Publication: Antibiotic susceptibility of clinical burkholderia pseudomallei isolates in northeast thailand from 2015 to 2018 and the genomic characterization of β-lactam-resistant isolates
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Issued Date
2021-05-01
Resource Type
ISSN
10986596
00664804
00664804
Other identifier(s)
2-s2.0-85105098806
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Antimicrobial Agents and Chemotherapy. Vol.65, No.5 (2021)
Suggested Citation
Shirley Yi Fen Hii, Sarunporn Tandhavanant, Rungnapa Phunpang, Peeraya Ekchariyawat, Natnaree Saiprom, Claire Chewapreecha, Rathanin Seng, Ekkachai Thiansukhon, Chumpol Morakot, Narongchai Sangsa, Sunee Chayangsu, Somchai Chuananont, Kittisak Tanwisaid, Wirayut Silakun, Noppol Buasi, Seksan Chaisuksant, Tanin Hompleum, Ploenchan Chetchotisakd, Nicholas P.J. Day, Wasun Chantratita, Ganjana Lertmemongkolchai, T. Eoin West, Narisara Chantratita Antibiotic susceptibility of clinical burkholderia pseudomallei isolates in northeast thailand from 2015 to 2018 and the genomic characterization of β-lactam-resistant isolates. Antimicrobial Agents and Chemotherapy. Vol.65, No.5 (2021). doi:10.1128/AAC.02230-20 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/78246
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Title
Antibiotic susceptibility of clinical burkholderia pseudomallei isolates in northeast thailand from 2015 to 2018 and the genomic characterization of β-lactam-resistant isolates
Author(s)
Shirley Yi Fen Hii
Sarunporn Tandhavanant
Rungnapa Phunpang
Peeraya Ekchariyawat
Natnaree Saiprom
Claire Chewapreecha
Rathanin Seng
Ekkachai Thiansukhon
Chumpol Morakot
Narongchai Sangsa
Sunee Chayangsu
Somchai Chuananont
Kittisak Tanwisaid
Wirayut Silakun
Noppol Buasi
Seksan Chaisuksant
Tanin Hompleum
Ploenchan Chetchotisakd
Nicholas P.J. Day
Wasun Chantratita
Ganjana Lertmemongkolchai
T. Eoin West
Narisara Chantratita
Sarunporn Tandhavanant
Rungnapa Phunpang
Peeraya Ekchariyawat
Natnaree Saiprom
Claire Chewapreecha
Rathanin Seng
Ekkachai Thiansukhon
Chumpol Morakot
Narongchai Sangsa
Sunee Chayangsu
Somchai Chuananont
Kittisak Tanwisaid
Wirayut Silakun
Noppol Buasi
Seksan Chaisuksant
Tanin Hompleum
Ploenchan Chetchotisakd
Nicholas P.J. Day
Wasun Chantratita
Ganjana Lertmemongkolchai
T. Eoin West
Narisara Chantratita
Other Contributor(s)
Ramathibodi Hospital
Faculty of Tropical Medicine, Mahidol University
Udon Thani Center Hospital
Faculty of Medicine, Khon Kaen University
Surin Hospital
Khon Kaen University
Khon Kaen Regional Hospital
Mahidol University
Nuffield Department of Medicine
King Mongkut's University of Technology Thonburi
Wellcome Sanger Institute
Harborview Medical Center
Buriram Hospital
Sisaket Hospital
Roi Et Hospital
Nakhon Phanom Hospital
Mukdahan Hospital
Faculty of Tropical Medicine, Mahidol University
Udon Thani Center Hospital
Faculty of Medicine, Khon Kaen University
Surin Hospital
Khon Kaen University
Khon Kaen Regional Hospital
Mahidol University
Nuffield Department of Medicine
King Mongkut's University of Technology Thonburi
Wellcome Sanger Institute
Harborview Medical Center
Buriram Hospital
Sisaket Hospital
Roi Et Hospital
Nakhon Phanom Hospital
Mukdahan Hospital
Abstract
Melioidosis is an often fatal infection in tropical regions caused by an environmental bacterium, Burkholderia pseudomallei. Current recommended melioidosis treatment requires intravenous β-lactam antibiotics such as ceftazidime (CAZ), meropenem (MEM), or amoxicillin-clavulanic acid (AMC) and oral trimethoprim-sulfamethoxazole. Emerging antibiotic resistance could lead to therapy failure and high mortality. We performed a prospective multicenter study in northeast Thailand from 2015 to 2018 to evaluate antibiotic susceptibility and characterize β-lactam resistance in clinical B. pseudomallei isolates. A collection of 1,317 B. pseudomallei isolates from patients with primary and relapse infections were evaluated for susceptibility to CAZ, imipenem (IPM), MEM, and AMC. β-Lactam-resistant isolates were confirmed by the broth microdilution method and characterized by whole-genome sequence analysis, penA expression, and β-lactamase activity. The resistant phenotype was verified via penA mutagenesis. All primary isolates were IPM susceptible, but we observed two CAZ-resistant isolates and one CAZ-intermediate isolate, two MEMCitation less-susceptible isolates, and one AMC-resistant and two AMC-intermediate isolates. One of 13 relapse isolates was resistant to both CAZ and AMC. Two isolates were MEM less susceptible. Strains DR10212A (primary) and DR50054E (relapse) were multidrug resistant. Genomic and mutagenesis analyses supplemented with gene expression and β-lactamase analyses demonstrated that the CAZ-resistant phenotype was caused by PenA variants: P167S (n = 2) and penA amplification (n = 1). Despite the high mortality rate in melioidosis, our study revealed that B. pseudomallei isolates had a low frequency of β-lactam resistance caused by penA alterations. Clinical data suggest that resistant variants may emerge in patients during antibiotic therapy and may be associated with a poor response to treatment.