In Vitro Susceptibility of Strains of Pseudomonas pseudomallei Isolated in Thailand and Hong Kong to Some Newer  -Lactam Antibiotics and Quinolone Derivatives

Chau, Pui Hing; Ng, Waterman; Leung, Y. K.; Lolekha, Somsak

doi:10.1093/infdis/153.1.167

Cited by 47 publications

(19 citation statements)

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“…Ciprofloxacin was the most effective agent, with an MIC for 90% of the strains tested of 8 ,ug/ml. The results of our work are in agreement with those of Chau et al (1). They tested the susceptibilities of 27 isolates of P. pseuidomallei to a number of antimicrobial agents, including two quinolones, ciprofloxacin and ofloxacin.…”

supporting

confidence: 92%

Activities of five new fluoroquinolones against Pseudomonas pseudomallei

Winton

Everett

Dolan

1988

Antimicrob Agents Chemother

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Thirty-four isolates of Pseudomonas pseudomallei were tested by a broth microdilution technique for susceptibility to amifloxacin, ciprofloxacin, enoxacin, norfloxacin, and ofloxacin. Ciprofloxacin was the most active agent tested, with an MIC for 90% of the strainis tested of 8 ,ug/Iml. These in vitro results suggest that the fluoroquinolones tested would not be optimal for therapy of melioidosis.The new quinolones have marked activity against aerobic gram-negative rods, including many strains of Pseudomonas aeruginosa (4). Because Pseudomonas pseudomallei, the causative agent of melioidosis, is an important pathogen in certain parts of the world, and the current therapeutic armamentarium is limited, it would be desirable to find an additional effective agent against this pathogen (3,5). In reviewing the literature we found little information on the activity of the newer quinolones against P. pseudomallei. Therefore, we tested the susceptibilities of 34 isolates of P. pseudomallei to five fluoroquinolones in order to determine their possible role in the therapy of melioidosis.Thirty-four isolates of P. pseudomallei were provided from material collected by Richard A. Finkelstein. The strains were obtained from environmental sources in Thailand and from U.S. Armed Forces patients in Vietnam. The strains had previously been identified and had been stored in a lyophilized state for several years. All strains were reconstituted from the lyophilized state and harvested. They were frozen until needed and then grown in Mueller-Hinton broth, and an overnight growth of log-phase bacteria was used for inoculation. Escherichia coli ATCC 25922 and P. aeruginosa ATCC 27853 were used as control strains.Antimicrobial The results of the broth dilution susceptibility tests are shown in Table 1. Ciprofloxacin was the most active quinolone tested against all strains of P. pseudomallei. Current recommendations provided by the manufacturers suggest a cutoff value of 1 ,ug/ml for gram-negative rods to be considered susceptible to amifloxacin, ciprofloxacin, and ofloxacin and a cutoff value of 2 ,ug/ml for enoxacin and norfloxacin. As noted, all MICs for 90% of the strains tested exceeded these limits.The quinolones are potent antimicrobial agents for many pathogens. They provide an attractive oral therapeutic alternative to intravenous therapy in many situations. Because of their potency, ease of administration, low development of in vitro resistance, and low toxicity, they would be an appealing alternative to standard therapy in melioidosis.The current study demonstrated that the MICs of the quinolones for 34 strains of P. pseudomallei were lower than commonly achievable concentrations in serum of the five agents tested (2, 4). Ciprofloxacin was the most effective agent, with an MIC for 90% of the strains tested of 8 ,ug/ml. The results of our work are in agreement with those of Chau et al.(1). They tested the susceptibilities of 27 isolates of P. pseuidomallei to a number of antimicrobial agents, including two quinolones, ciproflox...

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confidence: 92%

Activities of five new fluoroquinolones against Pseudomonas pseudomallei

Winton

Everett

Dolan

1988

Antimicrob Agents Chemother

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“…Studies subsequently showed B. pseudomallei to be susceptible to various newer b-lactam antibiotics, especially ceftazidime, imipenem, piperacillin, amoxycillin/clavulanate, ceftriaxone and cefotaxime [116][117][118][119][120][121][122]. Unlike with ''conventional antibiotics'', most studies suggested these newer b-lactam antibiotics to be bactericidal for B. pseudomallei [118,120].…”

Section: Laboratory Diagnosis Of Melioidosismentioning

confidence: 99%

Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions

Currie¹

2003

Eur Respir J

166

171

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“…Empirical regimens of combinations of antibiotics had often been used (133,170), probably because of the disappointing results of single-agent therapy, since no evidence of in vitro synergy between the components had been obtained (47). Several new betalactam agents are active and bactericidal against P. pseudomallei (8,28), and one of these, ceftazidime, has recently been compared in an open randomized trial with the combination of chloramphenicol, doxycycline, and trimethoprim-sulfamethoxazole for the treatment of acute severe melioidosis (170). Ceftazidime treatment (120 mg/kg/day) was associated with a 50% (95% confidence interval, 19 to 81%) lower overall mortality (170).…”

Section: Treatmentmentioning

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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In Vitro Susceptibility of Strains of Pseudomonas pseudomallei Isolated in Thailand and Hong Kong to Some Newer -Lactam Antibiotics and Quinolone Derivatives

Cited by 47 publications

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Activities of five new fluoroquinolones against Pseudomonas pseudomallei

Activities of five new fluoroquinolones against Pseudomonas pseudomallei

Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions

Melioidosis: the tip of the iceberg?

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