HIV-ASSOCIATED PNEUMONIA DIAGNOSIS AND SURVEILLANCE FOR DRUG RESISTANCE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Penumocystis carinii penumonia (PCP) is the leading serious opportunistic infection in the United States in persons with acquired immunodeficiency syndrome (AIDS) and is responsible for an estimated 3,000 deaths per year. Although currently available antibiotics provide effective prophylaxis and treatment, there is an increasing concern that P. carinii may be developing resistance to these drugs. In order to determine if drug resistance is developing and to measure its possible spread, the Centers for Disease Control and Prevention (CDC) will establish surveillance for PCP prophylaxis and treatment failures. In addition, the CDC and collaborators will examine diagnostic tools for PCP. This is a prospective, multi-center study, sponsored and funded by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), that is being undertaken to establish survelliance for possible drug resistant strains of Pneumocystis carinii. The hypothesis is that widespread use of trimethoprim-sulfamethoxazole prophylaxis for Pneumocystis carinii pneumonia (PCP) will lead to drug resistant strains of P. carinii. In addition, this study is also examining new diagnostic tests for PCP. The specific research objectives are to: a. Establish survelliance for possible drug resistant PCP in laboratory-confirmed cases of PCP. b. Use molecular typing techniques to correlate the P. carinii genotypes of clinically resistant isolates with those of clinically sensitive ones. c. Evaluate serum assays as potential diagnostic tools to identify P. carinii.