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Outcomes of Patients with Melioidosis Treated with Meropenem. Allen C. Cheng, 2004.Melioidosis, an infection due to Burkholderia pseudomallei, is endemic in southeast Asia and northern Australia . We reviewed our experience with meropenem in the treatment of severe melioidosis in 63 patients over a 6-year period . Outcomes were similar to those of ceftazidime-treated patients (n = 153) despite a deliberate selection bias to more-unwell patients receiving meropenem . The mortality among meropenem-treated patients was 19% . One patient had a possible drug fever associated with the use of meropenem . We conclude that meropenem (1 g or 25 mg/kg every 8 h intravenously for  14 days) is an alternative to ceftazidime and imipenem in the treatment of melioidosis . The use of meropenem may be associated with improved outcomes in patients with severe sepsis associated with melioidosis .
Analysis of Vibrio vulnificus from Market Oysters and Septicemia Cases for Virulence Markers. Angelo DePaola, 2003.Representative encapsulated strains of Vibrio vulnificus from market oysters and oyster-associated primary septicemia cases (25 isolates each) were tested in a blinded fashion for potential virulence markers that may distinguish strains from these two sources . These isolates were analyzed for plasmid content, for the presence of a 460-bp amplicon by randomly amplified polymorphic DNA PCR, and for virulence in subcutaneously (s.c.) inoculated, iron-dextran-treated mice . Similar percentages of market oyster and clinical isolates possessed detectable plasmids (24 and 36%, respectively), produced the 460-bp amplicon (45 and 50%, respectively), and were judged to be virulent in the mouse s.c . inoculation-iron-dextran model (88% for each) . Therefore, it appears that nearly all V . vulnificus strains in oysters are virulent and that genetic tests for plasmids and specific PCR size amplicons cannot distinguish between fully virulent and less virulent strains or between clinical and environmental isolates . The inability of these methods to distinguish food and clinical V . vulnificus isolates demonstrates the need for alternative subtyping approaches and virulence assays .
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