A Novel Virulent Clinical Isolate of Burkholderia pseudomallei Imported from Thailand Exhibiting Resistance to Trimethoprim-Sulfamethoxazole
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.
Authors
- Erez Bar‐Haim (ORCID: https://orcid.org/0000-0003-3435-8599)
- Ron Alcalay (ORCID: https://orcid.org/0000-0003-1276-0464)
- Galia Zaide (ORCID: https://orcid.org/0000-0002-5699-648X)
- Asaf Biber (ORCID: https://orcid.org/0000-0001-6007-0383)
- Shay Weiss (ORCID: https://orcid.org/0000-0003-0634-7817)
- Shahar Rotem
- Paula David (ORCID: https://orcid.org/0000-0003-0075-5895)
- Anat Zvi (ORCID: https://orcid.org/0000-0003-3743-9642)
- Inbar Cohen-Gihon
- Theodor Chitlaru (ORCID: https://orcid.org/0000-0002-6351-0820)
- Shirley Lazar
- Emanuelle Mamroud (ORCID: https://orcid.org/0000-0001-5685-293X)
- Uri Elia (ORCID: https://orcid.org/0000-0003-0710-5481)
- Ofer Cohen (ORCID: https://orcid.org/0000-0002-4374-9981)
- Ofir Israeli (ORCID: https://orcid.org/0000-0002-4590-6151)
- Moshe Aftalion
- Hagai Cohen (ORCID: https://orcid.org/0000-0001-8488-0727)
- Ma’ayan Israeli
- Raphael Ber
- Adi Beth-Din
- David Gur
- Sharon Amit (ORCID: https://orcid.org/0000-0002-0867-1824)
Institutions
- Israel Institute for Biological Research (IL)
- Holon Institute of Technology (IL)
- Tel Aviv University (IL)
- Sheba Medical Center (IL)
Publication Details
- Journal
- American Journal of Tropical Medicine and Hygiene
- Published
- 2024-10-23
- DOI
- https://doi.org/10.4269/ajtmh.24-0231
- Citations
- 1
- Primary Topic
- Burkholderia infections and melioidosis
- Type
- article
- Field-Weighted Citation Impact
- 0.39