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Original ArticleOpen Access
Comparision Between the Antimicrobial Susceptibility of Burkholderia pseudomallei to Trimethoprim-Sulfamethoxazole by Standard Disk Diffusion Method and by Minimal Inhibitory Concentration Determination
Lumbiganon P 
,
Tattawasatra U ,
Thinkhamrop B
,
Tattawasatra U ,
Thinkhamrop B Melioidosis, an infection caused
by Burkholderia pseudomallei,
usually occurs in
immunocompromised patients and requires prolonged antibiotic therapy. Previously, oral trime-
thoprim-sulfamethoxazole (TM/SM), an inexpensive and effective drug has been used as a main-
tenance therapy. The susceptibility of
B. pseudomallei
to TM/SM by the standard disk diffusion
method is very low. However, some patients who were treated with TM/SM as a maintenance
therapy despite the
in vitro
resistance showed good clinical responses. There were no data com-
paring the susceptibility of
B. pseudomallei
by the standard disk diffusion method with other
quantitative susceptibility tests. The objective of this study was to determine the agreement between
the antimicrobial susceptibility of
B. pseudomallei
to TM/SM by standard disk diffusion and
minimal inhibitory concentration determination (MIC).
We performed the susceptibility test of 144 strains of
B. pseudomallei
to TM/SM by
both the standard disk diffusion and microbroth dilution MIC. The sensitivity results were 53.5
per cent and 84.0 per cent respectively. The agreement between the 2 tests was very poor (Kappa=
0.14 ; 95% CI = -0.01 to 0.29). The false resistant rate by the standard disk diffusion test was
67.9 per cent. Further
in vitro
susceptibility and clinical study are needed to define the interpretive
criteria that correlate with clinical response.
Key word : Susceptibility,
B. pseudomallei,
TM/SM, Disk Diffusion, MIC
by Burkholderia pseudomallei,
usually occurs in
immunocompromised patients and requires prolonged antibiotic therapy. Previously, oral trime-
thoprim-sulfamethoxazole (TM/SM), an inexpensive and effective drug has been used as a main-
tenance therapy. The susceptibility of
B. pseudomallei
to TM/SM by the standard disk diffusion
method is very low. However, some patients who were treated with TM/SM as a maintenance
therapy despite the
in vitro
resistance showed good clinical responses. There were no data com-
paring the susceptibility of
B. pseudomallei
by the standard disk diffusion method with other
quantitative susceptibility tests. The objective of this study was to determine the agreement between
the antimicrobial susceptibility of
B. pseudomallei
to TM/SM by standard disk diffusion and
minimal inhibitory concentration determination (MIC).
We performed the susceptibility test of 144 strains of
B. pseudomallei
to TM/SM by
both the standard disk diffusion and microbroth dilution MIC. The sensitivity results were 53.5
per cent and 84.0 per cent respectively. The agreement between the 2 tests was very poor (Kappa=
0.14 ; 95% CI = -0.01 to 0.29). The false resistant rate by the standard disk diffusion test was
67.9 per cent. Further
in vitro
susceptibility and clinical study are needed to define the interpretive
criteria that correlate with clinical response.
Key word : Susceptibility,
B. pseudomallei,
TM/SM, Disk Diffusion, MIC
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