Molecular detection of antimalarial resistance in Plasmodium vivax isolates from a tertiary care setting in Puducherry

Indian J Med Microbiol. 2024 Jan-Feb:47:100496. doi: 10.1016/j.ijmmb.2023.100496. Epub 2023 Nov 11.

Abstract

Purpose: The study was aimed at detecting the mutation patterns in the drug targets in Plasmodium vivax that confer resistance to the common antimalarial agents used in India.

Methods: A total of 27 Plasmodium vivax isolates collected from whole blood samples over a three year period were subjected to PCR amplification followed by sequencing of the genes pvmdr1, pvdhfr, pvdhps and pvk12, which serve as the molecular targets to detect resistance to chloroquine, pyrimethamine, sulfadoxine and artemisinin respectively.

Results: The study found T958 M F1076L double mutants of pvmdr1 in 52 %(14/27) isolates, S58R S117 N double mutants of pvdhfr in 67 % (18/27) isolates, A383G A553G double mutant pvdhps in 59 % (16/27) isolates and wild type of pvk12 gene in all the isolates.

Conclusions: There was a rise in the proportion of double mutants of pvmdr1 and pvdhfr over time. Those cases with double mutant pvmdr1 gene in their isolates were found to have a prolonged hospital stay compared to those without, indicating reduced clinical response to chloroquine.

MeSH terms

  • Antimalarials* / pharmacology
  • Antimalarials* / therapeutic use
  • Chloroquine / pharmacology
  • Chloroquine / therapeutic use
  • Drug Resistance
  • Humans
  • Malaria, Vivax* / drug therapy
  • Mutation
  • Plasmodium vivax / genetics
  • Polymerase Chain Reaction
  • Protozoan Proteins / genetics
  • Sequence Analysis, DNA
  • Tertiary Healthcare
  • Tetrahydrofolate Dehydrogenase / genetics
  • Tetrahydrofolate Dehydrogenase / therapeutic use

Substances

  • Antimalarials
  • Protozoan Proteins
  • Chloroquine
  • Tetrahydrofolate Dehydrogenase