Laboratory Models of Infection and Transmission of Mycobacterium ulcerans; causative agent of Buruli ulcer disease

Identification of the environmental reservoir of Mycobacterium ulcerans, the etiological agent of Buruli ulcer, within the aquatic ecosystem has been a salient research area within the last five years. Based on extensive environmental sampling and elegant laboratory models, associations have been made between the bacterial DNA and aquatic invertebrates, biofilms, plants, fish and detritus material captured on 0.2μm pore filters. These studies have suggested that M. ulcerans is widely distributed within many functional feeding groups and may be concentrated through different trophic links; however, the specific route of transmission to humans remains a mystery. In this study we have used laboratory models of infection to ascertain the role of aquatic invertebrates and fish in M. ulcerans transmission. A biologically relevant infection model in which M. ulcerans-infected mosquito larvae were fed to a species of predaceous hemiptera (African Belostomatidae) was used to demonstrate the persistent colonization of M. ulcerans and subsequent transmission of bacteria to naïve prey. The association of M. ulcerans with specific anatomical compartments showed that M. ulcerans accumulates preferentially on the exoskeleton. No difference was found between the ability of wild-type M. ulcerans and an M. ulcerans isogenic mycolactone-negative mutant to colonize belostomatids. These data show that African belostomatids can successfully be colonized by M. ulcerans and support the trophic transfer of M. ulcerans within the environment. We have shown that M. ulcerans with or without the toxin is not lethal to fish (Medaka) even at high doses following direct inoculation. Over time (23wks), infected Medaka do not exhibit any visible signs of infection or toxicity and histopathological sections do not reveal significant gross pathogenesis. M. ulcerans also appears not to replicate in infected Medaka. We also show that fish monocytes are susceptible to nanogram amounts of purified mycolactone. This is the first study to demonstrate the possibility of fish as a reservoir for M. ulcerans within the aquatic environment.