Epidemiological cut-off value of clinical isolates of Burkholderia pseudomallei from Northern Queensland to meropenem, ceftazidime, trimethoprim/sulfamethoxazole and doxycycline by the microbroth dilution method

Maloney, Samuel; Engler, Cathy; Norton, Robert

doi:10.1016/j.jgar.2017.04.012

Cited by 15 publications

(10 citation statements)

References 16 publications

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“…An earlier study by Maloney et al generated MIC distributions of B. pseudomallei for ceftazidime, meropenem, doxycycline and trimethoprim-sulfamethoxazole [30]. The researchers used the reference BMD method to test 234 consecutive, clinical B. pseudomallei isolates.…”

Section: Discussionmentioning

confidence: 99%

Burkholderia pseudomallei multi-centre study to establish EUCAST MIC and zone diameter distributions and epidemiological cut-off values

Karatuna

Dance

Matuschek

et al. 2021

Clinical Microbiology and Infection

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Objectives: Melioidosis, caused by Burkholderia pseudomallei, requires intensive antimicrobial treatment. However, standardized antimicrobial susceptibility testing (AST) methodology based on modern principles for determining breakpoints and ascertaining performance of methods are lacking for B. pseudomallei. This study aimed to establish MIC and zone diameter distributions on which to set epidemiological cut-off (ECOFF) values for B. pseudomallei using standard EUCAST methodology for nonfastidious organisms. Methods: Non-consecutive, non-duplicate clinical B. pseudomallei isolates (9e70 per centre) were tested at eight study centres against eight antimicrobials by broth microdilution (BMD) and the EUCAST disc diffusion method. Isolates without and with suspected resistance mechanisms were deliberately selected. The EUCAST Development Laboratory ensured the quality of study materials, and provided guidance on performance of the tests and interpretation of results. Aggregated results were analysed according to EUCAST recommendations to determine ECOFFs. Results: MIC and zone diameter distributions were generated using BMD and disc diffusion results obtained for 361 B. pseudomallei isolates. MIC and zone diameter ECOFFs (mg/L; mm) were determined for amoxicillin-clavulanic acid (8; 22), ceftazidime (8; 22), imipenem (2; 29), meropenem (2; 26), doxycycline (2; none), tetracycline (8; 23), chloramphenicol (8; 22) and trimethoprim-sulfamethoxazole (4; 28). Conclusions: We have validated the use of standard BMD and disc diffusion methodology for AST of B. pseudomallei. The MIC and zone diameter distributions generated in this study allowed us to establish MIC and zone diameter ECOFFs for the antimicrobials studied. These ECOFFs served as background data for EUCAST to set clinical MIC and zone diameter breakpoints for B. pseudomallei.

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Section: Discussionmentioning

confidence: 99%

Burkholderia pseudomallei multi-centre study to establish EUCAST MIC and zone diameter distributions and epidemiological cut-off values

Karatuna

Dance

Matuschek

et al. 2021

Clinical Microbiology and Infection

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“…In northern Queensland, the microbroth dilution method has been used to provide epidemiological cut-off values of clinical isolates of B. pseudomallei to meropenem, ceftazidime, trimethoprim-sulfamethoxazole (TMP-SMX) and doxycycline [ 74 ]. Meropenem and ceftazidime provide reliable first-line agents against melioidosis, with primary resistance being extremely rare [ 75 , 76 ].…”

Section: Diagnosismentioning

confidence: 99%

Melioidosis: An Australian Perspective

2018

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Burkholderia pseudomallei is endemic in northern Australia, with cases of melioidosis most commonly occurring during the wet season in individuals with diabetes, hazardous alcohol use, and chronic kidney disease. Pneumonia is the most common presentation and the majority of patients are bacteraemic—however, infection may involve almost any organ, with the skin and soft tissues, genitourinary system, visceral organs, and bone and joints affected most commonly. Central nervous system involvement is rarer, but has a high attributable mortality. Increased awareness of the disease amongst healthcare providers, ready access to appropriate antibiotic therapy and high-quality intensive care services has resulted in a sharp decline in the case fatality rate over the last 20 years. Further improvement in clinical outcomes will require a greater understanding of the disease′s pathophysiology, its optimal management, and more effective strategies for its prevention.

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“…Sensitive, intermediate and resistant cut-offs were based on the Clinical and Laboratory Standards Institute (CLSI) M100-S17 guidelines for B. pseudomallei (≤8/4, 16/8, and ≥32/16 µg/mL for AMC; ≤8, 16, ≥32 µg/mL for CAZ; ≤4, 8, ≥16 µg/mL for DOX and IPM; ≤2/38, nil, ≥4/76 µg/mL for SXT). CLSI guidelines do not list MEM for B. pseudomallei ; however, based on prior work [ 16 , 17 ], and recent proposed EUCAST breakpoints for B. pseudomallei , we categorised MEMr as ≥3 µg/mL. Likewise, the CLSI guidelines do not list gentamicin (GEN) MIC values for B. pseudomallei due to almost ubiquitous resistance (>16 µg/mL) towards this antibiotic; however, there are notable exceptions [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Taking the next-gen step: Comprehensive antimicrobial resistance detection from Burkholderia pseudomallei

et al. 2021

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Epidemiological cut-off value of clinical isolates of Burkholderia pseudomallei from Northern Queensland to meropenem, ceftazidime, trimethoprim/sulfamethoxazole and doxycycline by the microbroth dilution method

Cited by 15 publications

References 16 publications

Burkholderia pseudomallei multi-centre study to establish EUCAST MIC and zone diameter distributions and epidemiological cut-off values

Burkholderia pseudomallei multi-centre study to establish EUCAST MIC and zone diameter distributions and epidemiological cut-off values

Melioidosis: An Australian Perspective

Taking the next-gen step: Comprehensive antimicrobial resistance detection from Burkholderia pseudomallei

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