{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:25:26Z","timestamp":1790915126263,"version":"4.1.0"},"reference-count":49,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2010,6,1]],"date-time":"2010-06-01T00:00:00Z","timestamp":1275350400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n            pneumonia (PCP) is an important cause of morbidity and mortality in immunocompromised patients. Sulfa-containing drugs are used for the treatment and prophylaxis of PCP. Mutations in the\n            <jats:italic>P. jirovecii fas<\/jats:italic>\n            gene, which encodes dihydropteroate synthase (DHPS), are associated with prior exposure to sulfa drugs, and their appearance suggests the emergence of variants with reduced sulfa susceptibility. The present study examined the prevalence of DHPS mutations in\n            <jats:italic>P. jirovecii<\/jats:italic>\n            strains isolated from South African patients with PCP.\n            <jats:italic>P. jirovecii<\/jats:italic>\n            infection was investigated by immunofluorescence microscopy and quantitative real-time PCR with respiratory specimens from 712 patients (93% of whom were &gt;15 years of age) with suspected PCP consecutively received for the detection of\n            <jats:italic>P. jirovecii<\/jats:italic>\n            over 1 year. PCR amplification and sequencing of the DHPS\n            <jats:italic>fas<\/jats:italic>\n            gene was attempted with DNA from the\n            <jats:italic>P. jirovecii<\/jats:italic>\n            -positive samples.\n            <jats:italic>P. jirovecii<\/jats:italic>\n            infection was confirmed by immunofluorescence microscopy in 168\/712 (24%) of the patients. Carriage of the fungus was revealed by real-time PCR in 17% of the patients with negative microscopy results. The\n            <jats:italic>P. jirovecii fas<\/jats:italic>\n            gene was successfully amplified from specimens from 151 patients and sequenced. Mutations resulting in the Thr55Ala and\/or Pro57Ser amino acid substitution were detected in\n            <jats:italic>P. jirovecii<\/jats:italic>\n            strains from 85\/151 (56%) patients. The high frequency of PCP episodes with\n            <jats:italic>P. jirovecii<\/jats:italic>\n            harboring DHPS mutations in South Africa indicates that populations of this fungus are evolving under the considerable selective pressure exerted by sulfa-containing antibiotics. These results, similar to previous observations of sulfa drug resistance in bacterial populations, underscore the importance of the rational use of sulfa medications either prophylactically against PCP or for the treatment of other infections.\n          <\/jats:p>","DOI":"10.1128\/jcm.02004-09","type":"journal-article","created":{"date-parts":[[2010,3,30]],"date-time":"2010-03-30T03:40:54Z","timestamp":1269920454000},"page":"2016-2021","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":35,"title":["High Prevalence of Dihydropteroate Synthase Mutations in\n            <i>Pneumocystis jirovecii<\/i>\n            Isolated from Patients with\n            <i>Pneumocystis<\/i>\n            Pneumonia in South Africa"],"prefix":"10.1128","volume":"48","author":[{"given":"Leigh","family":"Dini","sequence":"first","affiliation":[{"name":"Department of Parasitology, Mycology, and Environmental Microbiology, Swedish Institute for Infectious Disease Control, Solna, Sweden"},{"name":"School of Molecular and Cell Biology, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mignon","family":"du Plessis","sequence":"additional","affiliation":[{"name":"Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Johannesburg, South Africa"},{"name":"School of Pathology, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Frean","sequence":"additional","affiliation":[{"name":"School of Pathology, University of the Witwatersrand, Johannesburg, South Africa"},{"name":"Parasitology Reference Unit, National Institute for Communicable Diseases, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Mycology, and Environmental Microbiology, Swedish Institute for Infectious Disease Control, Solna, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/00365540701474508"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2008.04.016"},{"key":"e_1_3_2_4_2","first-page":"30","volume":"80","year":"2003","unstructured":"Chakaya, J. 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