Emergence and spread of <i>Mycobacterium ulcerans</i> at different geographic scales

Abstract

<i>Mycobacterium ulcerans</i> is an environmental mycobacterial pathogen that can cause Buruli ulcer, a severe cutaneous infection, mostly spread in Africa and Australia. We conducted a large genomic study of <i>M. ulcerans</i>, combining genomic and evolutionary approaches to decipher its evolutionary history and pattern of spread at different geographic scales. At the scale of villages in an endemic area of Benin, the circulating genotypes have been introduced in recent decades and are not randomly distributed along the river. On a global scale, <i>M. ulcerans</i> has been spreading for much longer, resulting in distinct and compartmentalized endemic foci across Africa and Australia.