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Emergence of Burkholderia pseudomallei and pandrug-resistant non-fermenters from southern Karnataka, India

Mukhopadhyay, Chiranjay and Chawla, Kiran and Krishna, Sushma and Nagalakshmi, N and Rao, Sugandhi P and Bairy, Indira (2008) Emergence of Burkholderia pseudomallei and pandrug-resistant non-fermenters from southern Karnataka, India. Transactions of the Royal Society of Tropical Medicine and Hygiene, 102 (S1). S12-S17.

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Abstract

Summary Melioidosis has recently gained the status of an emerging disease in India. Multidrugresistant (MDR) Gram-negative bacteria, however, are already responsible for treatment failure and mortality. In addition, pandrug-resistant (PDR) Gram-negative bacteria have emerged as a new threat to modern medicine. The treatment, clinical follow up, and outcome of 25 patients with melioidosis and 46 patients with MDR non-fermenters (Pseudomonas aeruginosa and Acinetobacter spp.) infection were documented during the period 2005 2007. Pandrug resistance status of the MDR strains was evaluated with the minimum inhibitory concentration breakpoint of colistin. Skin and soft-tissue involvement (16%), liver abscess (16%) and bone and joint involvement (16%) were the most common presentations of melioidosis in diabetic patients. The presence of septicaemia (44%) and major organ failure (48%) resulted in death. Relapse was seen in patients with inappropriate treatment. Clinical cure was observed in five cases infected with PDR strains; colistin was used in only one case. Comorbid conditions may have contributed to the high fatality (82.7%). More awareness among clinicians and laboratory staff, and environmental investigations of soil are required for accurate diagnosis and prompt treatment of melioidosis. For MDR strains, colistin is the ‘last resort’ and should be used with caution; resistance should be monitored both globally and locally.

Item Type: Article
Uncontrolled Keywords: Melioidosis, Burkholderia, pseudomallei, Colistin, Multidrug resistance, Pandrug resistance, India
Subjects: Medicine > KMC Manipal > Microbiology
Depositing User: KMC Manipal
Date Deposited: 30 May 2011 10:04
Last Modified: 09 Oct 2013 11:47
URI: http://eprints.manipal.edu/id/eprint/96

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