprae. Bacteriological examination did not prove to be an efficient technique for the analysis of saliva and periodontium samples. PCR analysis of skin smears was more efficient at diagnosing PB patients than bacteriological examination. PCR positive results for the detection of M. leprae in PB patients can be increased by collecting slit skin smears, periodontium and saliva samples.

Key words:Mycobacterium leprae; skin smears; PCR; periodontium; saliva; bacteriological examination

RESUMO

OBJETIVO: verificar através da baciloscopia e da reação em cadeia da polimerase (PCR) a presença do M. leprae no periodonto, saliva e raspados intradérmicos de pacientes com hanseníase.

METODOLOGIA: Realizou-se um estudo transversal do tipo detecção de casos numa instituição referência de hanseníase no Amazonas.

RESULTADOS: Foram avaliados 48 pacientes, sendo 15 multibacilares (MB) e 33 paucibacilares (PB). Os pacientes MB tiveram o diagnóstico confirmado pela baciloscopia e PCR dos raspados intradérmicos, enquanto que 16 (48,5%) dos PB foram positivos apenas na PCR. Quatro pacientes PB negativos na PCR de raspados intradérmicos foram positivos no periodonto e na saliva, 1 positivo na saliva e 2 no periodonto. Nenhuma amostra do periodonto e da saliva foi positiva na baciloscopia.

CONCLUSÃO: Não houve relação entre a doença periodontal e a presença do M. leprae; a baciloscopia não mostrou ser uma técnica eficiente para análise da saliva e periodonto; a técnica de PCR de raspado dérmico mostrou ser um método mais eficaz no diagnóstico dos PB do que a baciloscopia; a positividade da PCR para detecção do M. leprae nos PB pode ser aumentada coletando raspado intradérmico, periodonto e saliva.

Key words:Mycobacterium leprae; hanseníase; PCR; periodonto; saliva; exame bacteriológico

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Acknowledgments

This study received financial support from the Fundação de Amparo e Pesquisa no Amazonas (FAPEAM) through the RH-Amazônia program.

Received: June 20, 2009

Accepted: February 9, 2010

Conflict of Interest Statement: The authors state that there are no financial and personal conflicts of interest that could have inappropriately influenced their work.

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Publication Dates

• Publication in this collection
  26 Aug 2011
• Date of issue
  2010

History

• Received
  20 June 2009
• Accepted
  09 Feb 2010