学科主题临床医学
Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV-negative immunocompromised patients with Pneumocystis pneumonia
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
2014-12-01
DOI10.3892/etm.2014.2002
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
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被引频次:1[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/57441
专题北京大学第一临床医学院_呼吸和危重症医学科
北京大学第一临床医学院_呼吸科
作者单位Peking Univ, Dept Pulm Med, Hosp 1, Beijing 100034, Peoples R China
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GB/T 7714
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.
APA Long, Yingjiao,Zhang, Cheng,Su, Li,&Que, Chengli.(2014).Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV-negative immunocompromised patients with Pneumocystis pneumonia.EXPERIMENTAL AND THERAPEUTIC MEDICINE,8(6),1825-1830.
MLA Long, Yingjiao,et al."Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV-negative immunocompromised patients with Pneumocystis pneumonia".EXPERIMENTAL AND THERAPEUTIC MEDICINE 8.6(2014):1825-1830.
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