摘要
耶氏肺孢子虫是导致免疫抑制宿主尤其是艾滋病患者机会性肺部感染（即肺孢子虫肺炎，PCP）的一种真菌。虽然磺胺类药物和氨苯砜的预防性应用已经明显降低了艾滋病患者PCP的发病率，但是与这些药物相关的抗药性的产生越来越引人关注。二氢蝶酸合成酶（DHPS）和二氢叶酸还原酶（DHFR）是磺胺类药物和氨苯砜作用的位点，现已发现这些相关基因的特殊位点会发生突变。此文对是否由于广泛的预防性用药导致了耶氏肺孢子虫的DHPS和DHFR基因突变、感染突变株患者的预后、DHPS和DHFR基因突变与对甲氧苄啶．磺胺甲基异嚼唑或氨苯砜加甲氧苄啶或乙胺嘧啶耐药的关系进行综述。
Pneumocystis jiroveci remains an important cause of pneumonia in immunocompromised patients, especially in patients with AIDS. Although prophylaxis using sulfa drugs has reduced the incidence of PCP in AIDS patients, its application has raised concerns about development of resistant P. firoveci. In other microorganisms, sulfa drug resis-tance has resulted from specific point mutations in the dihydropteroate synthase （DHPS） gene and dihydrofolate reductase gene （DHFR）. Similar mutations have been observed in P. jirovecii. Some studies have demonstrated a significant asso-ciation between the use of sulfa drugs for PCP prophylaxis and DHPS gene mutations. Whether these mutations confer resistance to TMP-SMX or dapsone plus trimethoprim for PCP treatment remains unclear. We review the studies of DHPS and DHFR mutations in P. jirovecii and summarize the evidence for resistance to sulfamethoxazole and dapsone.
出处
《国际流行病学传染病学杂志》
CAS
2008年第1期37-40,共4页
International Journal of Epidemiology and Infectious Disease
基金
广州市重大科技攻关项目（2006Z1-E0091）
广州市医药卫生科技重点项目（2005-ZDi-04）
关键词
突变
耶氏肺孢子虫
二氢蝶酸合成酶
二氢叶酸还原酶
Mutations
Pneumocystis jiroveci
Dihydropteroate synthase
Dihydrofolate reductase
