Journal Article

Trimethoprim/sulfamethoxazole resistance in clinical isolates of <i>Burkholderia pseudomallei</i>

Vanaporn Wuthiekanun, Allen C. Cheng, Wirongrong Chierakul, Premjit Amornchai, Direk Limmathurotsakul, Wipada Chaowagul, Andrew J. H. Simpson, Jennifer M. Short, Gumphol Wongsuvan, Bina Maharjan, Nicholas J. White and Sharon J. Peacock

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 55, issue 6, pages 1029-1031
Published in print June 2005 | ISSN: 0305-7453
Published online April 2005 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dki151
Trimethoprim/sulfamethoxazole resistance in clinical isolates of Burkholderia pseudomallei

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Objectives: Trimethoprim/sulfamethoxazole is commonly used to treat melioidosis. Antimicrobial susceptibility testing using the disc diffusion method is commonly used in melioidosis-endemic areas, but may overestimate resistance to trimethoprim/sulfamethoxazole.

Patients and methods: We performed disc diffusion and Etest on isolates from the first positive culture for all patients presenting to Sappasithiprasong Hospital, Ubon Ratchathani, Thailand, with culture-confirmed melioidosis between 1992 and 2003.

Results: The estimated resistance rate for 1976 clinical Burkholderia pseudomallei isolates was 13% by Etest and 71% by disc diffusion. All isolates classed as either susceptible (n=358) or as having intermediate resistance (n=218) on disc diffusion were susceptible by Etest. Only 258 of the 1400 (18%) isolates classed as resistant on disc diffusion were resistant by Etest.

Conclusions: Disc diffusion testing of B. pseudomallei may be useful as a limited screening tool in resource poor settings. Isolates assigned as ‘susceptible’ or ‘intermediate’ by disc diffusion may be viewed as ‘susceptible’; those assigned as ‘resistant’ require further evaluation by MIC methodology.

Keywords: Burkholderia pseudomallei; melioidosis; susceptibility; Etest

Journal Article.  1354 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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