Development of ceftazidime resistance in an acute burkholderia pseudomallei infection

Derek S. Sarovich, Erin P. Price, Direk Limmathurotsakul, James M. Cook, Alex T. von Schulze, Spenser R. Wolken, Paul S Keim, Cref Refidaff, Talima R Pearson

Research output: Contribution to journalArticle

28 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)129-132
Number of pages4
JournalInfection and Drug Resistance
Volume5
Issue number1
StatePublished - 2012

Fingerprint

Burkholderia Infections
Burkholderia pseudomallei
Ceftazidime
Melioidosis
meropenem
Therapeutics
Anti-Bacterial Agents
Lactams
Clavulanic Acid
Imipenem
Amoxicillin
Infection
Proline
Pharmaceutical Preparations
Serine
Real-Time Polymerase Chain Reaction

Keywords

  • β-lactamase
  • Antibiotic resistance
  • Burkholderia pseudomallei
  • Ceftazidime
  • Melioidosis
  • Pena

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Pharmacology

Cite this

Sarovich, D. S., Price, E. P., Limmathurotsakul, D., Cook, J. M., von Schulze, A. T., Wolken, S. R., ... Pearson, T. R. (2012). Development of ceftazidime resistance in an acute burkholderia pseudomallei infection. Infection and Drug Resistance, 5(1), 129-132.

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 S; Refidaff, Cref; Pearson, Talima R.

In: Infection and Drug Resistance, Vol. 5, No. 1, 2012, p. 129-132.

Research output: Contribution to journalArticle

Sarovich, DS, Price, EP, Limmathurotsakul, D, Cook, JM, von Schulze, AT, Wolken, SR, Keim, PS, Refidaff, C & Pearson, TR 2012, 'Development of ceftazidime resistance in an acute burkholderia pseudomallei infection', Infection and Drug Resistance, vol. 5, no. 1, pp. 129-132.
Sarovich DS, Price EP, Limmathurotsakul D, Cook JM, von Schulze AT, Wolken SR et al. Development of ceftazidime resistance in an acute burkholderia pseudomallei infection. Infection and Drug Resistance. 2012;5(1):129-132.
Sarovich, Derek S. ; Price, Erin P. ; Limmathurotsakul, Direk ; Cook, James M. ; von Schulze, Alex T. ; Wolken, Spenser R. ; Keim, Paul S ; Refidaff, Cref ; Pearson, Talima R. / Development of ceftazidime resistance in an acute burkholderia pseudomallei infection. In: Infection and Drug Resistance. 2012 ; Vol. 5, No. 1. pp. 129-132.
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