Given that presents a similar antibiotic-susceptibility pattern as and in a few cases, studies are done using both pathogens. pneumonia, skin or organ abscesses, septicemia, or chronic infection, often depending MHP 133 on the route of infection . The estimated case fatality rate for melioidosis ranges from 10 C 50% depending on the geographical region and availability of treatment and from those that survived, approximately 5 C 28% experience reoccurring infections . In contrast, glanders is a zoonotic disease with high transmissibility between solipeds (horses, donkeys, and mules) [2, 7]. Although glanders was eradiated from a large portion of the Western Hemisphere in the late 20th century, the disease remains endemic in Western Asia, India, Africa, and South America, with focal outbreaks still occurring [7, 8]. Today, glanders is primarily an occupational disease where infections can occur when individuals come in contact with infected animals . Like melioidosis, both equines and humans can present a range of clinical signs depending on the route of infection . Disease with can present as a pulmonary infection with nasal discharge, referred to as glanders; or cutaneous infection, known as farcy, which can develop as either acute or chronic infections [2, 7]. The high mortality, common routes of transmission and the ability for aerosolization with MHP 133 the capability of infecting both humans and animals, has resulted in the dual classification of both and as Tier 1 Select Agents by the Centers for Disease Control and Prevention (CDC) and the United States Department of Agriculture (USDA) . There are currently no available vaccines for humans or animals and the treatment options though limited, include a biphasic antibiotic therapy which can last up to 6 months [2, 3]. 1.2. Treatment for Melioidosis and Glanders Early detection for both melioidosis and glanders is imperative for effective pathogen control and early management of disease. In regions with effective diagnosis, early implementation of proper therapy, and facilities with adequate infrastructure for managing sepsis, the mortality of septicemic melioidosis is reduced significantly to approximately ~10% [3, 10]. However, such measures are often not available or are very limited in many countries were melioidosis is endemic. Therefore, effective melioidosis treatment have the potential to reduce mortality rates against this pathogen considerably. The limited knowledge of glanders epidemiology C due in part to the limited number of cases C has resulted in the decline of studies measuring the susceptibility of to common antibiotics and other therapies [2, 9]. Given that presents a similar antibiotic-susceptibility pattern as and in a few cases, studies are done MHP 133 using both pathogens. Single drug-therapy is only partially effective; therefore, therapy relies on the use combination of antibiotics for extended periods MHP 133 of time . An additional concern is the fact that there is a larger number of antibiotic-resistant variants of and to first and second-generation cephalosporins, penicillin, gentamicin, tobramycin, streptomycin, macrolide, polymyxins, and aminoglycosides . However, the majority of clinical isolates have a similar antimicrobial susceptibility pattern including, -lactam antibiotics such as ceftazidime, meropenem, imipenem, and co-amoxiclav, and almost always present similar susceptibility patterns to bacteriostatic antibiotics like doxycycline, chloramphenicol, and trimethoprim-sulfamethoxazole [3, 11]. Furthermore, concerns regarding the rise of multi-drug resistant by the overuse of antibiotics or by natural acquisition of resistance, combined with the limited treatment options against have generated the need to develop novel therapies that either enhance antibiotic therapy or that target specific mechanisms of pathogenesis . Although many candidates have shown variable degrees of success, none have replaced the formal guidelines for the treatment of melioidosis defined by Mouse monoclonal to IFN-gamma the CDC. The treatment for melioidosis includes an intensive phase of intravenous antibiotic therapy consisting of ceftazidime or meropenem for 10 C 14 days, followed by an extensive eradication phase to prevent relapse of disease, especially in highly susceptible immunosuppressed patients [3, 5, 13]. The eradication phase consists of an oral administration of trimethoprim-sulfamethoxazole that can last between 3 – 6 months, depending on clinical presentations, with more prolonged therapy recommended for neuro-melioidosis or osteomyelitis complications [1, 3]. Because of the long-term antibiotic therapy against melioidosis, adverse effects are reported in MHP 133 up to 40% of patients, including allergic reactions (e.g. rash, pruritus) or gastrointestinal disorders (e.g. nausea, vomiting) . Therefore, new therapies should address the potential side effects, specifically in the young and elder populations, or heavily immunocompromised individuals . In addressing the need.
Given that presents a similar antibiotic-susceptibility pattern as and in a few cases, studies are done using both pathogens