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Burkholderia gladioli
- Question
- Dear expert team,
after a 15-day imipenem therapy against Burkholderia gladioli, the first germ test was negative; now a few weeks later, however, an infection is traceable again. How would you proceed? Symptomatically, there is pain during breathing, which had ceased immediately after therapy and only returned at the same time as the germs reappeared.
Other than that, no limitations. Will the germ stay if it is not treated? What is the prognosis for this germ regarding lung function, and how can it be that imipenem appeared as sensitive again in the microbial sensitivity test? Is a two-week therapy with this drug not sufficient? The dosage was 1 gram of Zienam® per 300 ml NaCl.
Many thanks for your answer! - Answer
- Hello,
Information on the progression of infections with Burkholderia gladioli varies in the literature. If one summarizes the data, however, it seems that Burkholderia gladioli can be eradicated successfully in the majority of patients. It cannot be said for sure whether your symptoms can be directly related to the germ; it is not impossible, though. In most cases, the germs are sensitive against some of the antibiotics that are also used in the treatment of Pseudomonas aeruginosa; only some are actually also relatively antibiotics-resistant. You write that you have only been treated with imipenem. Personally, I would always treat such germs with a combination of drugs. Even with a greater number of resitances, the patient will probably profit from a combination more than from a single drug that has been tested as sensitive. Additionally, if a two-week therapy is not successful, I would try a three-week therapy next time in order to achieve eradication. If you ask about a possible chronic infection with this germ, I would like to point out a paper on Burkholderia gladioli infections that indicates that fraction of such patients as 40%. I would not give up yet concerning this, however, but would try again to treat the infection as effectively as possible.
Kind regards,
Olaf Sommerburg - 30.08.2011
- 30.8.11
Please find more about this germ under the search term: Burkholderia gladioli or use the following link to come to a former question:
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D. d'Alquen
