New Insights into the Geographic Distribution of XXXX SNP Genotypes Determined for Isolates from Leprosy Cases Diagnosed in Metropolitan France and French Territories.

@entity1 @entity3595 @entity4430 @entity1201
BACKGROUND: Between 20 and 30 bacteriologically confirmed cases of @entity1201 are diagnosed each year at the French National Reference Center for mycobacteria. @entity1 are mainly immigrants from various endemic countries or living in French overseas territories. We aimed at expanding data regarding the geographical distribution of the SNP genotypes of the @entity4430 isolates from these @entity1 . METHODOLOGY/PRINCIPAL FINDINGS: Skin biopsies were obtained from 71 @entity1201 @entity1 diagnosed between January 2009 and December 2013. Data regarding age, sex and place of birth and residence were also collected. Diagnosis of @entity1201 was confirmed by microscopic detection of acid-fast bacilli and/or amplification by PCR of the @entity4430 -specific RLEP region. Single nucleotide polymorphisms (SNP), present in the @entity4430 genome at positions 14 676, 1 642 875 and 2 935 685, were determined with an efficiency of 94% (67/71). Almost all @entity1 were from countries other than France where @entity1201 is still prevalent (n = 31) or from French overseas territories (n = 36) where @entity1201 is not totally eradicated, while only a minority (n = 4) was born in metropolitan France but have lived in other countries. SNP type 1 was predominant (n = 33), followed by type 3 (n = 17), type 4 (n = 11) and type 2 (n = 6). SNP types were concordant with those previously reported as prevalent in the @entity1 ' countries of birth. SNP types found in @entity1 born in countries other than France (Comoros, Haiti, Benin, Congo, @entity3595 Lanka) and French overseas territories (French Polynesia, Mayotte and La R  union) not covered by previous work correlated well with geographical location and history of @entity1 settlements. CONCLUSIONS/SIGNIFICANCE: The phylogenic analysis of @entity4430 strains isolated in France strongly suggests that French @entity1201 cases are caused by SNP types that are (a) concordant with the geographic origin or residence of the @entity1 (non-French countries, French overseas territories, metropolitan France) or (b) more likely random in regions where diverse migration flows occurred.
