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学科主题: 临床医学
题名:
Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV-negative immunocompromised patients with Pneumocystis pneumonia
作者: Long, Yingjiao; Zhang, Cheng; Su, Li; Que, Chengli
关键词: Pneumocystis jirovecii ; drug resistance ; dihydropteroate synthase gene ; mutation
刊名: EXPERIMENTAL AND THERAPEUTIC MEDICINE
发表日期: 2014-12-01
DOI: 10.3892/etm.2014.2002
卷: 8, 期:6, 页:1825-1830
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, Research & Experimental
研究领域[WOS]: Research & Experimental Medicine
关键词[WOS]: POLYMERASE-CHAIN-REACTION ; CARINII-PNEUMONIA ; AIDS PATIENTS ; ADJUNCTIVE CORTICOSTEROIDS ; SULFA RESISTANCE ; IN-VITRO ; CASPOFUNGIN ; PREVALENCE ; PATHOGENESIS ; EXPRESSION
英文摘要:

The purpose of this study was to investigate dihydropteroate synthase (DHPS) mutations and their clinical context in non-HIV-infected patients with Pneumocystis pneumonia (PCP). DHPS genes in respiratory samples collected from HIV-negative patients with PCP presented between January 2008 and April 2011 were amplified by polymerase chain reaction (PCR) and sequenced. Basic clinical data from the medical records of the patients were also reviewed. The most common point mutations, which result in Thr55Ala and Pro57Ser amino acid Substitutions, were not detected in the Pneumocystis jirovecii sampled from the HIV-negative patients. Two other point mutations, which result in nonsynonymous mutation, Asp90Asn and Glu98Lys, were identified in P. jirovecii from two patients. Among the patients, the levels of lactate dehydrogenase (LDH), C-reactive protein (CRP) and plasma (1-3) beta-D-glucan were elevated in 75, 92.31 and 42.86% of patients, respectively. The percentage of circulating lymphocytes was significantly lower in non-survivors than in survivors [4.2%, interquartile range (IQR) 2.4-5.85 versus 10.1%, IQR 5.65-23.4; P=0.0191. The neutrophil proportion in bronchoalveolar lavage fluid (BALF) was significantly higher in non-survivors than in survivors (49.78 +/- 27.67 versus 21.33 +/- 15.03%; P=0.047). Thirteen patients had received adjunctive corticosteroids (1 mg/kg/day prednisone equivalent) and nine (69.23%) of them eventually experienced treatment failure. No common DHPS gene mutations of P. jirovecii were detected in the HIV-negative PCP patients. However, other mutations did exist, the significance of which remains to be further identified. The elevation of neutrophil counts in BALF and reduction of the number of lymphocytes in peripheral blood may be associated with poor outcome. The efficacy of adjunctive steroid therapy in HIV-negative patients with P. jirovecii infection requires further investigation.

语种: 英语
WOS记录号: WOS:000345948000027
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57441
Appears in Collections:北京大学第一临床医学院_呼吸和危重症医学科_期刊论文

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作者单位: Peking Univ, Dept Pulm Med, Hosp 1, Beijing 100034, Peoples R China

Recommended Citation:
Long, Yingjiao,Zhang, Cheng,Su, Li,et al. Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV-negative immunocompromised patients with Pneumocystis pneumonia[J]. EXPERIMENTAL AND THERAPEUTIC MEDICINE,2014,8(6):1825-1830.
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