Low-dose treatment with sulfadoxine-pyrimethamine combinations selects for drug-resistant Plasmodium falciparum strains

被引:37
作者
Kun, JFJ
Lehman, LG
Lell, B
Schmidt-Ott, R
Kremsner, PG
机构
[1] Univ Tubingen, Inst Trop Med, Dept Parasitol, D-72074 Tubingen, Germany
[2] Albert Schweitzer Hosp, Res Unit, Lambarene, Gabon
[3] Univ Vienna, Dept Infect Dis, Vienna, Austria
关键词
D O I
10.1128/AAC.43.9.2205
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
A total of 252 children mere enrolled in a drug trial to assess the effect of minimal doses of sulfadoxine (Sdx) and pyrimethamine (Pyr). Parasite samples isolated from these patients,were analyzed before and after treatment to investigate the level of drug-resistant strains. The parasite genes encoding dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) were assayed for point mutations that are associated with resistance against drugs. Before treatment, Pyr(r) genotypes of the DHFR gene were found in 42% of all samples, 8% of the patients harbored a mixed parasite population and 50% had a sensitive DHFR genotype, In terms of the DHPS gene, me found mutations in 45% of the parasites. Twenty-four percent had a Ser,,, mutation, and 26% had a Gly(437) mutation. Recrudescent parasites were highly enriched for both Pyr(r) and Sdx(r) strains after treatment (P < 0.001 and P = 0.029? respectively).
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页码:2205 / 2208
页数:4
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