Ceftazidime-resistance in pediatric melioidosis : A case report and literature review
We report a first case of ceftazidime-resistant pediatric melioidosis involving a previously healthy seven-year-old boy who presented with right lobar pneumonia complicated with a 5-cm lung abscess. Ceftazidime was initiated on Day-6 of admission when Burkholderia pseudomallei (ceftazidime-suscept...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | en |
| Published: |
Elsevier Ltd.
2025
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/48495/1/1-s2.0-S2214250925000046-main.pdf http://ir.unimas.my/id/eprint/48495/ https://www.sciencedirect.com/science/article/pii/S2214250925000046 https://doi.org/10.1016/j.idcr.2025.e02149 |
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| Summary: | We report a first case of ceftazidime-resistant pediatric melioidosis involving a previously healthy seven-year-old
boy who presented with right lobar pneumonia complicated with a 5-cm lung abscess. Ceftazidime was initiated
on Day-6 of admission when Burkholderia pseudomallei (ceftazidime-susceptible, minimum inhibitory concentration [MIC] 1.0 mcg/mL) was isolated from blood. Despite ceftazidime therapy at the recommended dosage, he
developed fulminant septic shock and respiratory failure on Day-18 of hospitalization, requiring invasive
ventilation, hemodynamic support, and continuous renal replacement therapy. His antibiotic was empirically
escalated to meropenem; ceftazidime-resistant B. pseudomallei (MIC 32 mcg/mL) was subsequently isolated from
blood and endotracheal secretions. He improved after two weeks of intensive care and was discharged well after
two months of hospitalization. Our literature review on ceftazidime-resistant B. pseudomallei infection indicates
that acquired resistance is a rare but potentially lethal treatment-related complication. All melioidosis patients
should be carefully monitored during treatment with ceftazidime (or other β-lactams) for the development of
antimicrobial resistance. |
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