Burden of melioidosis in India and South Asia: Challenges and ways forward

Mohapatra, Prasanta Raghab; Mishra, Baijayantimala

doi:10.1016/j.lansea.2022.03.004

Cited by 35 publications

(27 citation statements)

References 40 publications

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“…It is one of the infectious diseases which are springing up mostly in western coastal region and central India. [1] B. pseudomallei is the causative organism of the disease found most commonly in soil and water with predominant evidence during monsoon in agricultural populations. [2] It is a level-3 pathogen with laboratory contaminants and can easily grow in hospital settings.…”

Section: Discussionmentioning

confidence: 99%

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Septicemic Melioidosis: In a Immunocompetent Host: A Case Report

Wadaskar¹,

Khairnar²

2023

VJIM

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Melioidosis is endemic and underreported in nearly 45 countries worldwide. South Asian region contributes 44% of total global burden of melioidosis. It mainly affects people of poor socioeconomic strata. About 32.9% mortality and 7.0% relapses have been reported. Up to 45% of people are diabetics and only 2% have no identifiable risk factors. Here, we report a case of melioidosis with severe septic shock in a immunocompetent host.

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Section: Discussionmentioning

confidence: 99%

“…High index of clinical suspicion is required to identify the organism on culture and Gram stain, since it can easily be confused with other Gram-negative rods such as pseudomonas and Escherichia coli. [1] This is a case of melioidosis in a healthy host presented with severe sepsis with septic shock.…”

Section: Introductionmentioning

confidence: 99%

Septicemic Melioidosis: In a Immunocompetent Host: A Case Report

Wadaskar¹,

Khairnar²

2023

VJIM

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“…Likewise, several melioidosis patients remain on antitubercular drugs, while others are treated with high-end antibacterial agents like carbapenems with inadequate and shorter regimens leading to temporary suppression and recurrence of infection. 11 This case is a reflection of the worldwide scenario of melioidosis, where a lack of awareness and negligence about the infection results in undiagnosed, unreported, missed diagnosed and mismanaged cases, leading to the increasing mortality rate.…”

Section: Misdiagnosis and Mismanagement Of Melioidosismentioning

confidence: 98%

“…However, the colonies are wrinkled in appearance, oxidase positive and non-lactose fermenters, and a lack of prior knowledge about these features raises doubt in the minds of the microbiologists, who may discard the plates as environmental contaminants. 11,13 Molecular diagnosis or detection of the organism by Vitek, may yield better and confirmatory results, but are not done routinely in developing countries due to expensive technologies and lack of expertise.…”

Section: Clinical Latencymentioning

confidence: 99%

Melioidosis: Bridging the gap from bedside to bench in Bangladesh

Farook¹,

Hoque²,

Shampa³

et al. 2022

ZHSWMCJ

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The potentially fatal infectious disease "Melioidosis", caused by the saprophyte Burkholderia pseudomallei, has remained in the shadows for far too long. Although, the bacterium has been described almost a century ago in Myanmar, and considerable progress in terms of diagnosis and treatment was achieved, B.pseudomallei is still "the unbeatable foe", for several reasons like under-recognition, high case-fatality rate, unacceptable relapse rate and a "time-bomb" effect for sero-positive individuals. Just like Mycobacterium tuberculosis, the organism can remain latent for decades before the onset of clinical signs and symptoms. The first case of melioidosis from Bangladesh was reported in 1964, in a 29 year old British sailor who was travelling through Bangladesh. Since then, around 68 culture proven melioidosis cases have been sporadically detected in Bangladesh over last several decades. However, the true melioidosis burden is unknown in this region due to lack of awareness and absence of systematic surveillance and research. The reasons for its under-recognition are unavailability of diagnostic microbiology laboratories serving the rural poor in the tropics, who are most likely to acquire melioidosis, and a lack of familiarity and awareness amongst medical and laboratory staff, where such laboratories are available. Clinical diagnosis is exceptionally challenging due to the varied clinical presentations, as the disease can mimic other infections. The most striking reason for this unawareness is that, melioidosis is still considered as one of the most neglected tropical diseases (NTDs), so much so that it is not even included in the WHO list of NTDs. The burden of melioidosis reveals the gaps in dealing with the disease, whereas the prevention mechanism clearly demands public health action in Bangladesh. Without early diagnosis and treatment and exploring better ways to prevent transmission, melioidosis will spread exponentially and claim more lives in the year to come. Therefore, clinicians and microbiologists should be made aware about this pathogen and its frequent misdiagnosis. Availability of validated diagnostic reagents for immunological and molecular tests and expansion of databases of commercial identification systems will likely remove the major hurdles in correct identification of B. pseudomallei. In conclusion, a high level of suspicion on the part of clinicians along with vigilant microbiologists and availability of discerning diagnostic assays may help in identification, reporting, and subsequent management of this "mimicker of maladies".

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“…A recent review of melioidosis in India and South Asia describes in detail the difficulties in clinical recognition and laboratory diagnosis of melioidosis and the formidable challenges of addressing these as well as in establishing effective prevention programs [24 ▪ ].…”

Section: Epidemiologymentioning

confidence: 99%

Melioidosis and Burkholderia pseudomallei: progress in epidemiology, diagnosis, treatment and vaccination

Currie

2022

Current Opinion in Infectious Diseases

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Purpose of reviewMelioidosis and its causative bacterium Burkholderia pseudomallei are being found in unexpected locations and bacterial genotyping is providing new insights into global spread and where and how individuals are being infected. This review summarizes recent studies covering the epidemiology, diagnosis, treatment, and prevention of melioidosis. Recent findingsWhole-genome sequencing of B. pseudomallei from patients and environmental sampling is informing the phylogeography of B. pseudomallei at regional, continental, and global levels, while also defining the epidemiology for individual cases. The situation in Africa remains the most unresolved, while the evolving story of B. pseudomallei in the Americas may establish that B. pseudomallei is endemic in parts of southern USA. Guidelines for diagnosis and treatment of melioidosis are well established, and published mortality has decreased from 50% or higher to 10% or lower in some countries but access to laboratory and therapeutic resources are not available or are extremely limited in many melioidosis-endemic regions.

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Burden of melioidosis in India and South Asia: Challenges and ways forward

Cited by 35 publications

References 40 publications

Septicemic Melioidosis: In a Immunocompetent Host: A Case Report

Septicemic Melioidosis: In a Immunocompetent Host: A Case Report

Melioidosis: Bridging the gap from bedside to bench in Bangladesh

Melioidosis and Burkholderia pseudomallei: progress in epidemiology, diagnosis, treatment and vaccination

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