Antimicrobial susceptibility pattern of clinical isolates of Burkholderia pseudomallei in Bangladesh

Abstract

BackgroundMelioidosis an infectious disease, caused by a Gram negative bacterium called Burkholderia pseudomallei, is endemic in Bangladesh. This organism is sensitive to limited number of antimicrobial agents and need prolonged treatment. There is no comprehensive data on the antimicrobial susceptibility profile of B. pseudomallei isolated in Bangladesh over last several years. The present study aimed to determine the antimicrobial susceptibility pattern of B. pseudomallei isolated in a tertiary care hospital of Dhaka city from 2009 to 2015.MethodsAll B. pseudomallei isolated from melioidosis patients over a period of 7 years (2009–2015) in the Department of Microbiology of a 725-bed tertiary care referral hospital in Dhaka city, Bangladesh were included in the study. B. pseudomallei was identified by Gram stain, culture, specific biochemical tests, serology and PCR using specific primers constructed from 16s rRNA region of B. pseudomallei. Antimicrobial susceptibility to specific agents was determined by disk diffusion and minimum inhibitory concentration methods.ResultsA total of 20 isolates of B. pseudomallei which were isolated from patients coming from different geographic locations of Bangladesh were included in the study. All the isolates were uniformly sensitive (100%) to ceftazidime, imipenem, piperacillin–tazobactam, amoxicillin–clavulanic acid and tetracycline by both disk diffusion and MIC methods. Two strains were resistant to trimethoprim–sulfamethoxazole by disk diffusion method but were sensitive by MIC method. The MIC50 and MIC90 values of the above antimicrobial agents were almost similar. All the isolates were resistant to amikacin by both MIC and disk diffusion methods.ConclusionThe results of the study suggest that B. pseudomallei prevalent in Bangladesh were still susceptible to all recommended antimicrobial agents used for the treatment of melioidosis. However, regular monitoring is needed to detect any emergence of resistance and shifting of MIC50 and MIC90 values.

<p>Pan-drug-resistant and biofilm-producing strain of <em>Burkholderia pseudomallei</em>: first report of melioidosis from a diabetic patient in Yogyakarta, Indonesia [Response to Letter]</p>

“…As reported by Inglis et al, the API 20NE method identified only 37% of the B. pseudomallei isolates.2 B. pseudomallei has a high degree of phenotypic plasticity and the colony morphology varies greatly within and between samples 3,4. Therefore, the identification was continued by nested PCR of 16S rRNA, which has been shown to be highly sensitive,5,6 being able to detect as few as two organisms present in the reaction.6 However, we fully welcome the suggestion of Dance et al that further additional testing, eg, multilocus sequence typing, nucleotide sequence analysis, or PCR for the TTS1 gene, is needed to verify the identification of B. pseudomallei . We have previously asked a member of the International Melioidosis Society Committee to review our identification method; however, that request was declined at the time.…”

Melioidosis in Bangladesh: A Clinical and Epidemiological Analysis of Culture-Confirmed Cases

“…The antimicrobial susceptibility pattern of clinical isolates showed 100% sensitivity to ceftazidime, imipenem, piperacillin–tazobactam, amoxicillin–clavulanic acid, and tetracycline by both disk diffusion and MIC methods in Bangladesh [ 47 ]. Intravenous antibiotics (ceftazidime and meropenem/imipenem) for the acute phase and oral antibiotics for the eradication phase are available in the local market (district and divisional level).…”

Drug susceptibility profiling of AustralianBurkholderiaspecies as models for developing melioidosis therapeutics

“…Burkholderia pseudomallei is a Gram-negative bacterium that causes melioidosis, 1, 2 a 46 neglected tropical disease with an estimated 165,000 cases and 89,000 deaths per year. 1…”

“…6,19,20 The 70 prolonged nature of the melioidosis treatment schedule can lead to acquired resistance, a 71 significant event that has been linked to treatment failure and mortality in melioidosis patients 72 from the Northern Territory. 5 Prolonged and costly treatments are especially undesirable in 73 many regions where melioidosis is endemic, 1,2,8 and to overcome both intrinsic and acquired 74 antibiotic resistance, more efficacious therapeutics for the treatment of melioidosis are 75 required. 1…”

“…5 Prolonged and costly treatments are especially undesirable in 73 many regions where melioidosis is endemic, 1,2,8 and to overcome both intrinsic and acquired 74 antibiotic resistance, more efficacious therapeutics for the treatment of melioidosis are 75 required. 1…”