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Ceftazidime resistance in Burkholderia pseudomallei: first report from India
Bijayini Behera1, T L V D Prasad Babu, A Kamalesh
1Yashoda Hospital, Secunderabad, India. drbinny2004@yahoo.co.in
Abstract:
Melioidosis, a disease of public health importance in Southeast Asia and Northern Australia, of late has shown an increasing trend in India, particularly Southern India. We describe a case of a 39-year-old diabetic patient with left elbow septic arthritis, multiple liver, splenic abscesses, pneumonia, pleural effusion, followed by sepsis syndrome. Blood cultures and culture of the joint aspirate yielded pure growth of Burkholderia pseudomallei (B. pesudomallei), sensitive to carbapenem, co-trimoxazole and resistant to ceftazidime. The patient was successfully treated with imipenem- cilastin. He was discharged on co-trimoxazole to complete the 24 weeks course and follow-up has continued to date. The patient continues to remain asymptomatic. The case re-emphasizes the need to monitor the trend of B. pseudomallei in India, particularly the development of ceftazidime resistance, which incidentally is the drug of choice.
Insights
Melioidosis is increasing in India. This case highlights a Burkholderia pseudomallei infection resistant to ceftazidime, emphasizing the need for monitoring antimicrobial resistance trends.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Melioidosis, caused by Burkholderia pseudomallei, is endemic in Southeast Asia and Northern Australia.
- An increasing trend of melioidosis has been observed in India, particularly in the southern regions.
Observation:
- A 39-year-old diabetic patient presented with septic arthritis, liver and splenic abscesses, pneumonia, and sepsis syndrome.
- Blood and joint aspirate cultures identified Burkholderia pseudomallei.
- The isolate was sensitive to carbapenems and co-trimoxazole but resistant to ceftazidime.
Findings:
- Successful treatment with imipenem-cilastin followed by oral co-trimoxazole.
- The patient completed a 24-week course and remains asymptomatic.
Implications:
- This case underscores the importance of monitoring Burkholderia pseudomallei trends in India.
- The emergence of ceftazidime resistance is a significant concern, as it is a primary treatment choice.
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