Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance
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 deve...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Centers for Disease Control and Prevention
2004-10-01
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| Series: | Emerging Infectious Diseases |
| Subjects: | |
| Online Access: | https://wwwnc.cdc.gov/eid/article/10/10/03-0994_article |
| _version_ | 1818034845982392320 |
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| author | Laurence Huang Kristina Crothers Chiara Atzori Thomas Benfield Robert Miller Meja Rabodonirina Jannik Helweg-Larsen |
| author_facet | Laurence Huang Kristina Crothers Chiara Atzori Thomas Benfield Robert Miller Meja Rabodonirina Jannik Helweg-Larsen |
| author_sort | Laurence Huang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T06:45:38Z |
| format | Article |
| id | doaj.art-c1cd7fcf7ea64a57b1bb75e3d711335b |
| institution | Directory Open Access Journal |
| issn | 1080-6040 1080-6059 |
| language | English |
| last_indexed | 2024-12-10T06:45:38Z |
| publishDate | 2004-10-01 |
| publisher | Centers for Disease Control and Prevention |
| record_format | Article |
| series | Emerging Infectious Diseases |
| spelling | doaj.art-c1cd7fcf7ea64a57b1bb75e3d711335b2022-12-22T01:58:40ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592004-10-0110101721172810.3201/eid1010.030994Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa ResistanceLaurence HuangKristina CrothersChiara AtzoriThomas BenfieldRobert MillerMeja RabodonirinaJannik Helweg-LarsenPneumocystis 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.https://wwwnc.cdc.gov/eid/article/10/10/03-0994_articleperspective, Pneumocystis, Pneumocystis jirovecii, pneumonia, Pneumocystis, dihydropteroate synthase, dihydrofolate reductase, mutation, trimethoprim-drug resistance, microbial |
| spellingShingle | Laurence Huang Kristina Crothers Chiara Atzori Thomas Benfield Robert Miller Meja Rabodonirina Jannik Helweg-Larsen Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance Emerging Infectious Diseases perspective, Pneumocystis, Pneumocystis jirovecii, pneumonia, Pneumocystis, dihydropteroate synthase, dihydrofolate reductase, mutation, trimethoprim- drug resistance, microbial |
| title | Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance |
| title_full | Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance |
| title_fullStr | Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance |
| title_full_unstemmed | Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance |
| title_short | Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance |
| title_sort | dihydropteroate synthase gene mutations in pneumocystis and sulfa resistance |
| topic | perspective, Pneumocystis, Pneumocystis jirovecii, pneumonia, Pneumocystis, dihydropteroate synthase, dihydrofolate reductase, mutation, trimethoprim- drug resistance, microbial |
| url | https://wwwnc.cdc.gov/eid/article/10/10/03-0994_article |
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