Genomic insights into ceftazidime resistance in Burkholderia pseudomallei: discovery of A172T mutation and palindromic GC-rich repeat sequences facilitating penA duplication and amplification

Ceftazidime (CAZ) resistance in Burkholderia pseudomallei, the causative agent of melioidosis, complicates treatment in endemic regions. This study identified a novel A172T mutation and other known penA mutations as critical contributors to CAZ resistance in a large Thai strain collection. Frequent gene duplication and amplification of penA, likely driven by Palindromic GC-Rich Repeat Sequences, highlights the urgent need for rapid diagnostics and optimized treatment strategies to manage this life-threatening disease effectively.