Whole-Genome Sequencing to Evaluate the Resistance Landscape Following Antimalarial Treatment Failure with Fosmidomycin-Clindamycin

Ann M. Guggisberg, Sesh A. Sundararaman, Miguel Lanaspa, Cinta Moraleda, Raquel González, Alfredo Mayor, Pau Cisteró, David Hutchinson, Peter G. Kremsner, Beatrice H. Hahn, Quique Bassat, Audrey R. Odom

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Novel antimalarial therapies are needed in the face of emerging resistance to artemisinin combination therapies. A previous study found a high cure rate in Mozambican children with uncomplicated Plasmodium falciparum malaria 7 days after combination treatment with fosmidomycin-clindamycin. However, 28-day cure rates were low (45.9%), owing to parasite recrudescence. We sought to identify any genetic changes underlying parasite recrudescence. To this end, we used a selective whole-genome amplification method to amplify parasite genomes from blood spot DNA samples. Parasite genomes from pretreatment and postrecrudescence samples were subjected to whole-genome sequencing to identify nucleotide variants. Our data did not support the existence of a genetic change responsible for recrudescence following fosmidomycin-clindamycin treatment. Additionally, we found that previously described resistance alleles for these drugs do not represent biomarkers of recrudescence. Future studies should continue to optimize fosmidomycin combinations for use as antimalarial therapies.

Original languageEnglish
Pages (from-to)1085-1091
Number of pages7
JournalJournal of Infectious Diseases
Issue number7
StatePublished - Oct 1 2016


  • Malaria
  • Plasmodium
  • clindamycin
  • fosmidomycin
  • recrudescence
  • whole genome amplification


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