Lab Med Online.  2015 Oct;5(4):219-222. 10.3343/lmo.2015.5.4.219.

A Case of Ceftazidime-Nonsusceptible Burkholderia pseudomallei Infection

• You E
• Seo MJ
• Kim YJ
• Park MJ
• Lee HJ

• KMID: 2046385
• DOI: http://doi.org/10.3343/lmo.2015.5.4.219

Abstract

Melioidosis, which is an infectious disease caused by Burkholderia pseudomallei, is prevalent mostly in Southeast Asia and northern Australia; it can progress to abscess formation, pneumonia and sepsis, and ultimately cause death. A 66-yr-old male patient with diabetes mellitus was hospitalized for sepsis 3 months after coming back from Cambodia, and B. pseudomallei was identified from the blood culture. The B. pseudomallei strain was found to be susceptible to carbapenem, and non-susceptible to trimethoprim/sulfamethoxazole and ceftazidime. Although the patient was treated with carbapenem, to which the strain was susceptible, the bacteremia persisted, and progressed to septic shock and pneumonia, and eventually to acute respiratory distress syndrome (ARDS). The patient died on the 12th day of hospitalization. This study, which reports the first case of ceftazidime-nonsusceptible B. pseudomallei in Korea, indicates the importance of B. pseudomallei infection, which is highly likely to be imported to Korea, and discuss its clinical progress, which can lead to fatality.

Keyword

Burkholderia pseudomallei; Ceftazidime non-susceptible; Melioidosis

MeSH Terms

Abscess
Asia, Southeastern
Australia
Bacteremia
Burkholderia pseudomallei*
Burkholderia*
Cambodia
Ceftazidime
Communicable Diseases
Diabetes Mellitus
Hospitalization
Humans
Korea
Male
Melioidosis
Pneumonia
Respiratory Distress Syndrome, Adult
Sepsis
Shock, Septic
Ceftazidime

Figure

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  Fig. 1 Colonies on blood agar grew small, smooth and ordinary after 15 hr of incubation (A), but they turned into typical wrinkled appearance after 48 hr of incubation (B). On gram staining, B. pseudomallei is a gram negative rod with a characteristic "safety pin" appearance (C).

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