In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 15, No. 2 ( 2021-2-16), p. e0008913-
Abstract:
Melioidosis is an endemic disease in southeast Asia and northern Australia caused by the saprophytic bacteria Burkholderia pseudomallei , with a high mortality rate. The clinical presentation is multifaceted, with symptoms ranging from acute septicemia to multiple chronic abscesses. Here, we report a chronic case of melioidosis in a patient who lived in Malaysia in the 70s and was suspected of contracting tuberculosis. Approximately 40 years later, in 2014, he was diagnosed with pauci-symptomatic melioidosis during a routine examination. Four strains were isolated from a single sample. They showed divergent morphotypes and divergent antibiotic susceptibility, with some strains showing resistance to trimethoprim-sulfamethoxazole and fluoroquinolones. In 2016, clinical samples were still positive for B . pseudomallei , and only one type of strain, showing atypical resistance to meropenem, was isolated. Principal findings We performed whole genome sequencing and RT-qPCR analysis on the strains isolated during this study to gain further insights into their differences. We thus identified two types of resistance mechanisms in these clinical strains. The first one was an adaptive and transient mechanism that disappeared during the course of laboratory sub-cultures; the second was a mutation in the efflux pump regulator amrR , associated with the overexpression of the related transporter. Conclusion The development of such mechanisms may have a clinical impact on antibiotic treatment. Indeed, their transient nature could lead to an undiagnosed resistance. Efflux overexpression due to mutation leads to an important multiple resistance, reducing the effectiveness of antibiotics during treatment.
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0008913
DOI:
10.1371/journal.pntd.0008913.g001
DOI:
10.1371/journal.pntd.0008913.g002
DOI:
10.1371/journal.pntd.0008913.g003
DOI:
10.1371/journal.pntd.0008913.g004
DOI:
10.1371/journal.pntd.0008913.g005
DOI:
10.1371/journal.pntd.0008913.g006
DOI:
10.1371/journal.pntd.0008913.t001
DOI:
10.1371/journal.pntd.0008913.t002
DOI:
10.1371/journal.pntd.0008913.t003
DOI:
10.1371/journal.pntd.0008913.t004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2429704-5
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