Successful Treatment of Melioidosis Caused by a Multiresistant Strain in an Immunocompromised Host with Third Generation Cephalosporins<sup>1</sup>

S, So; Chau, Pui Hing; Leung, Y. K.; Lam, Wai Yip; Yu, Dong

doi:10.1164/arrd.1983.127.5.650

Cited by 36 publications

(18 citation statements)

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“…These drugs are also associated with serious renal and hematological toxicities (18,23). Ceftazidime has been recommended as the drug of choice for the treatment of melioidosis on the basis of its good in vitro activity against P. pseudomallei (2, 7) and previous successes with the drug in a few noncomparative therapeutic trials (23,27). Our experience in an open multicenter trial also confirmed its efficacy and safety (20).…”

supporting

confidence: 56%

Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis

Sookpranee

Boonma

Susaengrat

et al. 1992

Antimicrob Agents Chemother

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supporting

confidence: 56%

Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis

Sookpranee

Boonma

Susaengrat

et al. 1992

Antimicrob Agents Chemother

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“…Small numbers of cases of locally acquired melioidosis have been observed in Hong Kong (397,398,440,483), and a seroprevalence of 14% was demonstrated by IHA in a tuberculosis sanatorium (396). An ongoing outbreak in marine mammals in an ocean park has been described (193).…”

Section: Vietnam Melioidosis Was First Noted In What Is Now Southernmentioning

confidence: 99%

Melioidosis: Epidemiology, Pathophysiology, and Management

2005

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Melioidosis, caused by the gram-negative saprophyte Burkholderia pseudomallei, is a disease of public health importance in southeast Asia and northern Australia that is associated with high case-fatality rates in animals and humans. It has the potential for epidemic spread to areas where it is not endemic, and sporadic case reports elsewhere in the world suggest that as-yet-unrecognized foci of infection may exist. Environmental determinants of this infection, apart from a close association with rainfall, are yet to be elucidated. The sequencing of the genome of a strain of B. pseudomallei has recently been completed and will help in the further identification of virulence factors. The presence of specific risk factors for infection, such as diabetes, suggests that functional neutrophil defects are important in the pathogenesis of melioidosis; other studies have defined virulence factors (including a type III secretion system) that allow evasion of killing mechanisms by phagocytes. There is a possible role for cell-mediated immunity, but repeated environmental exposure does not elicit protective humoral or cellular immunity. A vaccine is under development, but economic constraints may make vaccination an unrealistic option for many regions of endemicity. Disease manifestations are protean, and no inexpensive, practical, and accurate rapid diagnostic tests are commercially available; diagnosis relies on culture of the organism. Despite the introduction of ceftazidime- and carbapenem-based intravenous treatments, melioidosis is still associated with a significant mortality attributable to severe sepsis and its complications. A long course of oral eradication therapy is required to prevent relapse. Studies exploring the role of preventative measures, earlier clinical identification, and better management of severe sepsis are required to reduce the burden of this disease

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“…In the past decade, melioidosis in both human and other animals (dolphins and seals) has been reported from Hong Kong (140,141,165,175), and serological evidence indicates that human exposure to P. pseudomallei is not uncommon there (139). There is a dearth of information regarding the existence of melioidosis within mainland China.…”

Section: Introductionmentioning

confidence: 99%

Melioidosis: the tip of the iceberg?

1991

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For nearly 80 years clinical melioidosis has been considered a rare disease. This bacterial infection is caused by Pseudomonas pseudomallei, a saprophyte found in soil and surface water of endemic areas. Consequently, those who have most contact with soil, the rural poor, are likely to be at greatest risk of infection. Since the diversity of clinical manifestations necessitates the isolation and identification of the causative organism for a definitive diagnosis of melioidosis and the population at greatest risk within endemic areas rarely have access to an appropriate level of health care, the disease has probably been underrecognized. Melioidosis is now known to be an important cause of human morbidity and mortality in Thailand, and this may be true throughout Southeast Asia, which is usually regarded as the main endemic area for the disease. In Australia, melioidosis causes a smaller number of human infections, while disease among livestock has important economic and possible public health implications. Sporadic reports of the infection indicate its presence in several other tropical regions: in the Indian subcontinent, Africa, and Central and South America. Clinical melioidosis may be highly prevalent in these areas, but underdiagnosed as a result of a lack of awareness of the clinical and microbiological features of the disease, or simply because of a lack of health care facilities. Furthermore, during the last two decades the importation and transmission of melioidosis within nontropical zones have been documented. The causative organism is not difficult to grow, and modern antibiotics have improved disease prognosis. Further studies are needed to determine the true worldwide distribution and prevalence of melioidosis so that improved therapeutic and preventive measures can be developed and applied.

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Successful Treatment of Melioidosis Caused by a Multiresistant Strain in an Immunocompromised Host with Third Generation Cephalosporins¹

Cited by 36 publications

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Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis

Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis

Melioidosis: Epidemiology, Pathophysiology, and Management

Melioidosis: the tip of the iceberg?

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Successful Treatment of Melioidosis Caused by a Multiresistant Strain in an Immunocompromised Host with Third Generation Cephalosporins1

Cited by 36 publications

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Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis

Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis

Melioidosis: Epidemiology, Pathophysiology, and Management

Melioidosis: the tip of the iceberg?

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Successful Treatment of Melioidosis Caused by a Multiresistant Strain in an Immunocompromised Host with Third Generation Cephalosporins¹