Therapeutic options for Burkholderia cepacia infections beyond co-trimoxazole: a systematic review of the clinical evidence

Avgeri, Sophia G.; Matthaiou, Dimitrios K.; Dimοpoulos, George; Grammatikos, Alexandros P.; Falagas, Matthew E.

doi:10.1016/j.ijantimicag.2008.09.010

Cited by 90 publications

(63 citation statements)

References 97 publications

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“…Best drug of choice in B. cepacia infection is co-trimoxazole, followed by ceftazidime and meropenem, alone or in combination with other antibiotics [28]. Experimental results showed a significant alteration in sensitivity pattern after biofield treatment in azetronan, Several phenotypic identification tests were available to differentiate the Burkholderia species.…”

Section: Discussionmentioning

confidence: 99%

An Effect of Biofield Treatment on Multidrug-resistant Burkholderia cepacia: A Multihost Pathogen

Trivedi¹,

Patil²,

Shettigar³

et al. 2015

J Trop Dis

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Burkholderia cepacia (B. cepacia) is an opportunistic, Gram negative pathogen which causes infection mainly in immunocompromised population and associated with high rate of morbidity and mortality in cystic fibrosis patients. Aim of the present study was to analyze the impact of biofield treatment on multidrug resistant B. cepacia. Clinical sample of B. cepacia was divided into two groups i.e. control and biofield treated. The analysis was done after 10 days of treatment and compared with control group. Control and treated group were analyzed for susceptibility pattern, MIC value, biochemical studies and biotype number using MicroScan Walk-Away® system. Sensitivity assay results showed a change in pattern from resistant to intermediate in aztreonam, intermediate to resistant in ceftazidime, ciprofloxacin, imipenem, and levofloxacin while sensitive to resistant in meropenem and piperacillin/ tazobactam. The biofield treatment showed an alteration in MIC values of aztreonam, ceftazidime, chloramphenicol, ciprofloxacin, imipenem, levofloxacin, meropenem, piperacillin/tazobactam and tetracycline. Biochemical reactions of treated group showed negative reaction in colistin, lysine, and ornithine while positive reactions to acetamide, arginine, and malonate as compared to control. Overall results showed an alteration of 38.9% in susceptibility pattern, 30% in MIC values of tested antimicrobials and 18.2% change in biochemical reaction after biofield treatment. A significant change in biotype number (02063736) was reported with green pigment as special characteristics after biofield treatment as compared to control (05041776) group with yellow pigment. In treated group, a new species was identified as Pseudomonas aeruginosa, as compared to control. Study findings suggest that biofield treatment has a significant effect on the phenotypic character and biotype number of multidrug resistant strain of B. cepacia.

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Section: Discussionmentioning

confidence: 99%

An Effect of Biofield Treatment on Multidrug-resistant Burkholderia cepacia: A Multihost Pathogen

Trivedi¹,

Patil²,

Shettigar³

et al. 2015

J Trop Dis

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“…Current antimicrobial options for therapy of BCC infections are limited, and eradication of the organisms from patients with CF is a major challenge (2). In this study, we investigated resistance to polycationic antimicrobials in one specific species within the BCC, B. vietnamiensis.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Susceptibility of Burkholderia vietnamiensis to Aminoglycosides

Jassem

Zlosnik

Henry

et al. 2011

Antimicrob Agents Chemother

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Burkholderia cepacia complex (BCC) bacteria are opportunistic pathogens that can cause severe disease in cystic fibrosis (CF) patients and other immunocompromised individuals and are typically multidrug resistant. Here we observed that unlike other BCC species, most environmental and clinical Burkholderia vietnamiensis isolates were intrinsically susceptible to aminoglycosides but not to cationic antimicrobial peptides or polymyxin B. Furthermore, strains acquired aminoglycoside resistance during chronic CF infection, a phenomenon that could be induced under tobramycin or azithromycin pressure in vitro. In comparing susceptible and resistant B. vietnamiensis isolates, no gross differences in lipopolysaccharide structure were observed, all had lipid A-associated 4-amino-4-deoxy-L-arabinose residues, and all were resistant to the permeabilizing effects of aminoglycosides, a measure of drug entry via self-promoted uptake. However, susceptible isolates accumulated 5 to 6 times more gentamicin than a resistant isolate, and aminoglycoside susceptibility increased in the presence of an efflux pump inhibitor. B. vietnamiensis is therefore unusual among BCC bacteria in its susceptibility to aminoglycosides and capacity to acquire resistance. Aminoglycoside resistance appears to be due to decreased cellular accumulation as a result of active efflux.

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“…Our work shows that the pharmacological suppression of membrane hopanoids in certain clinical B. multivorans isolates can potentiate the effects of colistin, an antimicrobial agent currently used to treat P. aeruginosa infections in CF patients. There are few antimicrobial options for the therapy of Bcc infections, and eradication of the bacteria from the lungs of people living with CF is a major challenge (45). Further investigations are necessary to determine if our in vitro data have the potential to translate into a clinical application.…”

Section: Clinical B Multivorans Isolates From Cf Patients With Chronmentioning

confidence: 99%

Fosmidomycin Decreases Membrane Hopanoids and Potentiates the Effects of Colistin on Burkholderia multivorans Clinical Isolates

Malott

Lee

et al. 2014

Antimicrob Agents Chemother

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e Burkholderia cepacia complex (Bcc) pulmonary infections in people living with cystic fibrosis (CF) are difficult to treat because of the extreme intrinsic resistance of most isolates to a broad range of antimicrobials. Fosmidomycin is an antibacterial and antiparasitic agent that disrupts the isoprenoid biosynthesis pathway, a precursor to hopanoid biosynthesis. Hopanoids are involved in membrane stability and contribute to polymyxin resistance in Bcc bacteria. Checkerboard MIC assays determined that although isolates of the Bcc species B. multivorans were highly resistant to treatment with fosmidomycin or colistin (polymyxin E), antimicrobial synergy was observed in certain isolates when the antimicrobials were used in combination. Treatment with fosmidomycin decreased the MIC of colistin for isolates as much as 64-fold to as low as 8 g/ml, a concentration achievable with colistin inhalation therapy. A liquid chromatography-tandem mass spectrometry technique was developed for the accurate quantitative determination of underivatized hopanoids in total lipid extracts, and bacteriohopanetetrol cyclitol ether (BHT-CE) was found to be the dominant hopanoid made by B. multivorans. The amount of BHT-CE made was significantly reduced upon fosmidomycin treatment of the bacteria. Uptake assays with 1-N-phenylnaphthylamine were used to determine that dual treatment with fosmidomycin and colistin increases membrane permeability, while binding assays with boron-dipyrromethene-conjugated polymyxin B illustrated that the addition of fosmidomycin had no impact on polymyxin binding. This work indicates that pharmacological suppression of membrane hopanoids with fosmidomycin treatment can increase the susceptibility of certain clinical B. multivorans isolates to colistin, an agent currently in use to treat pulmonary infections in CF patients.

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Therapeutic options for Burkholderia cepacia infections beyond co-trimoxazole: a systematic review of the clinical evidence

Cited by 90 publications

References 97 publications

An Effect of Biofield Treatment on Multidrug-resistant Burkholderia cepacia: A Multihost Pathogen

An Effect of Biofield Treatment on Multidrug-resistant Burkholderia cepacia: A Multihost Pathogen

In Vitro Susceptibility of Burkholderia vietnamiensis to Aminoglycosides

Fosmidomycin Decreases Membrane Hopanoids and Potentiates the Effects of Colistin on Burkholderia multivorans Clinical Isolates

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