[Genotypic resistance to sulfamide drugs among patients with Pneumocystis jiroveci pneumonia].
OBJECTIVE
The absence of culture methods to recognize the presence of resistance to sulfa or sulfone drugs in Pneumocystis jiroveci has led to develop molecular techniques based on the identification of mutations in the dihydropteroate synthase gene (DHPS). The aim of this study was to determine the frequency of these mutations in our geographical area, since in Spain there is no information concerning this issue.


METHODS
The study included all Pneumocystis pneumonia cases identified in our hospital during two years. Diagnosis was made by nested PCR in bronchoalveolar lavage samples. DHPS-3 and DHPS-4 primers were used to amplify the DHPS gene and mutations associated with sulfa resistance were identified using a restriction fragment length polymorphism assay.


RESULTS
In 9 out of the 12 cases identified, DHPS could be amplified (75%) from which 3 (33.3%) showed some mutation linked to sulfa resistance.


CONCLUSIONS
In our area, we have found a relatively high frequency of pneumonia caused by P. jiroveci's strains with mutations associated with sulfa resistance.
Calderón
Enrique
E
Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España. sandube@cica.es
de la Horra
Carmen
C
Montes-Cano
Marco Antonio
MA
Respaldiza
Nieves
N
Martín-Juan
José
J
Varela
José Manuel
JM
D000328:Adult; D004094:Dihydropteroate Synthase / Q000235:genetics*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D045363:Pneumocystis carinii / Q000187:drug effects* / Q000201:enzymology*; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000382:microbiology*; D013449:Sulfonamides / Q000494:pharmacology* / Q000627:therapeutic use
D013449:Sulfonamides; D004094:Dihydropteroate Synthase