A hypermutated Mycobacterium leprae strain causing primary drug-resistance detected by specialized active search strategies in an endemic area of the Brazilian Amazon Title

Leprosy, an infectious disease caused by Mycobacterium leprae, remains a public health concern in endemic countries, particularly in Brazil. Whole genome sequencing of M. leprae from biopsies of three infected individuals from one extended family revealed a hypermutated M. leprae strain with multiple mutations for drug resistance in an unusual case of primary drug resistance while the other two strains were drug sensitive. Our results indicate the continuing transmission of leprosy that includes the spread of drug resistant strains in this region.