文摘
Mycobacterium ulcerans is an emerging pathogen causing the skin infection Buruli ulcer (BU), one of the most neglected tropical diseases. BU is characterized by the formation of chronic, necrotizing skin lesions. This pathology is mainly attributed to the cytotoxic and immunosuppressive activities of the unique polyketide-derived macrolide toxin mycolactone secreted by the pathogen. The disease has been reported from more than 30 countries worldwide, with an extremely focal geographic distribution within endemic countries and highest incidences in remote communities of West/Central Africa and also certain coastal areas of Australia. While M. ulcerans has long been considered an environmental bacterium, recent findings from south-eastern Australia, identifying possums as probable reservoirs of infection, indicate its zoonotic potential. The exact route of M. ulcerans transmission is unclear, although it is commonly assumed that infection takes place either through physical contact with environmental reservoirs via skin abrasions or through insect bites, while direct human-to-human transmission seems to be rare. Keywords Mycobacterium ulcerans Buruli ulcer Neglected tropical disease Animal reservoir Possums