Five-Year Surveillance for Burkholderia pseudomallei in Thailand from 2000 to 2004: Prevalence and Antimicrobial Susceptibility
Wantana Paveenkittiporn M.AppSc*, Anucha Apisarnthanarak MD**, Surang Dejsirilert MSc*, Suwanna Trakulsomboon PhD***, Orathai Thongmali Bsc*, Pathom Sawanpanyalert MD, DrPH*, Nalinee Aswapokee MD***
Affiliation : * National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand ** Division of Infectious Diseases, Faculty of Medicine, Thammasart University Hospital, Pratumthani, Thailand *** Unit of Infectious Diseases, Faculty of Internal Medicine, Siriraj University Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the prevalence and antibiotic susceptibility patterns of Burkholderia pseudomallei
isolates in Thailand from 2000 to 2004.
Material and Method: the data on WHONET from 28 hospitals participated in the National Antimicrobial
Resistance Surveillance Thailand (NARST) surveillance program, was reviewed and analyzed for the
prevalence and antimicrobial susceptibility patterns.
Results : During the five-year surveillance, the prevalence of B. pseudomallei in clinical isolates was 69% in
the Northeast, 14% in the North, 11.8 % in the Center, and 5% in the South. Compared to other regions, the
prevalence rate in the Northeast had gradually increased from 2000 to 2004. Burirum Hospital had the
highest prevalence rate in this area. The majority of isolates were obtained from blood (44.9%), pus (25.6%),
respiratory tract (13.3%), and urinary tract (6.3%). The isolates from unusual sites including bone marrow,
heart, and placenta were less commonly noted (< 1%). Based on in vitro susceptibility results, all isolates in
each region expressed high susceptibility to ceftazidime (> 98.5%), amoxicillin/clavulanic acid (> 95%),
cefoperazone/sulbactam (> 98%), imipenem (98.5%), and meropenem (98%), but express less susceptibility
to trimethoprim-sulfamethoxazole (< 53%). However, the susceptibility of B. pseudomallei to trimethoprim/
sulfamethoxazole determined by the disk diffusion method is unreliable; it must be performed by the minimal
inhibitory concentration method.
Conclusion : With the exception of the Northeast, the prevalence rate of B. pseudomallei remains stable for all
regions in Thailand. The isolates obtained from blood and pus represent more than two-thirds of all clinical
isolates. Antimicrobial susceptibility patterns showed no evidence of increased resistance to antimicrobials
most commonly prescribed for the treatment of melioidosis.
Keywords : Anti-infective agents, Burkholderia pseudomallei, Epidemiology, Microbial sensitivity tests, Population surveillance, Prevalence, Thailand
