Emerging Drug Resistance in Melioidosis

Pillai, Madhavan Pillai Gopalakrishna; Faizal, Baiju; Urs, Vishnu Dev

doi:10.4103/1755-6783.155020

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Reports of ceftazidime resistance due to its regular use for melioidosis are increasingly emerging from endemic areas such as Malaysia, Australia, Thailand, Singapore and India. [7], [8] It is becoming an important cause of treatment failure and relapse, probably due to the expression of βlactamase and efflux pumps. There are also reports of pan drug-resistant B. pseudomallei from southern Karnataka.…”

Section: Discussionmentioning

confidence: 99%

Relapse of the Bug at a Different Site- A Case of Multidrug Resistant Melioidosis

Nayak¹,

Furtado²,

Gomes³

et al. 2018

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A 60-year-old farmer who is diabetic for five years presented with pyrexia of unknown origin for one month. Fever was high grade associated with chills, dysuria and increased frequency of micturition, dull aching diffuse abdominal pain and weight loss. There was no history of rash, vomiting, altered bowel habits, cough, bleeding manifestations, altered sensorium and seizures. Patient denied history of recent travel, consumption of raw milk and contact with tuberculosis. Melioidosis, an emerging underdiagnosed infectious disease is caused by Burkholderia pseudomallei, a Gram negative bacillus commonly found in the soil of tropical countries. It is important to consider melioidosis as a differential diagnosis amongst pyrexia of unknown origin cases even in non-endemic areas for an early antibiotic treatment and prevention of relapse. [1] Almost all B. pseudomallei strains are susceptible to the first line antibiotic Ceftazidime. We report a case of culture proven melioidosis primarily resistant to ceftazidime who developed relapse at different sites in the eradication phase of treatment despite adequate course of in vitro sensitive antibiotics.

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Section: Discussionmentioning

confidence: 99%

Relapse of the Bug at a Different Site- A Case of Multidrug Resistant Melioidosis

Nayak¹,

Furtado²,

Gomes³

et al. 2018

jemds

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“…Generally, the antimicrobial susceptibility of isolates of B. pseudomallei in South Asia mirrors that from other regions [ 43 ], although rare instances of ceftazidime resistance have been reported [ 44 ]. Clinical failure of treatment despite apparent in vitro susceptibility has also been described [ 45 ].…”

Section: Antibiotic Susceptibility and Treatmentmentioning

confidence: 99%

Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan)

et al. 2018

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Despite the fact that South Asia is predicted to have the highest number of cases worldwide, melioidosis is a little-known entity in South Asian countries. It has never been heard of by the majority of doctors and has as yet failed to gain the attention of national Ministries of Health and country offices of the World Health Organization (WHO). Although a few centers are diagnosing increasing numbers of cases, and the mortality documented from these institutions is relatively high (nearly 20%), the true burden of the disease remains unknown. In India, most cases have been reported from southwestern coastal Karnataka and northeastern Tamil Nadu, although this probably simply reflects the presence of centers of excellence and researchers with an interest in the disease. As elsewhere, the majority of cases have type 2 diabetes mellitus and occupational exposure to the environment. Most present with community-acquired pneumonia and/or bacteremia, especially during heavy rainfall. The high seropositivity rate (29%) in Karnataka and isolation of B. pseudomallei from the environment in Tamil Nadu and Kerala confirm India as melioidosis-endemic, although the full extent of the distribution of the organism across the country is unknown. There are limited molecular epidemiological data, but, thus far, the majority of Indian isolates have appeared distinct from those from South East Asia and Australia. Among other South Asian countries, Sri Lanka and Bangladesh are known to be melioidosis-endemic, but there are no cases that have conclusively proved to have been acquired in Nepal, Bhutan, Afghanistan or Pakistan. There are no surveillance systems in place for melioidosis in South Asian countries. However, over the past two years, researchers at the Center for Emerging and Tropical Diseases of Kasturba Medical College, University of Manipal, have established the Indian Melioidosis Research Forum (IMRF), held the first South Asian Melioidosis Congress, and have been working to connect researchers, microbiologists and physicians in India and elsewhere in South Asia to raise awareness through training initiatives, the media, workshops, and conferences, with the hope that more patients with melioidosis will be diagnosed and treated appropriately. However, much more work needs to be done before we will know the true burden and distribution of melioidosis across South Asia.

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Ceftazidime/meropenem

2015

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Emerging Drug Resistance in Melioidosis

Cited by 3 publications

References 5 publications

Relapse of the Bug at a Different Site- A Case of Multidrug Resistant Melioidosis

Relapse of the Bug at a Different Site- A Case of Multidrug Resistant Melioidosis

Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan)

Ceftazidime/meropenem

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