Chapter 148 : Mechanisms of Resistance to Antiparasitic Agents

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The chapter talks about the mechanisms of resistance to antiparasitic agents. , the most virulent species, which adapts more easily to environmental constraints in tropical areas, has become the dominant species, and its resistance to chloroquine, to sulfadoxine-pyrimethamine, and, further, to all known drugs has developed to various degrees. True resistance is more likely in anthroponotic forms of leishmaniasis, such as those caused by and , because the zoonotic species that infect primarily animals, with humans as an occasional host, rarely encounter drugs. Laboratory or field isolates with resistance to pentavalent antimonials are also killed effectively by paromomycin and miltefosine. Several factors contribute to the emergence of drug- resistant parasites. Public health interventions to correct these factors have not always been successful and would benefit from a better understanding of the drug resistance mechanisms used by parasites. These mechanisms are very diverse and have been difficult to study, but recent technological advances now provide long-awaited tools that will facilitate the task. The genome sequences for , , , , and have been compiled. When these data are used, for example, in combination with microarray technology, where the DNA of drug-resistant parasite strains is compared to that of drugsusceptible strains, identification of the genes that confer resistance should proceed even more rapidly than in the last few years.

Citation: Secor W, Le Bras J. 2011. Mechanisms of Resistance to Antiparasitic Agents , p 2296-2306. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch148

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Generic image for table

Summary of proposed mechanisms of resistance to selected antiparasitic drugs

Disease caused predominantly by , , , and .

Disease caused by Trichomonas vaginalis.

Diseases caused by one of several species.

Disease caused by subsp. rhodesiense and subsp. gambiense.

caused predominantly by , , and .

Citation: Secor W, Le Bras J. 2011. Mechanisms of Resistance to Antiparasitic Agents , p 2296-2306. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch148

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