Absence of dihydropteroate synthase gene mutations in Pneumocystis jirovecii strains isolated from Aegean region of Turkey

• Published in: Parasitology research (1987) Vol. 117; no. 10; pp. 3103 - 3108
• Main Authors: Ozkoc, Soykan, Erguden, Ceren, Bayram Delibas, Songul
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2018; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Alveoli; Antifungal Agents - therapeutic use; Ascomycota; Autopsy; Biomedical and Life Sciences; Biomedicine; Bronchoalveolar Lavage Fluid; Bronchus; Child, Preschool; Dapsone; DHPS gene; Dihydropteroate synthase; Dihydropteroate Synthase - genetics; Drug Resistance, Fungal - genetics; Gene mutation; Gene polymorphism; Genetic aspects; Genotype; Humans; Immunocompromised Host; Immunology; Infant; Lung - parasitology; Medical Microbiology; Microbial enzymes; Microbiology; Middle Aged; Mutation; Mutation - genetics; Original Paper; Pneumocystis carinii - drug effects; Pneumocystis carinii - genetics; Pneumocystis carinii - isolation & purification; Pneumonia, Pneumocystis - drug therapy; Pneumonia, Pneumocystis - microbiology; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Prophylaxis; Restriction fragment length polymorphism; Studies; Sulfamethoxazole; Sulfonamides; Sulfonamides - therapeutic use; Trimethoprim; Trimethoprim-sulfamethoxazole; Turkey; Young Adult; Turkey; Cotrimaxazole; Turkey; Mutation; dihydropteroate synthase gene; Pneumocystis jirovecii
• ISSN: 0932-0113; 1432-1955
• DOI: 10.1007/s00436-018-6004-6

Sulfonamide group drugs and their antimetabolite combinations are the most preferred drugs in the treatment and prophylaxis of
Pneumocystis jirovecii
pneumonia (PCP). Especially with the long-term use of trimethoprim-sulfamethoxazole (TMP-SMX) and dapsone, certain point mutations in the
Pneumocystis jirovecii
(
P. jirovecii
) dihydropteroate synthase (DHPS) gene are known to play an important role in the development of resistance. In the present study, we investigated the 165th and 171st nucleotide mutations in the DHPS gene in the
P. jirovecii
isolates from immunosuppressed and immunocompetent cases.
P. jirovecii
isolates from the bronchoalveolar lavage fluid (BALF) samples of 31 hospitalized cases and lung tissue samples of 37 autopsy cases were included in the study. For the analysis of wild-type and mutant genotypes, after the touchdown-PCR amplification method, the restriction fragment length polymorphism (RFLP) method was used. In this study,
P. jirovecii
DHPS gene was amplified in 28 of 68 (41%) of the samples. The RFLP method revealed that all the isolates in which the DHPS gene was amplified were considered as wild-type genotypes. To our knowledge, this present study is the first study in Turkey investigating
P. jirovecii
DHPS gene mutations associated with the sulfonamide resistance. All the isolates showed a wild-type pattern indicating that the occurrence of
P. jirovecii
DHPS mutations in Turkey is very low or absent.