Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11014
Title: Antibiotic susceptibility of Burkholderia pseudomallei from tropical northern Australia and implications for therapy of melioidosis.
Authors: Jenney, A W
Lum, G
Fisher, D A
Currie, B J
Affiliation: Infectious Diseases Unit, Royal Darwin Hospital, Darwin, NT 0810, Australia..
Issue Date: Feb-2001
Citation: International journal of antimicrobial agents 2001-02; 17(2): 109-13
Abstract: From a prospective melioidosis study commencing in 1989 at Royal Darwin Hospital, 170 initial isolates of Burkholderia pseudomallei were available for susceptibility testing. Of these 163 (96%) were susceptible to meropenem/imipenem, ceftazidime, trimethoprim-sulphamethoxazole (SMX/TMP) and doxycycline. Seven (4%) showed primary resistance; three had low-level resistance to SMX/TMP, one to ceftriaxone and amoxycillin/clavulanate (AMOX/CA) and three to doxycycline. Of 167 patients who survived their initial presentation, seven (4%) had culture positive infections which persisted for greater than 3 months after start of therapy. All ultimately cleared carriage of B. pseudomallei though three required changing to SMX/TMP after development of doxycycline resistance. Nineteen (11%) of the initial survivors clinically relapsed and 17 of these had repeat isolates available for testing. Four of these had acquired resistance: one to doxycycline, one to AMOX/CA and ceftazidime, one to SMX/TMP and one to both SMX/TMP and doxycycline. Molecular typing using randomly amplified polymorphic DNA and pulsed-field gel electrophoresis showed all but one relapse isolate to be the same as the original strain. These data are similar to published data from Thailand. As melioidosis has a high mortality (21% in this series) these results emphasize the need for prolonged eradication therapy and regular clinical and microbiological monitoring so that the emergence of resistance can be detected early and appropriate treatment modifications made.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11014
ISSN: 0924-8579
Type: Journal Article
Subjects: Amoxicillin-Potassium Clavulanate Combination
Anti-Bacterial Agents
Australia
Burkholderia pseudomallei
Ceftazidime
Doxycycline
Drug Resistance, Microbial
Humans
Imipenem
Melioidosis
Microbial Sensitivity Tests
Prospective Studies
Thienamycins
Trimethoprim, Sulfamethoxazole Drug Combination
Tropical Climate
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