Caractéristiques épidémiologiques des toxoplasmoses cérébrales chez 399 patients infectés par le VIH suivis entre 1983 et 1994

Bossi, Philippe; Caumes, Éric; Astagneau, Pascal; Ts, Li; Paris, Luc; Mengual, X; Katlama, Christine; Bricaire, François

doi:10.1016/s0248-8663(98)80100-8

Cited by 14 publications

(4 citation statements)

References 24 publications

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“…Also, there have been several reports on failures of the long-term treatment of toxoplasmic encephalitis, chorioretinitis, and congenital toxoplasmosis with antifolate, particularly among AIDS patients (Jacobson et al, 1996 ; Bossi et al, 1998 ; Villena et al, 1998 . Hence, there is controversy whether these failures are related to pharmacological parameters (drug intolerance, poor compliance, and malabsorption) and/or to the development of drug-resistant parasites or a lower susceptibility of the T. gondii strain (Meneceur et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

Drug Resistance in Toxoplasma gondii

et al. 2018

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Toxoplasma gondii (T. gondii) is a global protozoan parasite infecting up to one-third of the world population. Pyrimethamine (PYR) and sulfadiazine (SDZ) are the most widely used drugs for treatment of toxoplasmosis; however, several failure cases have been recorded as well; suggesting the existence of drug resistant strains. This review aims to give a systematic and comprehensive understanding of drug resistance in T. gondii including mechanisms of resistance and sites of drug action in parasite. Analogous amino acid substitutions in the Toxoplasma enzyme were identified to confer PYR resistance. Moreover, resistance to clindamycin, spiramycin, and azithromycin is encoded in the rRNA genes of T. gondii. However, T. gondii SDZ resistance mechanism has not been proved yet. Recently there has been a slight increase in SDZ resistance. That is why the majority of studies were carried out using SDZ. Six strains resistant to SDZ were found in clinical cases between 2013 and 2017 which among Brazilian T. gondii isolates, TgCTBr11, Ck3, and Pg1 were identified in human toxoplasmosis, as well as in livestock intended for human consumption. In conclusion, recent experimental studies in clinical cases have clearly shown that drug resistance in Toxoplasma is ongoing. Thus, establishing a more effective therapeutic scheme in the treatment of toxoplasmosis is critically needed. The emergence of T. gondii strains resistant to current drugs, reviewed here, represents a concern not only for treatment failure but also for increased clinical severity in immunocompromised patients. To improve the therapeutic outcome in patients, a greater understanding of the exact mechanisms of drug resistance in T. gondii should be developed. Thus, monitoring the presence of resistant parasites, in food products, would seem a prudent public health program.

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Section: Introductionmentioning

confidence: 99%

Drug Resistance in Toxoplasma gondii

et al. 2018

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“…The rst-choice therapy for the treatment of toxoplasmosis is still the combination of pyrimethamine (PYR) and sulfadiazine (SDZ) [ 5,6 ]. Although this therapy is usually effective, failures in the long-term treatment of chorioretinitis, congenital toxoplasmosis, and mainly toxoplasmic encephalitis have been reported [ 5,7,8 ]. The lack of response to treatment could be related to pharmacological parameters (drug intolerance, poor adherence, and malabsorption) and/or due to infection with drug-resistant parasites [ 9,10 ].…”

Section: Introductionmentioning

confidence: 99%

In vitro and in vivo susceptibility to sulfadiazine and pyrimethamine of Toxoplasma gondii strains isolated from Brazilian free wild bird

Bessa

Vítor

Lobo

et al. 2023

Preprint

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Little is known about the existence of drug-resistant Toxoplasma gondii strains and their possible impact on clinics. To expand our knowledge about the existence of natural variations on drug susceptibility of T. gondii strains in Brazil, we evaluated the in vitro and in vivo susceptibility to sulfadiazine (SDZ) and pyrimethamine (PYR) of three atypical strains (Wild2, Wild3, and Wild4) isolated from free-living wild birds. In vitro susceptibility assay showed that the three strains were equally susceptible to SDZ and PYR but variations in the susceptibility were observed to SDZ+PYR treatment. Variations in the proliferation rates in vitro and spontaneous conversion to bradyzoites were also accessed for all strains. Wild2 showed a lower cystogenesis capacity compared to Wild3 and Wild4. In the in vivo analysis, showed that while Wild3 was highly susceptible to all SDZ and PYR doses, and their combination, Wild2 and Wild4 showed low susceptibility to the lower doses of SDZ or PYR. Interestingly, Wild2 was also low susceptible to the higher doses of SDZ, PYR and their combination. Our results suggest that the variability to treatment response by T. gondii isolates could possibly be related not only to drug resistance but also the strain cystogenesis capacity.

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“…The first-choice therapy for the treatment of toxoplasmosis is still the combination of pyrimethamine (PYR) and sulfadiazine (SDZ) 5 , 6 . Although this therapy is usually effective, failures in the long-term treatment of chorioretinitis, congenital toxoplasmosis, and mainly toxoplasmic encephalitis have been reported 5 , 7 , 8 . The lack of response to treatment could be related to pharmacological parameters (drug intolerance, poor adherence, and malabsorption) and/or due to infection with drug-resistant parasites 9 , 10 .…”

Section: Introductionmentioning

confidence: 99%

In vitro and in vivo susceptibility to sulfadiazine and pyrimethamine of Toxoplasma gondii strains isolated from Brazilian free wild birds

Bessa

Vitor

Lobo

et al. 2023

Sci Rep

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Little is known about the existence of drug-resistant Toxoplasma gondii strains and their possible impact on clinic outcomes. To expand our knowledge about the existence of natural variations on drug susceptibility of T. gondii strains in Brazil, we evaluated the in vitro and in vivo susceptibility to sulfadiazine (SDZ) and pyrimethamine (PYR) of three atypical strains (Wild2, Wild3, and Wild4) isolated from free-living wild birds. In vitro susceptibility assay showed that the three strains were equally susceptible to SDZ and PYR but variations in the susceptibility were observed to SDZ plus PYR treatment. Variations in the proliferation rates in vitro and spontaneous conversion to bradyzoites were also accessed for all strains. Wild2 showed a lower cystogenesis capacity compared to Wild3 and Wild4. The in vivo analysis showed that while Wild3 was highly susceptible to all SDZ and PYR doses, and their combination, Wild2 and Wild4 showed low susceptibility to the lower doses of SDZ or PYR. Interestingly, Wild2 presented low susceptibility to the higher doses of SDZ, PYR and their combination. Our results suggest that the variability in treatment response by T. gondii isolates could possibly be related not only to drug resistance but also to the strain cystogenesis capacity.

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Caractéristiques épidémiologiques des toxoplasmoses cérébrales chez 399 patients infectés par le VIH suivis entre 1983 et 1994

Cited by 14 publications

References 24 publications

Drug Resistance in Toxoplasma gondii

Drug Resistance in Toxoplasma gondii

In vitro and in vivo susceptibility to sulfadiazine and pyrimethamine of Toxoplasma gondii strains isolated from Brazilian free wild bird

In vitro and in vivo susceptibility to sulfadiazine and pyrimethamine of Toxoplasma gondii strains isolated from Brazilian free wild birds

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