ArticleProceedings of the National Academy of Sciences of the United States of America2011
Antimicrobial resistance to ceftazidime involving loss of penicillin-binding protein 3 in Burkholderia pseudomallei.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers.
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Who cites it
73 citing papers in PubMed, 117 citations in OpenAlex.
- Case Commentary: When susceptibility is not enough in recurrentAntimicrobial agents and chemotherapy · 2026Article
- Case Report: Eschar-like subcutaneous lesion in disseminated melioidosis revealing anti-interferon-γ autoantibody-associated adult-onset immunodeficiency and a review of the literature.Frontiers in medicine · 2026Article
- Meropenem treatment failure in severe melioidosis despite in vitro susceptibility: A case report.IDCases · 2026Article
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- Genomic insights into ceftazidime resistance inAntimicrobial agents and chemotherapy · 2025Article
- Immune responses following DNA vaccination by needle-free injection againstFrontiers in immunology · 2025Article
- Melioidosis clinically unresponsive to meropenem in a traveller returning from Thailand.IDCases · 2025Article
- Comparison of homologous and heterologous vaccination strategies for combating disease caused byFrontiers in immunology · 2025Article
- Article
- Burkholderia pseudomallei and melioidosis.Nature reviews. Microbiology · 2024Review
- TetR-like regulator BP1026B_II1561 controls aromatic amino acid biosynthesis and intracellular pathogenesis inFrontiers in microbiology · 2024Article
- In Vitro Susceptibility ofJournal of laboratory physicians · 2023Article
- Exploring Cefiderocol Resistance Mechanisms in Burkholderia pseudomallei.Antimicrobial agents and chemotherapy · 2023Article
- Antibiotic susceptibility of clinicalAntimicrobial agents and chemotherapy · 2023Article
- DNase I and chitosan enhance efficacy of ceftazidime to eradicate Burkholderia pseudomallei biofilm cells.Scientific reports · 2023Article
- Express Yourself: Quantitative Real-Time PCR Assays for Rapid Chromosomal Antimicrobial Resistance Detection in Pseudomonas aeruginosa.Antimicrobial agents and chemotherapy · 2022Article
- Real-life comparison of three intravitreal antibiotic drug regimens in endophthalmitis.Indian journal of ophthalmology · 2022Article
- In silico analyses of penicillin binding proteins in Burkholderia pseudomallei uncovers SNPs with utility for phylogeography, species differentiation, and sequence typing.PLoS neglected tropical diseases · 2022Article
- Genetic diversity and transmission patterns ofMicrobial genomics · 2021Article
- Antimicrobial Susceptibility of Western Hemisphere Isolates ofMicrobial drug resistance (Larchmont, N.Y.) · 2021Article
13 more citing papers are in PubMed but not listed here.
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Authors and funding
14 authors at 6 institutions in 4 countries.
Funding
Abstract
Known mechanisms of resistance to β-lactam antibiotics include β-lactamase expression, altered drug target, decreased bacterial permeability, and increased drug efflux. Here, we describe a unique mechanism of β-lactam resistance in the biothreat organism Burkholderia pseudomallei (the cause of melioidosis), associated with treatment failure during prolonged ceftazidime therapy of natural infection. Detailed comparisons of the initial ceftazidime-susceptible infecting isolate and subsequent ceftazidime-resistant variants from six patients led us to identify a common, large-scale genomic loss involving a minimum of 49 genes in all six resistant strains. Mutational analysis of wild-type B. pseudomallei demonstrated that ceftazidime resistance was due to deletion of a gene encoding a penicillin-binding protein 3 (BPSS1219) present within the region of genomic loss. The clinical ceftazidime-resistant variants failed to grow using commonly used laboratory culture media, including commercial blood cultures, rendering the variants almost undetectable in the diagnostic laboratory. Melioidosis is notoriously difficult to cure and clinical treatment failure is common in patients treated with ceftazidime, the drug of first choice across most of Southeast Asia where the majority of cases are reported. The mechanism described here represents an explanation for ceftazidime treatment failure, and may be a frequent but undetected resistance event.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.