02263nas a2200253   4500000000100000008004100001260001300042653001200055653003100067653001100098653001000109653001200119100001600131700001500147700001600162700001500178700001700193245019900210856004100409300001100450490000700461520152700468022001401995       1983                            d  c1983 Sep10aDapsone10aDrug Resistance, Microbial10aHumans10aIndia10aleprosy1 aAlmeida J G1 aChacko C J1 aChristian M1 aTaylor P M1 aFritschi E P00aDDS-resistant infection among leprosy patients in the population of Gudiyatham Taluk, South India. Part 3. Prevalence, incidence, risk factors, and interpretation of mouse foot pad test results.  uhttp://ila.ilsl.br/pdfs/v51n3a10.pdf  a366-730 v513 a<p>At the Schieffelin Leprosy Research and Training Centre, Karigiri, India, a study of the population of Gudiyatham Taluk revealed that the prevalence of dapsone (DDS)-resistant infection among lepromatous (LL) and borderline lepromatous (BL) leprosy patients treated for a minimum of three years was 3.3% (33 per 1000), with an average annual incidence of 0.28% per year. DDS-resistant infection was diagnosed when review of skin smear readings showed a continuing increase in the number of Mycobacterium leprae in successive smears despite adequate DDS treatment. The attainment of smear negativity in an LL or BL patient was found to be a favorable prognostic sign, indicating a reduced risk of DDS-resistant infection. No association was found between the incidence of DDS-resistant infection on the one hand and either the regularity or the initial dosage of DDS treatment on the other. Ninety-five (88.0%) out of 108 successful mouse foot pad tests on patients with a Bacterial Index (BI) greater than or equal to 2+ detected DDS-resistant M. leprae. The mouse test detected bacilli resistant to 0.01% w/w DDS in mouse diet not only among patients deteriorating despite adequate DDS monotherapy, but also among patients improving on DDS monotherapy. Since the mouse test as presently used does not measure the proportion of M. leprae in a sample that are resistant to DDS, the detection of DDS-resistant bacilli in the mouse test may not always indicate that the patient will fail to respond to DDS monotherapy.</p>  a0148-916X