title: Molecular surveillance of drug resistance through imported isolates of Plasmodium falciparum in Europe.
abstract: BACKGROUND
  Results from numerous studies point convincingly to correlations between mutations at selected genes and phenotypic resistance to antimalarials in Plasmodium falciparum isolates. In order to move molecular assays for point mutations on resistance-related genes into the realm of applied tools for surveillance, we investigated a selection of P. falciparum isolates that were imported during the year 2001 into Europe to study the prevalence of resistance-associated point mutations at relevant codons. In particular, we tested for parasites which were developing resistance to antifolates and chloroquine. The screening results were used to map the prevalence of mutations and, thus, levels of potential drug resistance in endemic areas world-wide.
  
  
  RESULTS
  337 isolates have been tested so far. Prevalence of mutations that are associated with resistance to chloroquine on the pfcrt and pfmdr genes of P. falciparum was demonstrated at high levels. However, the prevalence of mutations associated with resistance to antifolates at the DHFR and DHPS genes was unexpectedly low, rarely exceeding 60% in endemic areas.
  
  
  CONCLUSIONS
  Constant screening of imported isolates will enable TropNetEurop to establish a screening tool for emerging resistance in endemic areas.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, University of Munich, Leopoldstr, 5, 80802 Munich, Germany. jelinek@lrz.uni-muenchen.de
authors.forename: Tomas
authors.initials: T
authors.lastname: Jelinek
authors.forename: Gabriele
authors.initials: G
authors.lastname: Peyerl-Hoffmann
authors.forename: Nikolai
authors.initials: N
authors.lastname: Mühlberger
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
authors.forename: Michael
authors.initials: M
authors.lastname: Wilhelm
authors.forename: Nadja
authors.initials: N
authors.lastname: Schmider
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: Frank
authors.initials: F
authors.lastname: von Sonnenburg
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gascon
authors.forename: Hermann
authors.initials: H
authors.lastname: Laferl
authors.forename: Christoph
authors.initials: C
authors.lastname: Hatz
authors.forename: Michael
authors.initials: M
authors.lastname: Alifrangis
authors.forename: Gerd
authors.initials: G
authors.lastname: Burchard
authors.forename: Paul
authors.initials: P
authors.lastname: McWhinney
authors.forename: Marco
authors.initials: M
authors.lastname: Schulze
authors.forename: Herwig
authors.initials: H
authors.lastname: Kollaritsch
authors.forename: Saraiva
authors.initials: S
authors.lastname: da Cunha
authors.forename: Jiri
authors.initials: J
authors.lastname: Beran
authors.forename: Peter
authors.initials: P
authors.lastname: Kern
authors.forename: Ida
authors.initials: I
authors.lastname: Gjørup
authors.forename: Juan
authors.initials: J
authors.lastname: Cuadros
mesh_terms: D018528:ATP-Binding Cassette Transporters / Q000235:genetics*; D000818:Animals; D000962:Antimalarials / Q000494:pharmacology*; D002738:Chloroquine / Q000494:pharmacology; D003062:Codon; D004094:Dihydropteroate Synthase / Q000235:genetics; D004351:Drug Resistance / Q000235:genetics*; D018432:Drug Resistance, Multiple / Q000235:genetics; D005060:Europe; D005493:Folic Acid Antagonists / Q000494:pharmacology; D006801:Humans; D016778:Malaria, Falciparum / Q000469:parasitology; D008565:Membrane Proteins / Q000235:genetics*; D026901:Membrane Transport Proteins; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D017354:Point Mutation; D015800:Protozoan Proteins / Q000235:genetics*; D013762:Tetrahydrofolate Dehydrogenase / Q000235:genetics; D014195:Travel
chemical_list: D018528:ATP-Binding Cassette Transporters; D000962:Antimalarials; D003062:Codon; D005493:Folic Acid Antagonists; D008565:Membrane Proteins; D026901:Membrane Transport Proteins; C416369:PfCRT protein, Plasmodium falciparum; D015800:Protozoan Proteins; C059987:mdr gene protein, Plasmodium; D002738:Chloroquine; D013762:Tetrahydrofolate Dehydrogenase; D004094:Dihydropteroate Synthase