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Journal of Clinical Microbiology, September 2000, p. 3161-3164, Vol. 38, No. 9
Departments of Infectious
Diseases,1 Infectious Diseases and
Applied Immunology,3 and Tumor
Biology,6 Institute of Medical Science,
University of Tokyo, Tokyo 108-8639, Departments of Internal
Medicine4 and Infectious
Diseases,5 Tokyo Metropolitan Bokutoh General
Hospital, Tokyo 130-0022, and Laboratory of Biomedical
Chemistry, Department of Applied Chemistry, Tokai University, Kanagawa
259-1292,2 Japan
Received 2 March 2000/Returned for modification 13 April
2000/Accepted 12 June 2000
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.
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Relationship between Mutations in Dihydropteroate
Synthase of Pneumocystis carinii f. sp.
hominis Isolates in Japan and Resistance to
Sulfonamide Therapy
*
Corresponding author. Mailing address: Department of
Infectious Diseases, Institute of Medical Science, University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan. Phone: 81-3-5449-5336. Fax: 81-3-5449-5427. E-mail:
takahata{at}ims.u-tokyo.ac.jp.
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