Genomic characterization of recrudescent Plasmodium malariae after treatment with artemether/lumefantrine

Rutledge, G. G. et al. (2017) Genomic characterization of recrudescent Plasmodium malariae after treatment with artemether/lumefantrine. Emerging Infectious Diseases, 23(8), pp. 1300-1307. (doi: 10.3201/eid2308.161582) (PMID:28430103) (PMCID:PMC5547787)

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Plasmodium malariae is the only human malaria parasite species with a 72-hour intraerythrocytic cycle and the ability to persist in the host for life. We present a case of a P. malariae infection with clinical recrudescence after directly observed administration of artemether/lumefantrine. By using whole-genome sequencing, we show that the initial infection was polyclonal and the recrudescent isolate was a single clone present at low density in the initial infection. Haplotypic analysis of the clones in the initial infection revealed that they were all closely related and were presumably recombinant progeny originating from the same infective mosquito bite. We review possible explanations for the P. malariae treatment failure and conclude that a 3-day artemether/lumefantrine regimen is suboptimal for this species because of its long asexual life cycle.

Item Type:Articles
Additional Information:This work was supported by the Medical Research Council (grant no. MR/J004111/1) and the Wellcome Trust (grant no. 098051 and Senior Fellowship in Clinical Science to R.N.P., 200909). R.N.P., C.I.N., and N.J.W. are funded by the Wellcome Trust. N.M.A. is supported by the National Health and Medical Research Council (practitioner fellowship no. 1042072).
Glasgow Author(s) Enlighten ID:Otto, Dr Thomas
Authors: Rutledge, G. G., Marr, I., Huang, G. K. L., Auburn, S., Marfurt, J., Sanders, M., White, N. J., Berriman, M., Newbold, C. I., Anstey, N. M., Otto, T. D., and Price, R. N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Emerging Infectious Diseases
ISSN (Online):1080-6059
First Published:First published in Emerging Infectious Diseases 23(8):1300-1307
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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