Case Report: A Novel Virulent Clinical Isolate of Burkholderia pseudomallei Imported from Thailand Exhibiting Resistance to Trimethoprim-Sulfamethoxazole.

Autor:	Amit S; Clinical Microbiology, Sheba Medical Center, Ramat-Gan, Israel.; Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel., Gur D; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Aftalion M; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Biber A; Infectious Diseases Unit, The Center for Geographic Medicine and Tropical Diseases, Sheba Medical Center, Ramat-Gan, Israel., David P; Department of Internal Medicine, Sheba Medical Center, Ramat-Gan, Israel., Cohen-Gihon I; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Cohen H; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Alcalay R; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Zaide G; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Israeli O; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Ber R; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Rotem S; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Israeli M; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Lazar S; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Zvi A; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Beth-Din A; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Bar-Haim E; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Elia U; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Weiss S; Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel., Cohen O; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Mamroud E; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel., Chitlaru T; Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel.; Faculty of Digital Technologies in Medicine, Holon Institute of Technology, Holon, Israel.
Jazyk:	angličtina
Zdroj:	The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2024 Oct 22. Date of Electronic Publication: 2024 Oct 22.
DOI:	10.4269/ajtmh.24-0231
Abstrakt:	We present the investigation of a Burkholderia pseudomallei strain isolated from the urine of a 56-year-old male returning from a recreational trip to Thailand. The patient initially presented with fever and chills, and lobar as well as bladder and prostate involvement was demonstrated on imaging. Treatment first involved trimethoprim-sulfamethoxazole, the backbone of melioidosis therapy, but was discontinued upon the discovery of resistance to the drug through antimicrobial sensitivity testing via broth microdilution. Further analysis included genomic sequencing, immunotyping, and phenotypic assessment, including virulence testing in an animal model. Results indicated that this strain is a distinct, novel variant with antigenic similarity to other Thai strains displaying high virulence, with a significantly low murine intranasal lethal dose 50% inoculum. The emergence of such a strain, particularly if prevalent in tourist destinations in Thailand, could pose a substantial public health risk, highlighting the need for ongoing vigilance among infectious disease specialists and clinical microbiologists.
Databáze:	MEDLINE
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