Parola Philippe, Pradines Bruno, Simon Fabrice, Carlotti Marie-Paule, Minodier Philippe, Ranjeva Marie-Pierre, Badiaga Sékéné, Bertaux Lionel, Delmont Jean, Morillon Marc, Silai Ramatou, Brouqui Philippe, Parzy Daniel
Service des Maladies Infectieuses et Tropicales, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Am J Trop Med Hyg. 2007 Sep;77(3):431-7.
A total of 248 Plasmodium falciparum isolates were sampled in travelers with malaria who came to Marseille, France from Comoros to investigate in vitro activities of antimalarial drugs and molecular markers of drug resistance. Of the 248 isolates, 126 were maintained in culture. Of these, 53% were resistant to chloroquine, and 3% had reduced susceptibility to quinine, mefloquine, and atovaquone; 1% had reduced susceptibility to halofantrine and dihydroartemisinin; 7% had reduced susceptibility to monodesethylamodiaquine; 37% had reduced susceptibility to cycloguanil; and none had reduced susceptibility to lumefantrine. Resistance-associated point mutations were screened in 207 isolates. No mutations in the cytochrome b gene were found. Of the 207 isolates, 119 (58%) had a mutation in the P. falciparum dihydrofolate reductase (Pfdhfr) gene at codon 108, 6 (5%) had mutations in both Pfdhfr codon 108 and the P. falciparum dihydropteroate synthase codon 437, and 115 (56%) had the chloroquine resistance-associated K76T mutation in the P. falciparum chloroquine resistance transporter gene. This study represents a unique opportunity to improve surveillance of P. falciparum drug resistance in Comoros with consequences for treatment and chemoprophylaxis guidelines.
对248株来自科摩罗、前往法国马赛的疟疾患者体内的恶性疟原虫分离株进行了采样，以研究抗疟药物的体外活性和耐药性分子标记。在这248株分离株中，126株进行了培养。其中，53%对氯喹耐药，3%对奎宁、甲氟喹和阿托伐醌的敏感性降低；1%对卤泛群和双氢青蒿素的敏感性降低；7%对单去乙基氨喹的敏感性降低；37%对环氯胍的敏感性降低；无一株对本芴醇的敏感性降低。对207株分离株进行了耐药相关点突变筛查。未发现细胞色素b基因的突变。在207株分离株中，119株（58%）恶性疟原虫二氢叶酸还原酶（Pfdhfr）基因第108位密码子发生突变，6株（5%）Pfdhfr第108位密码子和恶性疟原虫二氢蝶酸合酶第437位密码子均发生突变，115株（56%）恶性疟原虫氯喹耐药转运蛋白基因存在与氯喹耐药相关的K76T突变。本研究为加强科摩罗恶性疟原虫耐药性监测提供了独特契机，对治疗和化学预防指南具有重要意义。
