Figure 1.
Buruli ulcer on the left limb following surgical debridement.
Also shown is joint contracture of the left wrist from scarring caused by Buruli ulcer.
Table 1.
Ghanaian isolates of M. ulcerans and other mycolactone producing mycobacteria.
Table 2.
Presumptive identification of M. ulcerans in aquatic vertebrate and invertebrate samples in Ghana 2004–2006.
Table 3.
Primers used for identification of M. ulcerans in the environment.
Figure 2.
Comparison of IS2404 and ER PCR for detection of M. ulcerans.
Lanes represent serial dilutions of M. ulcerans 1615 from 107 to 10−4 CFU detected using probes for IS2404 (A) or ER (B). Lanes are labeled 1: 1KB ladder; 2: water blank for DNA extraction; 3: water blank for PCR; 4: M. marinum 1218; 5: M. ulcerans 1615 107 CFU; 6: M. ulcerans 1615 106 CFU; 7: M. ulcerans 1615 105 CFU; 8: M. ulcerans 1615 104 CFU; 9: M. ulcerans 1615 103 CFU; 10: M. ulcerans 1615 102 CFU; 11: M. ulcerans 1615 101 CFU; 12: M. ulcerans 1615 1 CFU; 13: M. ulcerans 1615 10−1 CFU; 14: M. ulcerans 1615 10−2 CFU; 15: M. ulcerans 1615 10−3 CFU; 16: M. ulcerans 1615 10−4 CFU; 17: M. ulcerans 1615 positive control for PCR.
Figure 3.
Endemicity is based on human incidence of disease defined at the community level from data obtained from the Ghana Ministry of Health. **Location is approximate and endemicity is based on district level disease incidence data (GPS coordinates not available).
Table 4.
Detection of M. ulcerans and MPM in environmental samples using ER and VNTR PCR.
Table 5.
VNTR profiles of M. ulcerans and other MPM isolates based upon numbers of repeats found at different loci (MIRU1, locus 6, ST1, and Locus 19 when applicable).
Table 6.
VNTR analysis of ER positive samples.
Figure 4.
Collection of bacterial biofilms on glass slides from aquatic environments.
(A) Slide 1, Adigon: 3 weeks, slide 2, Adigon: 14 weeks, slide 3, Amasaman: 3 weeks, slide 4, Amasaman: 14 wks. (B) 1, Acid-fast stain of bacilli found on a slide in which VNTR profiling matched M. liflandii. 2, Acid-fast stain of bacilli found on a slide in which VNTR profiling matched M. ulcerans. Acid-fast bacilli shown are representative of those found on most collected slides.
Figure 5.
A timecourse of VNTR profiles of M. ulcerans or other mycolactone producing mycobacteria from biofilm slide samples collected from a Buruli ulcer endemic and non-endemic aquatic site.
(Top) Percent of ER-positive biofilm slides with M. ulcerans or MPM VNTR profiles at 21d, 42, and 98d from A-Adigon (non-endemic). (Bottom) Percent ER-positive biofilm slides collected at 21d, 42d, and 98d from Amasaman (endemic).
Table 7.
ER and VNTR results from all samples obtained from endemic and non-endemic sites sampled.