Costa M C, Gaspar J, Mansinho K, Esteves F, Antunes F, Matos O
Unidade de Protozoários Oportunistas/VIH e outras Protozooses, Unidade de Parasitologia e Microbiologia Médicas (UPMM), Instituto de Higiene e Medicina Tropical, Lisboa, Portugal.
Scand J Infect Dis. 2005;37(10):766-71. doi: 10.1080/00365540510038505.
In the present study, in order to improve the detection of Pneumocystis jirovecii dihydropteroate synthase (DHPS) mutations in pulmonary specimens of HIV-infected patients with P. jirovecii pneumonia, we evaluated a microfiltration procedure for the removal of human cell contamination and a nested-PCR method, for amplification in specimens with low parasite load. In the studied population, PCR amplification of the DHPS gene was more successful in unfiltered than in filtered specimens, with both touchdown-PCR and nested-PCR procedures (p<0.05 and p<0.001, respectively), but the amount of host DNA in the samples analysed seems to be inversely related with the successful PCR parasite detection. Amplification of P. jirovecii DHPS gene with nested-PCR was achieved in 77.5% of the specimens studied, demonstrating that this is a useful method for the identification of mutations in pulmonary specimens, including samples with low parasite loads, and will facilitate the evaluation of the relationship between the P. jirovecii DHPS polymorphisms and clinical resistance to sulfa drugs.
在本研究中,为了提高对感染耶氏肺孢子菌肺炎的HIV感染患者肺部标本中耶氏肺孢子菌二氢蝶酸合酶(DHPS)突变的检测,我们评估了一种用于去除人细胞污染的微滤程序以及一种巢式PCR方法,用于在低寄生虫载量的标本中进行扩增。在所研究的人群中,无论是采用降落PCR还是巢式PCR程序,DHPS基因的PCR扩增在未过滤的标本中比在过滤后的标本中更成功(分别为p<0.05和p<0.001),但分析样本中宿主DNA的量似乎与成功进行PCR检测寄生虫呈负相关。在所研究的77.5%的标本中,通过巢式PCR实现了耶氏肺孢子菌DHPS基因的扩增,这表明该方法对于鉴定肺部标本中的突变是有用的,包括低寄生虫载量的样本,并且将有助于评估耶氏肺孢子菌DHPS多态性与对磺胺类药物临床耐药性之间的关系。