Abstract
Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical disease found in rural areas of West and Central Africa. Despite the ongoing efforts to tackle Buruli ulcer epidemics, the environmental reservoir of its pathogen remains elusive, underscoring the need for new approaches to improving disease prevention and management. In our study, we implemented a local-scale spatial clustering model and deciphered the genetic diversity of the bacteria in a small area of Benin where Buruli ulcer is endemic. Using 179 strain samples from West Africa, we conducted a phylogeographic analysis combining whole-genome sequencing with spatial scan statistics. The 8 distinct genotypes we identified were by no means randomly spread over the studied area. Instead, they were divided into 3 different geographic clusters, associated with landscape characteristics. Our results highlight the ability of M. ulcerans to evolve independently and differentially depending on location in a specific ecologic reservoir.
Highlights
Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical disease found in rural areas of West and Central Africa
We evaluated the presence of specific clusters according to the geographic localization of patients and performed local-scale clustering by using a phylogenetic analysis approach based on single-nucleotide polymorphism (SNP) typing, coupled with spatial scan statistics
Reservoirs of Mycobacterium ulcerans, Benin selected from Benin (Ouémé and Plateau) were representative of the epidemiologic data of Buruli ulcer (BU) in patients in Benin (Appendix 2 Tables 1, 2, https://wwwnc.cdc. gov/EID/article/26/3/19-0573-App2.xlsx)
Summary
Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical disease found in rural areas of West and Central Africa. Buruli ulcer (BU) is a devastating necrotic human skin disease caused by Mycobacterium ulcerans [1]. It is the third most common mycobacterial disease after tuberculosis and leprosy; ≈2,000 cases are reported each year worldwide, mostly in rural areas of West and Central Africa. Whole-genome sequencing (WGS), coupled with single-nucleotide polymorphism (SNP)–based genotyping, has led to major advances in M. ulcerans genomics This approach was applied recently to provide a description of the M. ulcerans population structure in Ghana [13]. It has been used to provide insights into the circulating genotypes in BUendemic regions of Cameroon [14] and to study the evolution of M. ulcerans in Africa and southeastern
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