TABLE 3

Dihydropteroate synthase genotypes and clinical outcomes among 56 patients with a first episode of PCPa

Treatment and/or outcomeHIV-infected patients (n = 46)Non-HIV-infected patients (n = 10)
Wild-type DHPS genotype (n = 24)Mutant DHPS genotype (n = 22)PWild-type DHPS genotype (n = 5)Mutant DHPS genotype (n = 5)P
Initial treatment with trimethoprim-sulfamethoxazole23/24 (96)b20/22 (91)c0.6005/5 (100)5/5 (100)ND
Adverse effect2/24 (8)d4/22 (18)e0.4520/5 (0)0/5 (0)ND
Need for treatment change0/24 (0)4/22 (18)f0.0451/5 (20)g0/5 (0)ND
Sulfa allergies1/24 (4)4/22 (18)0.1780/5 (0)0/5 (0)ND
Adjunctive corticosteroids21/24 (888)15/22 (68)0.1594/5 (80)4/5 (80)ND
Duration of hospitalization (days)
    Median (IQR)11 (6–19)20 (10–42)0.07330 (14–40)25 (8–37)ND
    No. with available data/total no.19/2416/225/55/5
Required supplemental oxygen24/24 (100)20/22 (91)5/5 (100)5/5 (100)
    Median days (IQR)11.5 (6.7–19.5)14.5 (7.0–20)0.20334 (14–40)17 (10–24)ND
    No. with available data/total no.22/2420/225/55/5
Need for early ICU admission8/22 (36)7/20 (35)0.7631/5 (20)3/4 (75)ND
    No. with available data/total no.22/2420/225/54/5
Mechanical ventilation9/24 (38)7/22 (32)4/5 (80)5/5 (100)
    Median days (IQR)6 (2.25–7.75)11 (8–56)0.01725 (10–30)14 (8–35)ND
Pulmonary coinfection7/24 (29)5/22 (23)3/5 (60)2/5 (40)
    Bacterial1h3i3j2k
    Viral4l000
    Bacterial + viral2m2n00
Treatment outcome
    Survived24/24 (100)22/22 (100)2/5 (40)3/5 (60)
    Died0 (0)0 (0)3/5 (60)2/5 (40)
    Death due to PCP0 (0)0 (0)2/3 (67)1/2 (50)
  • a Values are expressed as the number of patients/total number of patients (%), except as states otherwise in column 1.

  • b Pyrimethamine + sulfadoxine (n = 1).

  • c Caspofungin + trimethoprim-sulfamethoxazole (n = 1); dapsone + trimethoprim-sulfamethoxazole (n = 1).

  • d Rash (n = 2).

  • e Rash (n = 2); acute kidney injury (n = 1); rash, interstitial nephritis, hepatitis (n = 1).

  • f Change trimethoprim-sulfamethoxazole to: dapsone (n = 2); dapsone + clindamycin (n = 2).

  • g Treatment failure change to intravenous pentamidine.

  • h Acinetobacter baumannii (n = 1).

  • i Streptococcus pneumoniae (n = 1); Klebsiella pneumoniae (n = 1); Stenotrophomonas maltophilia (n = 1).

  • j Pseudomonas aeruginosa (n = 1); Klebsiella pneumoniae (n = 1); Proteus mirallis (n = 1).

  • k Enterobacter cloacae (n = 2).

  • l Cytomegalovirus (CMV).

  • m Acinetobacter baumannii + CMV (n = 1); Enterobacter cloacae + CMV (n = 1).

  • n β-Hemolytic streptococcus + CMV (n = 1); atypical mycobacteria + CMV (n = 1).