ArticlePloS one2012
Low prevalence of Pneumocystis pneumonia (PCP) but high prevalence of pneumocystis dihydropteroate synthase (dhps) gene mutations in HIV-infected persons in Uganda.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- The prevalence of laboratory-confirmed Pneumocystis jirovecii in HIV-infected adults in Africa: A systematic review and meta-analysis.Medical mycology · 2021Pooled it
- Pooled it
- Molecular Study ofJournal of fungi (Basel, Switzerland) · 2024Article
- Current situation of fungal diseases in Eritrea.Mycoses · 2022Article
- Molecular mechanisms of acquired antifungal drug resistance in principal fungal pathogens and EUCAST guidance for their laboratory detection and clinical implications.The Journal of antimicrobial chemotherapy · 2022Review
- Update on Dihydropteroate Synthase (DHPS) Mutations inJournal of fungi (Basel, Switzerland) · 2021Review
- Determining the burden of fungal infections in Zimbabwe.Scientific reports · 2021Article
- Efforts to Identify and Combat Antimicrobial Resistance in Uganda: A Systematic Review.Tropical medicine and infectious disease · 2021Review
- Consensus Multilocus Sequence Typing Scheme forJournal of fungi (Basel, Switzerland) · 2020Review
- Article
- Estimated Burden of Serious Fungal Infections in Ghana.Journal of fungi (Basel, Switzerland) · 2019Article
- A Molecular Window into the Biology and Epidemiology of Pneumocystis spp.Clinical microbiology reviews · 2018Review
- [Research progress on genes mutations related to sulfa drug resistance inZhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2017Review
- High Prevalence of Pneumocystis jirovecii Dihydropteroate Synthase Gene Mutations in Patients with a First Episode of Pneumocystis Pneumonia in Santiago, Chile, and Clinical Response to Trimethoprim-Sulfamethoxazole Therapy.Antimicrobial agents and chemotherapy · 2017Article
- Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients.Journal of clinical microbiology · 2016Article
- Pneumocystis jirovecii infection and the associated dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR) mutations in HIV-positive individuals from Pune, India.Mycopathologia · 2015Article
- Mutational analysis of Pneumocystis jirovecii dihydropteroate synthase and dihydrofolate reductase genes in HIV-infected patients in China.Journal of clinical microbiology · 2014Article
- Multilocus microsatellite genotyping array for investigation of genetic epidemiology of Pneumocystis jirovecii.Journal of clinical microbiology · 2014Article
- Low prevalence of Pneumocystis jirovecii lung colonization in Ugandan HIV-infected patients hospitalized with non-Pneumocystis pneumonia.Diagnostic microbiology and infectious disease · 2012Article
- Re-estimation of the burden of serious fungal diseases in Uganda.Therapeutic advances in infectious diseaseArticle
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
Pneumocystis jirovecii pneumonia (PCP) is an important opportunistic infection in patients infected with HIV, but its burden is incompletely characterized in those areas of sub-Saharan Africa where HIV is prevalent. We explored the prevalence of both PCP in HIV-infected adults admitted with pneumonia to a tertiary-care hospital in Uganda and of putative P. jirovecii drug resistance by mutations in fungal dihydropteroate synthase (dhps) and dihydrofolate reductase (dhfr). In 129 consecutive patients with sputum smears negative for mycobacteria, 5 (3.9%) were diagnosed with PCP by microscopic examination of Giemsa-stained bronchoalveolar lavage fluid. Concordance was 100% between Giemsa stain and PCR (dhps and dhfr). PCP was more prevalent in patients newly-diagnosed with HIV (11.4%) than in patients with known HIV (1.1%; p = 0.007). Mortality at 2 months after discharge was 29% overall: 28% among PCP-negative patients, and 60% (3 of 5) among PCP-positive patients. In these 5 fungal isolates and an additional 8 from consecutive cases of PCP, all strains harbored mutant dhps haplotypes; all 13 isolates harbored the P57S mutation in dhps, and 3 (23%) also harbored the T55A mutation. No non-synonymous dhfr mutations were detected. PCP is an important cause of pneumonia in patients newly-diagnosed with HIV in Uganda, is associated with high mortality, and putative molecular evidence of drug resistance is prevalent. Given the reliability of field diagnosis in our cohort, future studies in sub-Saharan Africa can investigate the clinical impact of these genotypes.
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