Association between a specific Pneumocystis jiroveci dihydropteroate synthase mutation and failure of pyrimethamine/sulfadoxine prophylaxis in human immunodeficiency virus-positive and -negative patients

Détails

ID Serval
serval:BIB_79DA7A2E9F6F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Association between a specific Pneumocystis jiroveci dihydropteroate synthase mutation and failure of pyrimethamine/sulfadoxine prophylaxis in human immunodeficiency virus-positive and -negative patients
Périodique
Journal of Infectious Diseases
Auteur(s)
Nahimana  A., Rabodonirina  M., Zanetti  G., Meneau  I., Francioli  P., Bille  J., Hauser  P. M.
ISSN
0022-1899 (Print)
Statut éditorial
Publié
Date de publication
10/2003
Volume
188
Numéro
7
Pages
1017-23
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Oct 1
Résumé
To investigate the possible association between different prophylactic sulfa drugs and the genotype of the Pneumocystis jiroveci dihydropteroate synthase (DHPS) gene, we examined DHPS polymorphisms in clinical specimens from 158 immunosuppressed patients (38 HIV-negative and 120 HIV-positive), using polymerase chain reaction-single-strand conformation polymorphism. Fifty-seven (36.1%) of 158 patients were infected with a mutant DHPS genotype. All patients who developed P. jiroveci pneumonia (PcP) while receiving pyrimethamine/sulfadoxine (PM/SD) prophylaxis (n=14) had a strain harboring DHPS with an amino acid change at position 57 (Pro-->Ser). This mutation was only present in 20 (14%) of 144 patients not receiving prophylaxis (P<.001). Hospitalization in a specific hospital was an independent risk factor for having P. jiroveci harboring the same DHPS mutation, which indirectly supports that interhuman transmission may affect the dissemination of the mutant strains.
Mots-clé
Adolescent Adult Aged Alleles *Anti-Bacterial Agents Antibiotic Prophylaxis/*methods Bronchoalveolar Lavage Fluid/microbiology Child Child, Preschool Dihydropteroate Synthase/*genetics Drug Combinations Drug Therapy, Combination/*pharmacology Female HIV Infections/immunology/*microbiology *Hiv-1 Humans Immunocompromised Host Male Middle Aged Pneumocystis/*enzymology/genetics Pneumocystis Infections/immunology/*microbiology/prevention & control/virology Point Mutation Polymerase Chain Reaction Polymorphism, Single-Stranded Conformational Pyrimethamine/*pharmacology Sulfadoxine/*pharmacology
Pubmed
Web of science
Open Access
Oui
Création de la notice
25/01/2008 18:07
Dernière modification de la notice
08/05/2019 20:44
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