Development and validation of a triplex quantitative real-time PCR assay to detect efflux pump-mediated antibiotic resistance in Burkholderia pseudomallei

Future Microbiol. 2018 Sep;13(12):1403-1418. doi: 10.2217/fmb-2018-0155. Epub 2018 Sep 26.

Abstract

Aim: To develop a probe-based triplex quantitative real-time PCR assay to simultaneously detect the upregulation of the efflux pumps AmrAB-OprA, BpeAB-OprB and BpeEF-OprC in Burkholderia pseudomallei strains exhibiting increased minimum inhibitory concentrations toward meropenem, doxycycline or trimethoprim-sulfamethoxazole.

Methods: The triplex assay was developed and subsequently tested on RNA isolated from eight clinical and eight laboratory-generated B. pseudomallei mutants harboring efflux pump regulator mutations.

Results: The triplex assay accurately detected efflux pump upregulation in all clinical and laboratory mutants, which corresponded with decreased antibiotic susceptibility or antibiotic resistance.

Conclusion: Rapid detection of antibiotic resistance provides clinicians with a tool to identify potential treatment failure in near real time, enabling informed alteration of treatment during an infection and improved patient outcomes.

Keywords: Burkholderia pseudomallei; antibiotic resistance; efflux pump; gene expression; melioidosis; qPCR.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / metabolism
  • Burkholderia pseudomallei / drug effects
  • Burkholderia pseudomallei / genetics
  • Burkholderia pseudomallei / isolation & purification*
  • Burkholderia pseudomallei / metabolism
  • Drug Resistance, Bacterial*
  • Humans
  • Melioidosis / microbiology*
  • Membrane Transport Proteins / genetics*
  • Membrane Transport Proteins / metabolism
  • Microbial Sensitivity Tests
  • Multiplex Polymerase Chain Reaction / methods*
  • Mutation
  • Real-Time Polymerase Chain Reaction / methods*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Membrane Transport Proteins