Antibiotic Resistance in Burkholderia Species

• Published in: Drug resistance updates Vol. 28; pp. 82 - 90
• Main Authors: Rhodes, Katherine A, Schweizer, Herbert P
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.09.2016
• Subjects: Animals; Anti-Bacterial Agents - pharmacology; Antibiotics resistance; Bacterial Proteins - genetics; Bacterial Proteins - metabolism; Burkholderia; Burkholderia - drug effects; Burkholderia - genetics; Burkholderia - growth & development; Burkholderia - pathogenicity; Burkholderia cepacia complex; Burkholderia Infections - drug therapy; Burkholderia Infections - microbiology; Burkholderia Infections - pathology; Burkholderia mallei - drug effects; Burkholderia mallei - genetics; Burkholderia mallei - growth & development; Burkholderia mallei - pathogenicity; Burkholderia pseudomallei - drug effects; Burkholderia pseudomallei - genetics; Burkholderia pseudomallei - growth & development; Burkholderia pseudomallei - pathogenicity; DNA Gyrase - genetics; DNA Gyrase - metabolism; Drug Resistance, Multiple, Bacterial - genetics; Gene Expression Regulation, Bacterial; Genes, MDR; Glanders; Glanders - drug therapy; Glanders - microbiology; Glanders - pathology; Hematology, Oncology and Palliative Medicine; Horses; Humans; Infectious Disease; Melioidosis; Melioidosis - drug therapy; Melioidosis - microbiology; Melioidosis - pathology; Porins - antagonists & inhibitors; Porins - genetics; Porins - metabolism; Tetrahydrofolate Dehydrogenase - genetics; Tetrahydrofolate Dehydrogenase - metabolism; Melioidosis; Glanders; Burkholderia; Antibiotics resistance; Burkholderia cepacia complex
• ISSN: 1368-7646; 1532-2084
• DOI: 10.1016/j.drup.2016.07.003

Abstract The genus Burkholderia comprises metabolically diverse and adaptable Gram-negative bacteria, which thrive in often adversarial environments. A few members of the genus are prominent opportunistic pathogens. These include B. mallei and B. pseudomallei of the B. pseudomallei complex, which cause glanders and melioidosis, respectively. B. cenocepacia , B. multivorans , and B. vietnamiensis belong to the B. cepacia complex and affect mostly cystic fibrosis patients. Infections caused by these bacteria are difficult to treat because of significant antibiotic resistance. The first line of defense against antimicrobials in Burkholderia species is the outer membrane penetration barrier. Most Burkholderia contain a modified lipopolysaccharide that causes intrinsic polymyxin resistance. Contributing to reduced drug penetration are restrictive porin proteins. Efflux pumps of the resistance nodulation cell division family are major players in Burkholderia multidrug resistance. Third and fourth generation β-lactam antibiotics are seminal for treatment of Burkholderia infections, but therapeutic efficacy is compromised by expression of several β-lactamases and ceftazidime target mutations. Altered DNA gyrase and dihydrofolate reductase targets cause fluoroquinolone and trimethoprim resistance, respectively. Although antibiotic resistance hampers therapy of Burkholderia infections, the characterization of resistance mechanisms lags behind other non-enteric Gram-negative pathogens, especially ESKAPE bacteria such as Acinetobacter baumannii , Klebsiella pneumoniae and Pseudomonas aeruginosa.