01730nas a2200349   4500000000100000008004100001260000900042653003100051653001700082653001000099653003600109653001100145653001000156653001500166653002700181653001300208653002500221653002200246100001500268700001300283700001400296700001300310700001300323700001200336245005700348856006300405300000900468490000700477050001700484520086500501022001401366       2013                            d  c201310aAfrica South of the Sahara10aBuruli ulcer10aChina10aCommunicable Diseases, Emerging10aHumans10aJapan10aMacrolides10aMycobacterium ulcerans10aPlasmids10aPolyketide Synthases10aVirulence Factors1 aNakanaga K1 aYotsu RR1 aHoshino Y1 aSuzuki K1 aMakino M1 aIshii N00aBuruli ulcer and mycolactone-producing mycobacteria.  uhttps://www.jstage.jst.go.jp/article/yoken/66/2/66_83/_pdf  a83-80 v66  aNAKANAGA20133 a<p>Buruli ulcer (BU) is an emerging human disease caused by Mycobacterium ulcerans, which mainly affects the extremities. It is most endemic in sub-Saharan Africa; however, it has been reported worldwide, including in some non-tropical areas. "M. ulcerans subsp. shinshuense" is proposed as a subspecies of M. ulcerans, which have been reported from Japan and China. A total of 35 BU cases have been reported as of November 2012. Although M. ulcerans is categorized as nontuberculous mycobacteria, it has some unique characteristics that could only be observed in this bacterium. It possesses a giant virulent plasmid, composed of 174-kbp nucleotides, coding polyketide synthase to produce macrolide toxin called mycolactone. The discovery of such a linkage of plasmid and its pathogenesis has not been reported in other human disease-causing mycobacteria.</p>  a1884-2836