The study, published March 26th in the open-access journal PLoS Neglected Tropical Diseases, lends support to the idea that the organism, Mycobacterium ulcerans, is transmitted to humans from environmental aquatic niches, rather than from person to person.
Buruli ulcer is a neglected, devastating, necrotizing disease, sometimes producing massive, disfiguring ulcers, with huge social impact. The disease occurs predominantly in impoverished, humid, tropical, rural areas of Africa, where the incidence has been increasing, surpassing tuberculosis and leprosy (two other diseases caused by mycobacteria) in some regions. Besides being a disease of the poor, Buruli ulcer is a poverty-promoting chronic infectious disease.
Although it has long been believed that Mycobacterium ulcerans is an environmental pathogen transmitted to humans from its aquatic niches, until now the organism has not been isolated in pure culture from environmental sources.
Françoise Portaels (Institute of Tropical Medicine, Antwerpen, Belgium) and colleagues in Ghana, Portugal, and the US, now present details of the isolation and characterization of a Mycobacterium ulcerans strain from the environment. To the best of their knowledge, this is the first time that the organism has ever been isolated and fully characterized from the environment.
The isolated strain has microbiological features typical of African strains of Mycobacterium ulcerans and was isolated from an aquatic insect (the Water Strider) from a Buruli ulcer-endemic area in Benin, West Africa.
"Our findings support the concept that Mycobacterium ulcerans is a pathogen of humans with an aquatic environmental niche," say the authors "and will have positive consequences for the control of this neglected and socially important tropical disease."
In a related expert commentary, Tim Stinear (Monash University, Clayton, Victoria, Australia) and Paul Johnson (Austin Hospital, Heidelberg, Australia), who were not involved in the study, say that the new study is “a major achievement and will serve as the definitive reference point for scientists’ intent on revealing the ecology, environmental reservoir, and precise mode of transmission of Mycobacterium ulcerans.”
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