Mutations in the dihydropteroate synthase gene of human-derived Pneumocystis carinii isolates from Italy are infrequent but correlate with prior sulfa prophylaxis
Mutations in the dihydropteroate synthase gene of human-derived Pneumocystis carinii isolates from Italy are infrequent but correlate with prior sulfa prophylaxis
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DOI：
10.1086/340220
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发表时间：
2002-05-15
影响因子：
6.4
通讯作者：
Atzori, C
中科院分区：
文献类型：
--
作者：
Ma, LA;Kovacs, JA;Atzori, C
据报道，人源性卡氏肺囊虫二氢蝶酸合成酶（DHPS）基因突变的频率越来越高，并且与先前的磺胺预防和可能出现的磺胺耐药性有关。本研究旨在研究意大利患者卡氏假单胞菌DHPS突变的患病率和临床意义。先前描述的单链构象多态性技术用于鉴定107例获得性免疫缺陷综合征患者的卡氏假单胞菌DHPS突变。总体患病率（8%）与其他报告相比较低。接受磺胺预防治疗的患者中有19%（6/31）发生突变，未接受磺胺预防治疗的患者中有4%（3/76）发生突变（P = 0.17）。未观察到DHPS突变与死亡率、CD4细胞计数或人口统计学因素之间存在显著关联。该研究证实了DHPS突变与既往磺胺预防之间的关联，并表明意大利患者人群中DHPS突变的患病率低于其他人群。
Mutations in the human-derived Pneumocystis carinii dihydropteroate synthase (DHPS) gene have been reported with increasing frequency and have been linked to prior sulfa prophylaxis and possible emergence of sulfa resistance. This study was done to examine the prevalence and clinical significance of P. carinii DHPS mutations in Italian patients. A previously described single-strand conformation polymorphism technique was used to identify P. carinii DHPS mutations in 107 patients with acquired immunodeficiency syndrome. Overall prevalence (8%) was low compared with that in other reports. Mutations were observed in 19% (6/31) of patients exposed to sulfa prophylaxis, compared with 4% (3/76) of patients not exposed to sulfa prophylaxis (P = 0.17). No significant association was observed between the presence of DHPS mutations and mortality, CD4 cell count, or demographic factors. The study confirms the association between DHPS mutations and prior sulfa prophylaxis and shows that the prevalence of DHPS mutations in an Italian patient population is lower than that in other populations.