pfmdr1 amplification associated with clinical resistance to mefloquine in West Africa: implications for efficacy of artemisinin combination therapies

Benoit Witkowski; Xavier Iriart; Patrice Njomnang Soh; Sandie Menard; Muriel Alvarez; Veronique Naneix-Laroche; Bruno Marchou; Jean-François Magnaval; Françoise Benoit-Vical; Antoine Berry

doi:10.1128/JCM.01057-10

pfmdr1 amplification associated with clinical resistance to mefloquine in West Africa: implications for efficacy of artemisinin combination therapies

J Clin Microbiol. 2010 Oct;48(10):3797-9. doi: 10.1128/JCM.01057-10. Epub 2010 Jul 28.

Authors

Benoit Witkowski¹, Xavier Iriart, Patrice Njomnang Soh, Sandie Menard, Muriel Alvarez, Veronique Naneix-Laroche, Bruno Marchou, Jean-François Magnaval, Françoise Benoit-Vical, Antoine Berry

Affiliation

¹ Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Université de Toulouse, Toulouse, France.

Abstract

We describe here a clinical failure in the treatment with mefloquine of acute falciparum malaria contracted in Africa and associated with in vitro mefloquine resistance and pfmdr1 copy number amplification. This case raises the question of the presence and the evolution of this genotype in Africa, which is also known to alter the susceptibility to artemisinin combination therapy (ACT).

Publication types

Case Reports

MeSH terms

Adult
Africa, Western
Artemisinins / pharmacology
Artemisinins / therapeutic use*
Drug Resistance*
Drug Therapy, Combination / methods
Gene Dosage
Humans
Inhibitory Concentration 50
Malaria, Falciparum / drug therapy*
Malaria, Falciparum / parasitology*
Male
Mefloquine / pharmacology
Mefloquine / therapeutic use*
Multidrug Resistance-Associated Proteins / genetics*
Treatment Failure

Substances

Artemisinins
Mdr1 protein, Plasmodium falciparum
Multidrug Resistance-Associated Proteins
artemisinin
Mefloquine