Immunotherapy markedly increases the effectiveness of antimicrobial therapy for treatment of Burkholderia pseudomallei infection

Antimicrob Agents Chemother. 2010 May;54(5):1785-92. doi: 10.1128/AAC.01513-09. Epub 2010 Feb 22.

Abstract

Burkholderia pseudomallei is a soil bacterium that is endemic in southeast Asia and northern Australia and that can cause both acutely lethal pneumonia and chronic systemic infections in humans. The effective treatment of infection with B. pseudomallei requires rapid diagnosis and prolonged treatment with high doses of antimicrobials, and even with appropriate antibiotic therapy, patient relapses are common. Thus, new approaches to the treatment of B. pseudomallei infections are needed. In the present study, we asked whether active immunotherapy with gamma interferon (IFN-gamma), a key cytokine regulating the intracellular replication of B. pseudomallei, could increase the effectiveness of conventional antimicrobial therapy for B. pseudomallei infection. Macrophage infection assays and in vivo pulmonary challenge models were used to assess the inhibitory effects of combined treatment with IFN-gamma and ceftazidime on B. pseudomallei infection. We found that treatment with even very low doses of IFN-gamma and ceftazidime elicited strong synergistic inhibition of B. pseudomallei growth within infected macrophages. In vivo, active immunotherapy markedly potentiated the effectiveness of low-dose ceftazidime therapy for the treatment of infected mice in a pulmonary challenge model of B. pseudomallei. Combined treatment was associated with a significant reduction in the bacterial burden and a significant lessening of bacterial dissemination. We concluded, therefore, that immunotherapy with either endogenous or exogenous IFN-gamma could significantly increase the effectiveness of conventional antimicrobial therapy for the treatment of acute B. pseudomallei infection.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Avian Proteins / immunology
  • Burkholderia pseudomallei / drug effects*
  • Burkholderia pseudomallei / immunology
  • Ceftazidime / pharmacology*
  • Cell Division / drug effects
  • Cytokines / immunology
  • Disease Models, Animal
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • Immunologic Factors / pharmacology
  • Interferon-gamma / pharmacology*
  • Macrophages / immunology
  • Macrophages / microbiology
  • Melioidosis / drug therapy*
  • Mice
  • Mice, Inbred BALB C

Substances

  • Anti-Bacterial Agents
  • Avian Proteins
  • Cytokines
  • EMF-1 protein, Gallus gallus
  • Immunologic Factors
  • Interferon-gamma
  • Ceftazidime