Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection

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....

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Main Authors:	Sarovich, Derek S, Price, Erin P, Limmathurotsakul, Direk, Cook, James M, Von Schulze, Alex T, Wolken, Spenser R, Keim, Paul, Peacock, Sharon J, Pearson, Talima
Format:	Online
Language:	English
Published:	Dove Medical Press 2012
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430440/

id	pubmed-3430440
recordtype	oai_dc
spelling	pubmed-34304402012-09-13 Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection Sarovich, Derek S Price, Erin P Limmathurotsakul, Direk Cook, James M Von Schulze, Alex T Wolken, Spenser R Keim, Paul Peacock, Sharon J Pearson, Talima Case Report 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. Dove Medical Press 2012-08-22 /pmc/articles/PMC3430440/ /pubmed/22977307 http://dx.doi.org/10.2147/IDR.S35529 Text en © 2012 Sarovich et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Sarovich, Derek S Price, Erin P Limmathurotsakul, Direk Cook, James M Von Schulze, Alex T Wolken, Spenser R Keim, Paul Peacock, Sharon J Pearson, Talima
spellingShingle	Sarovich, Derek S Price, Erin P Limmathurotsakul, Direk Cook, James M Von Schulze, Alex T Wolken, Spenser R Keim, Paul Peacock, Sharon J Pearson, Talima Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection
author_facet	Sarovich, Derek S Price, Erin P Limmathurotsakul, Direk Cook, James M Von Schulze, Alex T Wolken, Spenser R Keim, Paul Peacock, Sharon J Pearson, Talima
author_sort	Sarovich, Derek S
title	Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection
title_short	Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection
title_full	Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection
title_fullStr	Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection
title_full_unstemmed	Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection
title_sort	development of ceftazidime resistance in an acute burkholderia pseudomallei infection
description	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.
publisher	Dove Medical Press
publishDate	2012
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430440/
_version_	1611553089352892416

Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection

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