Kain K C, Kyle D E, Wongsrichanalai C, Brown A E, Webster H K, Vanijanonta S, Looareesuwan S
Department of Medicine, University of Toronto, Canada.
J Infect Dis. 1994 Dec;170(6):1626-30. doi: 10.1093/infdis/170.6.1626.
Multidrug-resistant falciparum malaria is increasing in most malaria-endemic areas. Rapid methods for predicting treatment failure would aid management and control of drug-resistant infections. In this study, Plasmodium falciparum DNA clearance was examined by qualitative and semiquantitative polymerase chain reaction (PCR). Thai patients with acute falciparum malaria were prospectively followed by light microscopy and by PCR of P. falciparum DNA eluted from filter paper blood samples. A 206-bp P. falciparum sequence was amplified and detected radiometrically and by high-performance liquid chromatography. Clearance of P. falciparum DNA was significantly delayed in treatment failures compared with that in successfully treated patients (P = .02). Semiquantitative PCR levels did not drop to < 50% of pretreatment levels until day 3 or later in treatment failures compared with day 1 or earlier for successfully treated parasitemia-matched controls (P = .005). These results suggest that qualitative and semiquantitative PCR may be useful as a method for monitoring response to therapy.
在大多数疟疾流行地区，耐多药恶性疟原虫疟疾正在增加。预测治疗失败的快速方法将有助于耐药性感染的管理和控制。在本研究中，通过定性和半定量聚合酶链反应（PCR）检测恶性疟原虫DNA清除情况。对泰国急性恶性疟原虫疟疾患者进行前瞻性跟踪，采用光学显微镜检查以及对滤纸血样洗脱的恶性疟原虫DNA进行PCR检测。扩增出一段206碱基对的恶性疟原虫序列，并通过放射性测量和高效液相色谱法进行检测。与成功治疗的患者相比，治疗失败患者的恶性疟原虫DNA清除明显延迟（P = .02）。与成功治疗的、寄生虫血症匹配的对照组在第1天或更早时相比，治疗失败患者的半定量PCR水平直到第3天或更晚才降至治疗前水平的< 50%（P = .005）。这些结果表明，定性和半定量PCR可能作为一种监测治疗反应的方法有用。
