Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance.
Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance.
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DOI：
10.3201/eid1010.030994
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发表时间：
2004-10
影响因子：
11.8
通讯作者：
Helweg-Larsen J
中科院分区：
文献类型：
--
作者：
Huang L;Crothers K;Atzori C;Benfield T;Miller R;Rabodonirina M;Helweg-Larsen J
我们回顾了耶氏肺孢子虫二氢蝶酸合酶基因突变的研究，并总结了对磺胺甲恶唑和氨苯砜耐药的证据。肺孢子虫肺炎仍然是艾滋病毒感染者患病和死亡的主要原因。磺胺类药物，甲氧苄啶-磺胺甲恶唑（TMP-SMX）和氨苯砜是治疗和预防PCP的主要药物。虽然预防措施降低了五氯苯酚的发病率，但其使用引起了人们对产生抗药性生物体的担忧。无法在标准化培养系统中培养人肺孢子虫，肺孢子虫，妨碍了常规的药敏试验和耐药性检测。在其他微生物中，磺胺类药物耐药性是由二氢蝶酸合酶（DHPS）基因中的特定点突变引起的。类似的突变在P. jirovecii中也观察到。研究一致表明，使用磺胺类药物预防五氯苯酚与DHPS基因突变之间存在重大关联。这些突变是否赋予对TMP-SMX或氨苯砜加甲氧苄啶治疗PCP的耐药性尚不清楚。我们回顾了关于耶氏疟原虫DHPS突变的研究，并总结了对磺胺甲恶唑和氨苯砜耐药的证据。
We review studies of dihydropteroate synthase gene mutations in Pneumocystis jirovecii and summarize the evidence for resistance to sulfamethoxazole and dapsone. Pneumocystis pneumonia (PCP) remains a major cause of illness and death in HIV-infected persons. Sulfa drugs, trimethoprim-sulfamethoxazole (TMP-SMX) and dapsone are mainstays of PCP treatment and prophylaxis. While prophylaxis has reduced the incidence of PCP, its use has raised concerns about development of resistant organisms. The inability to culture human Pneumocystis, Pneumocystis jirovecii, in a standardized culture system prevents routine susceptibility testing and detection of drug resistance. In other microorganisms, sulfa drug resistance has resulted from specific point mutations in the dihydropteroate synthase (DHPS) gene. Similar mutations have been observed in P. jirovecii. Studies have consistently demonstrated a significant association between the use of sulfa drugs for PCP prophylaxis and DHPS gene mutations. Whether these mutations confer resistance to TMP-SMX or dapsone plus trimethoprim for PCP treatment remains unclear. We review studies of DHPS mutations in P. jirovecii and summarize the evidence for resistance to sulfamethoxazole and dapsone.
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影响因子：
6.4
作者：
Kazanjian, P;Armstrong, W;Meshnick, SR
通讯作者：
Meshnick, SR
影响因子：
6.4
作者：
Ma, LA;Kovacs, JA;Atzori, C
通讯作者：
Atzori, C
影响因子：
4.9
作者：
Miller, RF;Lindley, AR;Wakefield, AE
通讯作者：
Wakefield, AE
影响因子：
6.4
作者：
Nahimana, A;Rabodonirina, M;Hauser, PM
通讯作者：
Hauser, PM
影响因子：
3.8
作者：
Kazanjian, P;Locke, AB;Meshnick, SR
通讯作者：
Meshnick, SR