期刊
LANCET
卷 366, 期 9501, 页码 1960-1963出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(05)67787-2
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Artemisinin derivatives are an essential component of treatment against multidrug-resistant Plasmodium falciparum malaria. We aimed to investigate in-vitro resistance to arternisinin derivatives in field isolates. In-vitro susceptibility of 530 P faliciparum isolates from three countries (Cambodia, French Guiana, and Senegal) with different arternisinin use was assessed with an isotopic microtest. Artemether IC50 up to 117 and 45 nmol/L was seen in French Guiana and Senegal, respectively. DNA sequencing in a subsample of 60 isolates lends support to SERCA-PfATPase6 as the target for artemisinins. The S769N PfATPase6 mutation, noted exclusively in French Guiana, was associated with raised (>30 nmol/L) artemether IC(50)s (p<0.0001, Mann-Whitney). All resistant isolates came from areas with uncontrolled use of arternisinin derivatives. This rise in resistance indicates the need for increased vigilance and a coordinated and rapid deployment of drug combinations.
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