Characterisation and molecular typing of Burkholderia pseudomallei: Are disease presentations of melioidosis clonally related?

Norton, Robert

doi:10.1016/s0928-8244(97)00104-1

Cited by 29 publications

(21 citation statements)

References 12 publications

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“…Within Australia, disease is particularly prevalent in north Queensland and the Northern Territory, with peaks of disease usually associated with high levels of rainfall in the wet season. (2,11,14,15). Three forms of the disease are recognized, acute, subacute, and chronic.…”

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“…Chronic infection often remains asymptomatic and may persist for years (5,13,14). Reactivation of chronic infection to an acute form can occur when the host is immunocompromised (13,14,16).The laboratory diagnosis of melioidosis is best made with a culture of the appropriate clinical material. Serology has a role in the diagnosis of this condition, particularly in patients from areas where it is not endemic who travel to an area where it is endemic and develop a suggestive clinical condition.…”

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Comparison of Automated and Nonautomated Systems for Identification of Burkholderia pseudomallei

2002

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The identification of Burkholderia pseudomallei, the causative agent of melioidosis, is usually not difficult in laboratories in areas where it is endemic. With the increase in international travel and the threat of bioterrorism, it has become more likely that laboratories in areas where it is not endemic could encounter this organism. The increase in the use of and dependence upon automated identification systems makes accurate identification of uncommonly encountered organisms such as B. pseudomallei critically important. This study compares the manual API 20NE and 20E identification systems with the automated Vitek 1 and 2 systems. A total of 103 B. pseudomallei isolates were tested and correctly identified in 98%, 99%, 99%, and 19% of cases, respectively. The failure of the Vitek 2 to correctly identify B. pseudomallei was largely due to differences in the biochemical reactions achieved compared to expected values in the database. It is suggested that this deficiency in the Vitek 2 may be due to the large number of uncertain results reported for these isolates. These results reduce the discriminating ability of the instrument to distinguish between uncommonly encountered isolates such as those of B. pseudomallei.Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in regions of southeast Asia and northern Australia (8, 10, 13). Within Australia, disease is particularly prevalent in north Queensland and the Northern Territory, with peaks of disease usually associated with high levels of rainfall in the wet season. (2,11,14,15). Three forms of the disease are recognized, acute, subacute, and chronic. Infection occurs via ingestion, inoculation, or inhalation. Acute melioidosis commonly presents as a fulminant septicemia, often resulting in death within a few days of exposure. Mortality rates for acute septicemic melioidosis remain high despite antibiotic therapy (6, 18; J. Warner, D. Learoyd, B. Pelowa, J. Koehler, and R. G. Hirst, Abstr. Ann. Sci. Meet. Med. Soc. Papua New Guinea, p. 38, 1998). Chronic infection often remains asymptomatic and may persist for years (5,13,14). Reactivation of chronic infection to an acute form can occur when the host is immunocompromised (13,14,16).The laboratory diagnosis of melioidosis is best made with a culture of the appropriate clinical material. Serology has a role in the diagnosis of this condition, particularly in patients from areas where it is not endemic who travel to an area where it is endemic and develop a suggestive clinical condition. Serum samples from patients resident in areas where it is endemic can be positive in the absence of clinical disease. This would represent previous exposure and does not necessarily imply current disease. Other diagnostic methods that have been used include latex agglutination for detection of antigen in urine (17) and molecular detection (3).With the increase in international travel, melioidosis is increasingly likely to show up in regions where it is not normally endemic (7). For the routine diagnostic labo...

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Comparison of Automated and Nonautomated Systems for Identification of Burkholderia pseudomallei

2002

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“…Acute septicemic melioidosis is the most severe form of disease (11,33,44). It is associated with a high mortality rate, often despite intensive antibiotic therapy (11,12,36). Acute septicemic melioidosis remains a significant cause of death due to gram-negative sepsis in some areas of endemicity (11,12).…”

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“…At the opposite end of the spectrum of clinical presentations is the chronic form of disease. Chronic infection can be manifested as a localized infection in almost any organ of the body (36,44). Similar to asymptomatic infection, chronic infection may persist for many years (12,44).…”

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“…The potential for relapse of disease following extended periods of antibiotic therapy has also been recognized (12). Risk factors for disease include alcoholism, renal dysfunction, and diabetes mellitus (12,33,36). The ability of B. pseudomallei to lie dormant in the host for prolonged periods has been associated with an ability to survive inside phagocytes including macrophages (25,29).…”

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