title: [Genotypic resistance to sulfamide drugs among patients with Pneumocystis jiroveci pneumonia].
abstract: 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.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España. sandube@cica.es
authors.forename: Enrique
authors.initials: E
authors.lastname: Calderón
authors.forename: Carmen
authors.initials: C
authors.lastname: de la Horra
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Montes-Cano
authors.forename: Nieves
authors.initials: N
authors.lastname: Respaldiza
authors.forename: José
authors.initials: J
authors.lastname: Martín-Juan
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Varela
mesh_terms: 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
chemical_list: D013449:Sulfonamides; D004094:Dihydropteroate Synthase