首页> 美国卫生研究院文献>Journal of Clinical Microbiology >Relationship between Mutations in Dihydropteroate Synthase of Pneumocystis carinii f. sp. hominis Isolates in Japan and Resistance to Sulfonamide Therapy
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Relationship between Mutations in Dihydropteroate Synthase of Pneumocystis carinii f. sp. hominis Isolates in Japan and Resistance to Sulfonamide Therapy

机译:卡氏肺孢子虫二氢蝶呤合酶突变之间的关系。 sp。日本的人型分离株和对磺胺疗法的耐药性

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摘要

We examined mutations in the dihydropteroate synthase (DHPS) genes of Pneumocystis carinii f. sp. hominis (P. carinii) strains isolated from 24 patients with P. carinii pneumonia (PCP) in Japan. DHPS mutations were identified at amino acid positions 55 and/or 57 in isolates from 6 (25.0%) of 24 patients. The underlying diseases for these six patients were human immunodeficiency virus type 1 infection (n = 4) or malignant lymphoma (n = 2). This frequency was almost the same as those reported in Denmark and the United States. None of the six patients whose isolates had DHPS mutations were recently exposed to sulfa drugs before they developed the current episode of PCP, suggesting that DHPS mutations not only are selected by the pressure of sulfa agents but may be incidentally acquired. Co-trimoxazole treatment failed more frequently in patients whose isolates had DHPS mutations than in those whose isolates had wild-type DHPS (n = 4 [100%] versus n = 2 [11.1%]; P = 0.002). Our results thus suggest that DHPS mutations may contribute to failures of co-trimoxazole treatment for PCP.
机译:我们检查了卡氏肺孢子虫f的二氢蝶呤合酶(DHPS)基因中的突变。 sp。从日本的24例卡氏肺炎性肺炎(PCP)患者中分离出的人型(Carinii)菌株。在24例患者中有6例(25.0%)的分离株中,在氨基酸位置55和/或57处鉴定到DHPS突变。这六名患者的基础疾病是人类免疫缺陷病毒1型感染(n = 4)或恶性淋巴瘤(n = 2)。该频率几乎与丹麦和美国报告的频率相同。分离出具有DHPS突变的六名患者中,没有一例在出现当前PCP发作之前就接触过磺胺类药物,这表明DHPS突变不仅是由磺胺类药物的作用选择的,而且可能偶然获得。与带有野生型DHPS的菌株相比,复方新诺明的治疗失败率更高(n = 4 [100%]对n = 2 [11.1%]; P = 0.002)。因此,我们的结果表明,DHPS突变可能导致PCP的复方新诺明治疗失败。

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