Multiple Class i and Class II Haemophilus ducreyi Strains Cause Cutaneous Ulcers in Children on an Endemic Island

Jacob C. Grant, Camila González-Beiras, Kristen M. Amick, Kate R. Fortney, Dharanesh Gangaiah, Tricia L. Humphreys, Oriol Mitjà, Ana Abecasis, Stanley M. Spinola

Research output: Contribution to journalArticle

2 Scopus citations


Background Together with Treponema pallidum subspecies pertenue, Haemophilus ducreyi is a major cause of exudative cutaneous ulcers (CUs) in children. For H. ducreyi, both class I and class II strains, asymptomatic colonization, and environmental reservoirs have been found in endemic regions, but the epidemiology of this infection is unknown. Methods Based on published whole-genome sequences of H. ducreyi CU strains, a single-locus typing system was developed and applied to H. ducreyi-positive CU samples obtained prior to, 1 year after, and 2 years after the initiation of a mass drug administration campaign to eradicate CU on Lihir Island in Papua New Guinea. DNA from the CU samples was amplified with class I and class II dsrA-specific primers and sequenced; the samples were classified into dsrA types, which were geospatially mapped. Selection pressure analysis was performed on the dsrA sequences. Results Thirty-seven samples contained class I sequences, 27 contained class II sequences, and 13 contained both. There were 5 class I and 4 class II types circulating on the island; 3 types accounted for approximately 87% of the strains. The composition and geospatial distribution of the types varied little over time and there was no evidence of selection pressure. Conclusions Multiple strains of H. ducreyi cause CU on an endemic island and coinfections are common. In contrast to recent findings with T. pallidum pertenue, strain composition is not affected by antibiotic pressure, consistent with environmental reservoirs of H. ducreyi. Such reservoirs must be addressed to achieve eradication of H. ducreyi.

Original languageEnglish (US)
Pages (from-to)1729-1735
Number of pages7
JournalClinical Infectious Diseases
Issue number11
StatePublished - Nov 13 2018



  • Haemophilus ducreyi
  • cutaneous ulcers
  • molecular epidemiology
  • single-locus typing

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Grant, J. C., González-Beiras, C., Amick, K. M., Fortney, K. R., Gangaiah, D., Humphreys, T. L., Mitjà, O., Abecasis, A., & Spinola, S. M. (2018). Multiple Class i and Class II Haemophilus ducreyi Strains Cause Cutaneous Ulcers in Children on an Endemic Island. Clinical Infectious Diseases, 67(11), 1729-1735.