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Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection

Sarovich, Derek S., Price, Erin P., Limmathurotsakul, Direk, Cook, James, Von Schulze, Alex T., Wolken, Spenser, Keim, Paul, Peacock, Sharon J. and Pearson, Talima (2012). Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection. Infection and Drug Resistance,2012(5):129-132.

Document type: Journal Article
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Title Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection
Author Sarovich, Derek S.
Price, Erin P.
Limmathurotsakul, Direk
Cook, James
Von Schulze, Alex T.
Wolken, Spenser
Keim, Paul
Peacock, Sharon J.
Pearson, Talima
Journal Name Infection and Drug Resistance
Publication Date 2012
Volume Number 2012
Issue Number 5
ISSN 1178-6973   (check CDU catalogue open catalogue search in new window)
Start Page 129
End Page 132
Total Pages 4
Place of Publication United Kingdom
Publisher Dove Medical Press Ltd.
HERDC Category C1 - Journal Article (DIISR)
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 treatment 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 identified. 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.
Keywords Burkholderia pseudomallei
antibiotic resistance
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Additional Notes This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited

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