Spelling of Emerging Pathogens

of Tropical Medicine, the World Health Organization Collaborating Centre for the Diagnosis and Surveillance of Mycobacterium ulcerans Infection by IS2404 PCR and biochemical tests (online Table, available from http:www.cdc.gov/ncidod/EID/ vol11no11/05-0234.htm#table). DNA extracted from cultures by 3 freeze-boiling cycles was used for amplification, according to the protocol described by Leao et al. (10). Gel images were analyzed by using GelCompar II v. 2.5 (AppliedMaths, Sint-Martens-Latem, Belgium). Two distinct M. ulcerans PRA-hsp65 patterns were identified. Of 36 strains, 34 had a PRA-hsp65 pattern indistinguishable from that of M. marinum [BstEII and HaeIII (bp) of 235/210/0 and 145/105/80] at the Swiss PRAsite (http://app.chuv.ch/prasite/index.html). Two strains, 1 each from Japan and China, showed a different pattern [BstEII and HaeIII (bp) of 235/210/0 and 190/105/80], that described by Devallois et al. (6). We have shown that PRA-hsp65 analysis performed on several M. ulcerans strains from different geographic areas produced different patterns. In fact, the unique PRA-hsp65 profile of the M. ulcerans strain previously published (6) was the most rarely found pattern among the profiles found in this study. This work helps to clarify the PRA-hsp65 patterns of M. ulcerans found in different countries. Because the epidemiology of Buruli ulcer is poorly understood, new molecular tools are still needed to differentiate M. ulcerans from different geographic settings, mainly in Africa, where the disease is more prevalent. The PRA-hsp65 method represents a rapid, easy, and inexpensive technique to differentiate M. shinshuense from M. ulcerans and M. marinum.