Benchmarking CRISPR-BP34 for point-of-care melioidosis detection in low-income and middle-income countries: a molecular diagnostics study

Pakdeerat, Sukripong; Boonklang, Phumrapee; Angchagun, Kesorn; Chomkatekaew, Chalita; Apichaidejudom, Navaporn; Dokket, Yaowaret; Faosap, Areeya; Wongsuwan, Gumphol; Wuthiekanun, Vanaporn; Aramrueung, Panatda; Khamnoi, Phadungkiat; Thananchai, Hathairat; Siriboon, Suwattiya; Chamnan, Parinya; Peacock, Sharon J; Day, Nicholas P J; Thomson, Nicholas R; Uttamapinant, Chayasith; Wongpalee, Somsakul Pop; Chewapreecha, Claire

doi:10.1016/s2666-5247(23)00378-6

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…Early diagnosis of melioidosis is critical. Most deaths will occur within days of presentation, but even among survivors, delays in diagnosis allow disease evolution, increasing the risk of more complicated disease and long-term sequelae [ 1 , 11 , 33 ]. In this context it noteworthy that the sole death in the cohort occurred in a patient in whom the diagnosis was delayed until over 6 weeks after his hospitalisation.…”

Section: Discussionmentioning

confidence: 99%

“…Even if melioidosis is diagnosed, suboptimal treatment increases the risk of early death and of recrudescence and relapse which may be fatal [ 2 , 33 , 38 ]. In Australia, the rate of relapse is much lower than in other jurisdictions which is explained, at least in part, by the longer courses of intravenous antibiotic therapy prescribed for the infection [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes

Dadwal,

Bonner,

Fraser

et al. 2024

PLoS Negl Trop Dis

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Background Melioidosis, a life-threatening infection caused by the gram negative bacterium Burkholderia pseudomallei, can involve almost any organ. Bone and joint infections (BJI) are a recognised, but incompletely defined, manifestation of melioidosis that are associated with significant morbidity and mortality in resource-limited settings. Methodology/principal findings We identified all individuals with BJI due to B. pseudomallei managed at Cairns Hospital in tropical Australia between January 1998 and June 2023. The patients’ demographics, their clinical findings and their treatment were correlated with their subsequent course. Of 477 culture-confirmed cases of melioidosis managed at the hospital during the study period, 39 (8%) had confirmed BJI; predisposing risk factors for melioidosis were present in 37/39 (95%). However, in multivariable analysis only diabetes mellitus was independently associated with the presence of BJI (odds ratio (95% confidence interval): 4.04 (1.81–9.00), p = 0.001). BJI was frequently only one component of multi-organ involvement: 29/39 (74%) had infection involving other organs and bacteraemia was present in 31/39 (79%). Of the 39 individuals with BJI, 14 (36%) had osteomyelitis, 8 (20%) had septic arthritis and 17 (44%) had both osteomyelitis and septic arthritis; in 32/39 (83%) the lower limb was involved. Surgery was performed in 30/39 (77%). Readmission after the initial hospitalisation was necessary in 11/39 (28%), 5/39 (13%) had disease recrudescence and 3/39 (8%) had relapse; 4/39 (10%) developed pathological fractures. ICU admission was necessary in 11/39 (28%) but all 11 of these patients survived. Only 1/39 (3%) died, 138 days after admission, due to his significant underlying comorbidity. Conclusions The case-fatality rate from melioidosis BJI in Australia’s well-resourced health system is very low. However, recrudescence, relapse and orthopaedic complications are relatively common and emphasise the importance of collaborative multidisciplinary care that includes early surgical review, aggressive source control, prolonged antibiotic therapy, and thorough, extended follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes

Dadwal,

Bonner,

Fraser

et al. 2024

PLoS Negl Trop Dis

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Integrating Genomic Data with the Development of CRISPR-Based Point-of-Care-Testing for Bacterial Infections

Wanitchanon,

Chewapreecha,

Uttamapinant

2024

Curr Clin Micro Rpt

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Purpose of Review Bacterial infections and antibiotic resistance contribute to global mortality. Despite many infections being preventable and treatable, the lack of reliable and accessible diagnostic tools exacerbates these issues. CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)-based diagnostics has emerged as a promising solution. However, the development of CRISPR diagnostics has often occurred in isolation, with limited integration of genomic data to guide target selection. In this review, we explore the synergy between bacterial genomics and CRISPR-based point-of-care tests (POCT), highlighting how genomic insights can inform target selection and enhance diagnostic accuracy. Recent Findings We review recent advances in CRISPR-based technologies, focusing on the critical role of target sequence selection in improving the sensitivity of CRISPR-based diagnostics. Additionally, we examine the implementation of these technologies in resource-limited settings across Asia and Africa, presenting successful case studies that demonstrate their potential. Summary The integration of bacterial genomics with CRISPR technology offers significant promise for the development of effective point-of-care diagnostics.

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Mycotic aneurysms due to Burkholderia pseudomallei in Far North Queensland, tropical Australia: A case series and review of the literature

Boyle,

Withey,

Smith

et al. 2024

Acta Tropica

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Benchmarking CRISPR-BP34 for point-of-care melioidosis detection in low-income and middle-income countries: a molecular diagnostics study

Cited by 5 publications

References 26 publications

Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes

Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes

Integrating Genomic Data with the Development of CRISPR-Based Point-of-Care-Testing for Bacterial Infections

Mycotic aneurysms due to Burkholderia pseudomallei in Far North Queensland, tropical Australia: A case series and review of the literature

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