02920nas a2200385   4500000000100000008004100001260001700042653001200059653001600071653001200087653003100099653004100130653001100171653001100182653001000193653002300203653001200226653000900238653000900247653002100256653003200277653002500309653001300334100001700347700001300364700001500377700001300392700001200405245010800417300001100525490000700536050003200543520194500575022001402520       2002                            d  c2002 Oct-Dec10aAnimals10aClofazimine10aDapsone10aDrug Resistance, Bacterial10aDrug Resistance, Multiple, Bacterial10aFemale10aHumans10aIndia10aLeprostatic Agents10aleprosy10aMale10aMice10aMice, Inbred CBA10aMicrobial Sensitivity Tests10aMycobacterium leprae10aRifampin1 aEbenezer G J1 aNorman G1 aJoseph G A1 aDaniel S1 aJob C K00aDrug resistant-Mycobacterium leprae--results of mouse footpad studies from a laboratory in south India.  a301-120 v74  aInfolep Library - available3 a<p>Out of 265 biopsies of leprosy patients received at the Experimental Pathology Laboratory of Schieffelin Leprosy Research and Training Centre from 1987 to 1997 for evaluating resistant strains of M. leprae, using the mouse footpad technique, 49 showed resistant strains of M leprae to varying concentrations of dapsone, rifampicin and clofazimine. 23 (47%) of these were from a control area. With 369 skin-smear positive multibacillary (MB) patients as the risk group (denominator), 23 (6.23%) were resistant to one or more drugs. 18 (4.88%) had dapsone resistance, 5 (1.36%) were resistant to rifampicin and 9 (2.44%) had resistance to low concentrations of clofazimine (0.0001%). Out of the 23 biopsies with drug resistance from the control area, primary dapsone resistance was seen in 7 (30%) biopsies and secondary dapsone resistance in 11 (48%). Primary rifampicin resistance was seen in 4 (17.4%) patients, secondary rifampicin resistance in 1 (4.35%) and primary clofazimine resistance in 7 (30%). 3 (13%) of the strains showed secondary clofazimine resistance. One biopsy had resistant strains to all the three drugs. In a control area where properly supervised effective multidrug therapy (MDT) was regularly administered over the years, the emergence of drug resistance is negligible. It may not be the case if the content, duration and regularity of the drug regimen were not satisfactory. Aware of the possible shortcomings in mass administration of MDT, it is emphasized that mouse footpad studies on drug resistance should be made available at least in endemic areas where the incidence of the disease has not changed despite good MDT coverage in order to monitor the emergence of drug resistance. Research into molecular biological identification of drug resistant-M.leprae should be intensified. These steps would help to institute timely measures to check the spread of any drug-resistant organisms in the community.</p>  a0254-9395