Cystic Fibrosis Patient with
            <i>Burkholderia pseudomallei</i>
            Infection Acquired in Brazil

Barth, Afonso Luís; Silva, Fernando Antonio de Abreu e; Hoffmann, Anneliese; Vieira, Maria Izolete; Zavascki, Alexandre Prehn; Ferreira, Alex Guerra; Cunha, Luiz Gonzaga da; Albano, Rodolpho Mattos; Marques, Elizabeth de Andrade

doi:10.1128/jcm.01386-07

Cited by 17 publications

(16 citation statements)

References 15 publications

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“…Conversely, B. pseudomallei is recognized as an important human pathogen endemic to Southeast Asia and Northern Australia, although it is not limited to these areas, since cases of melioidosis have been reported elsewhere [1–3]. The bacterium is an environmental saprophyte and can be cultured from wet soil and ground water.…”

Section: Infections Caused By Burkholderia Mallei and Burkholderia Pseumentioning

confidence: 99%

“…The prevalence and distribution of infection by B. pseudomallei appears to be increasing: recognition of melioidosis increased sharply in Thailand with the increase in hospital microbiology facilities able to identify this infection [11]. More recent identification of B. pseudomallei infections outside Southeast Asia and Northern Australia suggests that these bacteria may have a wider range of endemicity than was previously appreciated [1–3]. …”

Section: Expert Commentarymentioning

confidence: 99%

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Strategies toward vaccines againstBurkholderia malleiandBurkholderia pseudomallei

Bondi¹,

Goldberg²

2008

Expert Review of Vaccines

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Burkholderia mallei and Burkholderia pseudomallei are Gram-negative, rod-shaped bacteria, and are the causative agents of the diseases glanders and melioidosis, respectively. These bacteria have been recognized as important pathogens for over 100 years, yet a relative dearth of available information exists regarding their virulence determinants and immunopathology. Infection with either of these bacteria presents with nonspecific symptoms and can be either acute or chronic, impeding rapid diagnosis. The lack of a vaccine for either bacterium also makes them potential candidates for bioweaponization. Together with their high rate of infectivity via aerosols and resistance to many common antibiotics, both bacteria have been classified as category B priority pathogens by the US NIH and US CDC, which has spurred a dramatic increase in interest in these microorganisms. Attempts have been made to develop vaccines for these infections, which would not only benefit military personnel, a group most likely to be targeted in an intentional release, but also individuals who may come in contact with glanders-infected animals or live in areas where melioidosis is endemic. This review highlights some recent attempts of vaccine development for these infections and the strategies used to improve the efficacy of vaccine approaches. Keywordsbioweapon; Burkholderia; glanders; immunization; melioidosis; vaccine Infections caused by Burkholderia mallei & Burkholderia pseudomalleiBurkholderia mallei and Burkholderia pseudomallei cause the diseases glanders and melioidosis, respectively. While these bacteria are phylogenetically similar, their lifestyles and epidemiology are quite divergent. Specifically, B. mallei is an obligate mammalian pathogen that typically infects solipeds, such as horses, mules and donkeys, and only occasionally infects humans. Individuals most at risk of contracting the disease are animal handlers in close contact with infected creatures and those who ingest contaminated meat. Glanders was effectively eradicated in North America and Western Europe in the 1950s by the mass culling of infected animals, but remains in the equine population of Africa, Asia, the Middle East and Central and †Author for . This fact may help explain the long periods of latency observed in some infections. It is likely that intracellular replication and survival may also provide the bacteria with a means for evading the humoral immune system. Such factors should be taken into account when developing possible vaccine strategies.The high rate of infectivity via aerosols, their resistance to many common antibiotics and the absence of a vaccine for either infection make these bacteria of great concern as modern bioterror agents. Indeed, B. mallei is a proven bioweapon that was used in both World Wars I and II. It has been suggested that the former Soviet military used this agent more recently in Afghanistan and that they were also weaponizing B. pseudomallei [15]. With respect to natural infection with B. pseudomallei, even when th...

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Section: Infections Caused By Burkholderia Mallei and Burkholderia Pseumentioning

confidence: 99%

Section: Expert Commentarymentioning

confidence: 99%

Strategies toward vaccines againstBurkholderia malleiandBurkholderia pseudomallei

Bondi¹,

Goldberg²

2008

Expert Review of Vaccines

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“…However, neither B. pseudomallei nor B. mallei were among the clinical isolates tested. Sporadic cases of melioidosis in cystic fibrosis patients have been described in the literature and seem to be an emerging problem [18-22]. Due to increased travel activity, international trade, climate change, and the potential threat of bioterrorist attacks infections caused by B. pseudomallei and B. mallei can become a serious problem.…”

Section: Introductionmentioning

confidence: 99%

Rapid identification of Burkholderia mallei and Burkholderia pseudomalleiby intact cell Matrix-assisted Laser Desorption/Ionisation mass spectrometric typing

et al. 2012

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BackgroundBurkholderia (B.) pseudomallei and B. mallei are genetically closely related species. B. pseudomallei causes melioidosis in humans and animals, whereas B. mallei is the causative agent of glanders in equines and rarely also in humans. Both agents have been classified by the CDC as priority category B biological agents. Rapid identification is crucial, because both agents are intrinsically resistant to many antibiotics. Matrix-assisted laser desorption/ionisation mass spectrometry (MALDI-TOF MS) has the potential of rapid and reliable identification of pathogens, but is limited by the availability of a database containing validated reference spectra. The aim of this study was to evaluate the use of MALDI-TOF MS for the rapid and reliable identification and differentiation of B. pseudomallei and B. mallei and to build up a reliable reference database for both organisms.ResultsA collection of ten B. pseudomallei and seventeen B. mallei strains was used to generate a library of reference spectra. Samples of both species could be identified by MALDI-TOF MS, if a dedicated subset of the reference spectra library was used. In comparison with samples representing B. mallei, higher genetic diversity among B. pseudomallei was reflected in the higher average Eucledian distances between the mass spectra and a broader range of identification score values obtained with commercial software for the identification of microorganisms. The type strain of B. pseudomallei (ATCC 23343) was isolated decades ago and is outstanding in the spectrum-based dendrograms probably due to massive methylations as indicated by two intensive series of mass increments of 14 Da specifically and reproducibly found in the spectra of this strain.ConclusionsHandling of pathogens under BSL 3 conditions is dangerous and cumbersome but can be minimized by inactivation of bacteria with ethanol, subsequent protein extraction under BSL 1 conditions and MALDI-TOF MS analysis being faster than nucleic amplification methods. Our spectra demonstrated a higher homogeneity in B. mallei than in B. pseudomallei isolates. As expected for closely related species, the identification process with MALDI Biotyper software (Bruker Daltonik GmbH, Bremen, Germany) requires the careful selection of spectra from reference strains. When a dedicated reference set is used and spectra of high quality are acquired, it is possible to distinguish both species unambiguously. The need for a careful curation of reference spectra databases is stressed.

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“…It also causes both transient and chronic infections in CF patients (310,653). B. pseudomallei, the etiologic agent of melioidosis, occasionally causes respiratory infection in individuals with CF, suggesting that this species of Burkholderia must also be considered, especially when a history of travel to South and Southeast Asia, China, or northern Australia is elicited (36,112,271,531,628).…”

Section: Burkholderia Cepacia Complexmentioning

confidence: 99%

Clinical Significance of Microbial Infection and Adaptation in Cystic Fibrosis

et al. 2011

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SUMMARY A select group of microorganisms inhabit the airways of individuals with cystic fibrosis. Once established within the pulmonary environment in these patients, many of these microbes adapt by altering aspects of their structure and physiology. Some of these microbes and adaptations are associated with more rapid deterioration in lung function and overall clinical status, whereas others appear to have little effect. Here we review current evidence supporting or refuting a role for the different microbes and their adaptations in contributing to poor clinical outcomes in cystic fibrosis.

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Cystic Fibrosis Patient with Burkholderia pseudomallei Infection Acquired in Brazil

Cited by 17 publications

References 15 publications

Strategies toward vaccines againstBurkholderia malleiandBurkholderia pseudomallei

Strategies toward vaccines againstBurkholderia malleiandBurkholderia pseudomallei

Rapid identification of Burkholderia mallei and Burkholderia pseudomalleiby intact cell Matrix-assisted Laser Desorption/Ionisation mass spectrometric typing

Clinical Significance of Microbial Infection and Adaptation in Cystic Fibrosis

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