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

Mutations in the Dihydropteroate synthase (DHPS) gene of Pneumocystis jirovecii associate with failure of sulfa prophylaxis. They can develop by selection in patients receiving sulfa drugs, or be acquired via person-to-person transmission. DHPS mutations raise concern about decreasing efficacy of sulfa drugs, the main available therapeutic tool for Pneumocystis pneumonia (PCP).
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