Workshop on Treatment of and Postexposure Prophylaxis for Burkholderia Pseudomallei and B. Mallei Infection, 2010

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2012 Nov 23

PMID 23171644

Citations 119

Authors

Rebecca Lipsitz

Susan Garges

Rosemarie Aurigemma

Prasith Baccam

David D Blaney

Allen C Cheng

Bart J Currie

David Dance

Jay E Gee

Joseph Larsen

Direk Limmathurotsakul

Meredith G Morrow

Robert Norton

Elizabeth OMara

Sharon J Peacock

Nicki Pesik

L Paige Rogers

Herbert P Schweizer

Ivo Steinmetz

Gladys Tan

Patrick Tan

W Joost Wiersinga

Vanaporn Wuthiekanun

Theresa L Smith

Affiliations

Soon will be listed here.

Abstract

The US Public Health Emergency Medical Countermeasures Enterprise convened subject matter experts at the 2010 HHS Burkholderia Workshop to develop consensus recommendations for postexposure prophylaxis against and treatment for Burkholderia pseudomallei and B. mallei infections, which cause melioidosis and glanders, respectively. Drugs recommended by consensus of the participants are ceftazidime or meropenem for initial intensive therapy, and trimethoprim/sulfamethoxazole or amoxicillin/clavulanic acid for eradication therapy. For postexposure prophylaxis, recommended drugs are trimethoprim/sulfamethoxazole or co-amoxiclav. To improve the timely diagnosis of melioidosis and glanders, further development and wide distribution of rapid diagnostic assays were also recommended. Standardized animal models and B. pseudomallei strains are needed for further development of therapeutic options. Training for laboratory technicians and physicians would facilitate better diagnosis and treatment options.

Citing Articles

Performance of Antibody-Detection Tests for Human Melioidosis: A Systematic Review and Meta-analysis.

Selvam K, Ahmad Najib M, Khalid M, Harun A, Aziah I Malays J Med Sci. 2025; 31(6):34-56.

PMID: 39830111 PMC: 11740806. DOI: 10.21315/mjms2024.31.6.4.

Multi-systemic melioidosis.

Nagoba B, Dhotre S, Rayate A, Mumbre S, Dhotre P World J Clin Cases. 2024; 12(28):6151-6154.

PMID: 39371552 PMC: 11362900. DOI: 10.12998/wjcc.v12.i28.6151.

Pyrexia of Unknown Origin in a Young Male: Unmasking Melioidosis in a Tuberculosis-Endemic Setting.

Krishna M, Lakshmanan S, Rajendran V, Senthil N, Ayub I Cureus. 2024; 16(7):e64024.

PMID: 39109095 PMC: 11302954. DOI: 10.7759/cureus.64024.

Isolation, serological and molecular methods in screening of in East Azerbaijan province, Iran.

Tikmehdash H, Dehnad A, Mosavari N, Naghili Hokmabadi B, Mahmazi S Vet Res Forum. 2024; 15(5):231-236.

PMID: 39022578 PMC: 11251541. DOI: 10.30466/vrf.2024.2010651.4002.

Patient Presenting with Abscess Unresponsive to Treatment and Progressive to Osteomyelitis: A Rare Cause .

Cetin F, Ozgur Gundeslioglu O, Bakanoglu E, Ummuhan C, Alabaz D, Gumus H Sisli Etfal Hastan Tıp Bul. 2024; 58(2):258-261.

PMID: 39021687 PMC: 11249987. DOI: 10.14744/SEMB.2023.70194.

References

Rajchanuvong A, Chaowagul W, Suputtamongkol Y, Smith M, Dance D, White N . A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. Trans R Soc Trop Med Hyg. 1995; 89(5):546-9. DOI: 10.1016/0035-9203(95)90104-3. View

Jenney A, Lum G, Fisher D, Currie B . Antibiotic susceptibility of Burkholderia pseudomallei from tropical northern Australia and implications for therapy of melioidosis. Int J Antimicrob Agents. 2001; 17(2):109-13. DOI: 10.1016/s0924-8579(00)00334-4. View

Bowers J, Engelthaler D, Ginther J, Pearson T, Peacock S, Tuanyok A . BurkDiff: a real-time PCR allelic discrimination assay for Burkholderia pseudomallei and B. mallei. PLoS One. 2010; 5(11):e15413. PMC: 2980470. DOI: 10.1371/journal.pone.0015413. View

Sivalingam S, Sim S, Jasper L, Wang D, Liu Y, Ooi E . Pre- and post-exposure prophylaxis of experimental Burkholderia pseudomallei infection with doxycycline, amoxicillin/clavulanic acid and co-trimoxazole. J Antimicrob Chemother. 2008; 61(3):674-8. DOI: 10.1093/jac/dkm527. View

Peacock S, Chieng G, Cheng A, Dance D, Amornchai P, Wongsuvan G . Comparison of Ashdown's medium, Burkholderia cepacia medium, and Burkholderia pseudomallei selective agar for clinical isolation of Burkholderia pseudomallei. J Clin Microbiol. 2005; 43(10):5359-61. PMC: 1248505. DOI: 10.1128/JCM.43.10.5359-5361.2005. View

Puthucheary S, Parasakthi N, Lee M . Septicaemic melioidosis: a review of 50 cases from Malaysia. Trans R Soc Trop Med Hyg. 1992; 86(6):683-5. DOI: 10.1016/0035-9203(92)90191-e. View

Chierakul W, Anunnatsiri S, Chaowagul W, Peacock S, Chetchotisakd P, Day N . Addition of trimethoprim-sulfamethoxazole to ceftazidime during parenteral treatment of melioidosis is not associated with a long-term outcome benefit. Clin Infect Dis. 2007; 45(4):521-3. DOI: 10.1086/520010. View

Peacock S, Schweizer H, Dance D, Smith T, Gee J, Wuthiekanun V . Management of accidental laboratory exposure to Burkholderia pseudomallei and B. mallei. Emerg Infect Dis. 2008; 14(7):e2. PMC: 2600349. DOI: 10.3201/eid1407.071501. View

Wen S, Zhou J, Yang Q, Fraser W, Olatunbosun O, Walker M . Maternal exposure to folic acid antagonists and placenta-mediated adverse pregnancy outcomes. CMAJ. 2008; 179(12):1263-8. PMC: 2585135. DOI: 10.1503/cmaj.080859. View

10.

Chantratita N, Rholl D, Sim B, Wuthiekanun V, Limmathurotsakul D, Amornchai P . Antimicrobial resistance to ceftazidime involving loss of penicillin-binding protein 3 in Burkholderia pseudomallei. Proc Natl Acad Sci U S A. 2011; 108(41):17165-70. PMC: 3193241. DOI: 10.1073/pnas.1111020108. View

11.

Currie B, Ward L, Cheng A . The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis. 2010; 4(11):e900. PMC: 2994918. DOI: 10.1371/journal.pntd.0000900. View

12.

Rholl D, Papp-Wallace K, Tomaras A, Vasil M, Bonomo R, Schweizer H . Molecular Investigations of PenA-mediated β-lactam Resistance in Burkholderia pseudomallei. Front Microbiol. 2011; 2:139. PMC: 3129521. DOI: 10.3389/fmicb.2011.00139. View

13.

Wuthiekanun V, Desakorn V, Wongsuvan G, Amornchai P, Cheng A, Maharjan B . Rapid immunofluorescence microscopy for diagnosis of melioidosis. Clin Diagn Lab Immunol. 2005; 12(4):555-6. PMC: 1074392. DOI: 10.1128/CDLI.12.4.555-556.2005. View

14.

Stone R . Infectious disease. Racing to defuse a bacterial time bomb. Science. 2007; 317(5841):1022-4. DOI: 10.1126/science.317.5841.1022. View

15.

Limmathurotsakul D, Chaowagul W, Chierakul W, Stepniewska K, Maharjan B, Wuthiekanun V . Risk factors for recurrent melioidosis in northeast Thailand. Clin Infect Dis. 2006; 43(8):979-86. DOI: 10.1086/507632. View

16.

Tiangpitayakorn C, Songsivilai S, Piyasangthong N, Dharakul T . Speed of detection of Burkholderia pseudomallei in blood cultures and its correlation with the clinical outcome. Am J Trop Med Hyg. 1997; 57(1):96-9. DOI: 10.4269/ajtmh.1997.57.96. View

17.

Thibault F, Hernandez E, Vidal D, GIRARDET M, Cavallo J . Antibiotic susceptibility of 65 isolates of Burkholderia pseudomallei and Burkholderia mallei to 35 antimicrobial agents. J Antimicrob Chemother. 2004; 54(6):1134-8. DOI: 10.1093/jac/dkh471. View

18.

Chaowagul W, Simpson A, Suputtamongkol Y, Smith M, Angus B, White N . A comparison of chloramphenicol, trimethoprim-sulfamethoxazole, and doxycycline with doxycycline alone as maintenance therapy for melioidosis. Clin Infect Dis. 1999; 29(2):375-80. DOI: 10.1086/520218. View

19.

Antonov V, Tkachenko G, Altukhova V, Savchenko S, Zinchenko O, Viktorov D . Molecular identification and typing of Burkholderia pseudomallei and Burkholderia mallei: when is enough enough?. Trans R Soc Trop Med Hyg. 2009; 102 Suppl 1:S134-9. DOI: 10.1016/S0035-9203(08)70030-0. View

20.

Suputtamongkol Y, Rajchanuwong A, Chaowagul W, Dance D, Smith M, Wuthiekanun V . Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. Clin Infect Dis. 1994; 19(5):846-53. DOI: 10.1093/clinids/19.5.846. View