@article{fdi:010046354,
  title = {{R}esistance to trimethoprim/sulfamethoxazole and {T}ropheryma whipplei},
  author = {{F}enollar, {F}. and {R}olain, {J}. {M}. and {A}lric, {L}. and {P}apo, {T}. and {C}hauveheid, {M}. {P}. and van de {B}eek, {D}. and {R}aoult, {D}idier},
  editor = {},
  language = {{ENG}},
  abstract = {{W}hipple's disease ({WD}) is a chronic infection caused by {T}ropheryma whipplei. {A} 1-year treatment of oral trimethoprim/sulfamethoxazole ({SXT}) is commonly used. {A}dvances in the culture of {T}. whipplei have allowed for full genome sequencing and antibiotic susceptibility testing, which has demonstrated resistance of {T}. whipplei to trimethoprim. {S}everal mutations in the fol{P} gene that encodes dihydropteroate synthase, the target of sulphonamides, has been reported for one patient with clinically acquired resistance to {SXT}. {H}ere we report three new patients who experienced clinically acquired resistance to {SXT} during treatment and one patient with biological failure. {S}ixty-two fol{P} sequences from {DNA} samples of 59 {WD} patients were also obtained. {A}mong the detected amino acid changes, two positions ({N}4{S} and {S}234{F}) significantly predicted secondary sulfamethoxazole failure (four of five). {W}e suggest that these mutations should be detected at the time of {WD} diagnosis by sequencing fol{P} in order to avoid sulfamethoxazole monotherapy.},
  keywords = {{W}hipple's disease ; {T}ropheryma whipplei ; {T}rimethoprim/sulfamethoxazole ; {S}ulfadiazine ; {A}ntibiotic resistance},
  booktitle = {},
  journal = {{I}nternational {J}ournal of {A}ntimicrobial {A}gents},
  volume = {34},
  numero = {3},
  pages = {255--259},
  ISSN = {0924-8579},
  year = {2009},
  DOI = {10.1016/j.ijantimicag.2009.02.014},
  URL = {https://www.documentation.ird.fr/hor/fdi:010046354},
}