search button

Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV‑negative immunocompromised patients with Pneumocystis pneumonia

  • Authors:
    • Yingjiao Long
    • Cheng Zhang
    • Li Su
    • Chengli Que

  • View Affiliations

  • Published online on: October 3, 2014     https://doi.org/10.3892/etm.2014.2002
  • Pages: 1825-1830
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

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) β‑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=0.019]. 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.
View References

Related Articles

Journal Cover

December-2014
Volume 8 Issue 6

Print ISSN: 1792-0981
Online ISSN:1792-1015

Sign up for eToc alerts

Recommend to Library

  • Journal Metrics
  • Impact Factor: 2.7
  • Ranked Medicine Research and Experimental
    (total number of cites)
International Symposium on Molecular Medicine Conference Banner
The Cancer Story
World Congress on Advances in Oncology and International Symposium on Molecular Medicine Conference Banner
World Academy Of Sciences Banner
Heyday Road Banner

0

Copy and paste a formatted citation
x
Spandidos Publications style
Long Y, Zhang C, Su L and Que C: Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV‑negative immunocompromised patients with Pneumocystis pneumonia. Exp Ther Med 8: 1825-1830, 2014
APA
Long, Y., Zhang, C., Su, L., & Que, C. (2014). Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV‑negative immunocompromised patients with Pneumocystis pneumonia. Experimental and Therapeutic Medicine, 8, 1825-1830. https://doi.org/10.3892/etm.2014.2002
MLA
Long, Y., Zhang, C., Su, L., Que, C."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.
Chicago
Long, Y., Zhang, C., Su, L., Que, C."Pneumocystis jirovecii dihydropteroate synthase gene mutations in a group of HIV‑negative immunocompromised patients with Pneumocystis pneumonia". Experimental and Therapeutic Medicine 8, no. 6 (2014): 1825-1830. https://doi.org/10.3892/etm.2014.2002