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Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance

Haung, L; Crothers, KA; Atzori, C; Benfield, T; Miller, R; Rabodonirina, M; Helweg-Larsen, J; (2004) Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance. Emerging Infectious Diseases , 10 (10) 1721 - 1728. 10.3201/eid1010.030994. Green open access

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Abstract

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.

Type: Article
Title: Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance
Open access status: An open access version is available from UCL Discovery
DOI: 10.3201/eid1010.030994
Publisher version: http://dx.doi.org/10.3201/eid1010.030994
Language: English
Additional information: Emerging Infectious Diseases is published by the Centers for Disease Control and Prevention, a U.S. Government agency. Therefore, all materials published in Emerging Infectious Diseases are in the public domain and can be used without permission. Proper citation, however, is required.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/36171
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