Identification of Nonresponsive Isolates to Glucantime in Patients with Cutaneous Leishmanaisis in Bam

Background & Aims: Cutaneous leishmaniasis (CL) is a prevalent disease worldwide including Iran. In Iran Leishmania tropica and Leishmania major are two causing factors of cutaneous leishmaniasis and Bam is one of the old and well-known focuses of CL. The objective of the present study was to identify the resistant isolates to meglumine antimoniate (MA) for implementation of future control measures in Bam. Methods: This work has been conducted during ۲۰۰۹-۲۰۱۰ in the city of Bam and Kerman School of Medicine. From a total of ۲۱۲۶ patients with CL, ۲۳۵ patients (۱۱.۱%) were resistant against MA (Glucantime) of whom ۵۱ ones were randomly selected. Skin scrapings were taken for direct smear preparations and culture media and Nested-polymerase chain reaction (PCR) were used for species identification. Findings: In this study, ۱۲۲ males (۵۱.۹%) and ۱۱۳ females (۴۸.۱%), resistant to MA were identified that shows no significant difference between the two sexes. With a significant difference most of the resistant patients were in the age group ۱۱-۲۱ years (۲۹.۴%), followed by ۱۰ years (۲۱.۶%) and the lowest were in the age group ۵۵ years (۵.۹%). Most of the lesions were on face (۵۵.۵%), the majority had one lesion (۶۴.۵%) and ۳۳.۳% received MA intra -lesionally. According to the results of PCR, all ۵۱ isolates were Leishmania tropica. Conclusion: To our knowledge this is the first study that is carried out on the resistant patients to MA in Bam. Since the incidence of this disease and drug resistance have been increased after the earth quake of ۲۰۰۳, further studies to identify genetic variants of resistant isolates in order to use new alternative drugs are required.

Keywords:

Cutaneous leishmaniasis , Leishmania tropica , Drug resistance , Nested PCR , Bam