Publication: Development of ceftazidime resistance in an acute burkholderia pseudomallei infection
Issued Date
2012-12-01
Resource Type
ISSN
11786973
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2-s2.0-84871023451
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Mahidol University
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SCOPUS
Bibliographic Citation
Infection and Drug Resistance. Vol.5, No.1 (2012), 129-132
Suggested Citation
Derek S. Sarovich, Erin P. Price, Direk Limmathurotsakul, James M. Cook, Alex T. von Schulze, Spenser R. Wolken, Paul Keim, Cref Refidaff, Talima Pearson Development of ceftazidime resistance in an acute burkholderia pseudomallei infection. Infection and Drug Resistance. Vol.5, No.1 (2012), 129-132. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/14479
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Title
Development of ceftazidime resistance in an acute burkholderia pseudomallei infection
Abstract
Burkholderia pseudomallei, a bacterium that causes the disease melioidosis, is intrinsically resistant to many antibiotics. First-line antibiotic therapy for treating melioidosis is usually the synthetic β-lactam, ceftazidime (CAZ), as almost all B. pseudomallei strains are susceptible to this drug. However, acquired CAZ resistance can develop in vivo during treat- ment with CAZ, which can lead to mortality if therapy is not switched to a different drug in a timely manner. Serial B. pseudomallei isolates obtained from an acute Thai melioidosis patient infected by a CAZ susceptible strain, who ultimately succumbed to infection despite being on CAZ therapy for the duration of their infection, were analyzed. Isolates that developed CAZ resistance due to a proline to serine change at position 167 in the β-lactamase PenA were identi- fed. Importantly, these CAZ resistant isolates remained sensitive to the alternative melioidosis treatments; namely, amoxicillin-clavulanate, imipenem, and meropenem. Lastly, real-time polymerase chain reaction-based assays capable of rapidly identifying CAZ resistance in B. pseudomallei isolates at the position 167 mutation site were developed. The ability to rapidly identify the emergence of CAZ resistant B. pseudomallei populations in melioidosis patients will allow timely alterations in treatment strategies, thereby improving patient outcomes for this serious disease. © 2012 Sarovich et al, publisher and licensee Dove Medical Press Ltd.