Publication: Laboratory Detection of Artemisinin-Resistant Plasmodium falciparum.
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Accepted Date
2013-03-13
Issued Date
2014-06
Copyright Date
2014
Resource Type
Language
eng
ISSN
0066-4804 (printed)
1098-6596 (electronic)
1098-6596 (electronic)
Rights
Mahidol University
Rights Holder(s)
Antimicrobial agents and chemotherapy.
Bibliographic Citation
Chotivanich K, Tripura R, Das D, Yi P, Day NP, Pukrittayakamee S. et al. Laboratory Detection of Artemisinin-Resistant Plasmodium falciparum. Antimicrob Agents Chemother. 2014 Jun;58(6):3157-61.
Suggested Citation
Kesinee Chotivanich, เกศินี โชติวานิช, Tripura, Rupam, Das, Debashish, Poravuth Yi,c, Day, Nicholas P. J., Sasithon Pukrittayakamee, ศศิธร ผู้กฤตยาคามี, Chuor, Char Meng, Socheat, Duong, Dondorp, Arjen M., White, Nicholas J. Laboratory Detection of Artemisinin-Resistant Plasmodium falciparum.. Chotivanich K, Tripura R, Das D, Yi P, Day NP, Pukrittayakamee S. et al. Laboratory Detection of Artemisinin-Resistant Plasmodium falciparum. Antimicrob Agents Chemother. 2014 Jun;58(6):3157-61.. doi:10.1128/AAC.01924-13. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/743
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Title
Laboratory Detection of Artemisinin-Resistant Plasmodium falciparum.
Corresponding Author(s)
Abstract
Conventional 48-h in vitro susceptibility tests have low sensitivity in
identifying artemisinin-resistant Plasmodium falciparum, defined phenotypically
by low in vivo parasite clearance rates. We hypothesized originally that this
discrepancy was explained by a loss of ring-stage susceptibility and so developed
a simple field-adapted 24-h trophozoite maturation inhibition (TMI) assay
focusing on the ring stage and compared it to the standard 48-h schizont
maturation inhibition (WHO) test. In Pailin, western Cambodia, where
artemisinin-resistant P. falciparum is prevalent, the TMI test mean (95%
confidence interval) 50% inhibitory concentration (IC50) for artesunate was 6.8
(5.2 to 8.3) ng/ml compared with 1.5 (1.2 to 1.8) ng/ml for the standard 48-h WHO
test (P = 0.001). TMI IC50s correlated significantly with the in vivo responses
to artesunate (parasite clearance time [r = 0.44, P = 0.001] and parasite
clearance half-life [r = 0.46, P = 0.001]), whereas the standard 48-h test values
did not. On continuous culture of two resistant isolates, the
artemisinin-resistant phenotype was lost after 6 weeks (IC50s fell from 10 and 12
ng/ml to 2.7 and 3 ng/ml, respectively). Slow parasite clearance in falciparum
malaria in western Cambodia results from reduced ring-stage susceptibility.