Phylogeography of<i>Burkholderia pseudomallei</i>Isolates, Western Hemisphere

Gee, Jay E.; Gulvik, Christopher A.; Elrod, Mindy G.; Batra, Dhwani; Rowe, Lori A.; Sheth, Mili; Hoffmaster, Alex R.

doi:10.3201/eid2307.161978

Cited by 40 publications

(57 citation statements)

References 34 publications

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“…18 In some cases infection may become apparent as much as 29 years after exposure. 98 Recurrent infection may also occur in up to a third of patients, which may either be recrudescence, or reinfection with a different strain following re-exposure. 6,99 Molecular typing may help distinguish reinfection from relapse or recrudescence.…”

Section: Laboratory Diagnosis: Classic Cultures Remain Mainstay Of DImentioning

confidence: 99%

Melioidosis: A Neglected Cause of Community-Acquired Pneumonia

Virk

Mukhopadhyay

Wiersinga

2020

Semin Respir Crit Care Med

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AbstractMelioidosis, caused by the facultative intracellular gram-negative pathogen Burkholderia pseudomallei, is an emerging cause of community-acquired pneumonia across the tropics. The majority of patients present with pneumonia with or without sepsis, but localized and asymptomatic infection is also well recognized. Recent modeling and epidemiological studies have demonstrated the widespread presence of B. pseudomallei in otherwise unrecognized regions with a predicted mortality of 90,000 deaths worldwide. Innovative environmental studies are also uncovering how hydrodynamic, pedology, fauna, and weather events influence geographic distribution and incidence of melioidosis cases. Of concern is the changes associated with global warming, which will be conducive to B. pseudomallei in combination with the global diabetes pandemic. In fact, over 80% of patient developing melioidosis have underlying comorbidities. For this great mimicker, culture remains the mainstay of diagnosis and despite availability of other assays, challenges still remain in reducing time to diagnosis and avoiding misdiagnosis. With institution of timely antimicrobials such as ceftazidime and supportive intensive care, overall mortality can be reduced to 10%, although this can still be as high as 50% in poorly resourced areas. Promise is on the horizon with the first human vaccine trials being planned for 2021. Meanwhile new multiomics techniques are giving us a better understanding of the role of virulence and host–pathogen interactions on patient outcomes.

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Section: Laboratory Diagnosis: Classic Cultures Remain Mainstay Of DImentioning

confidence: 99%

Melioidosis: A Neglected Cause of Community-Acquired Pneumonia

Virk

Mukhopadhyay

Wiersinga

2020

Semin Respir Crit Care Med

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“…Historically, melioidosis was considered to be geographically restricted to countries in southeast Asia and northern Australia, because these regions have reported the highest incidence and prevalence of the disease, where annual incidence is up to 50 cases per 100 000 people [1,2]; however, the incidence of melioidosis increases in diabetic patients and, for example, in northern Australia it is estimated to be 260 cases per 100 000 [13]. The appearance of sporadic melioidosis cases and further investigation to identify other endemic areas worldwide has now expanded the global map of the disease to cover more countries within tropical areas [14], including the western hemisphere (Africa and America) [15] and the majority of the Asian continent ( Fig. 1) [14,16].…”

Section: Predicted and Evidenced Global Incidence Of Diseasementioning

confidence: 99%

Novel multi-component vaccine approaches for Burkholderia pseudomallei

Morici

Torres

Titball

2019

Clinical and Experimental Immunology

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Burkholderia pseudomallei is the causative agent of melioidosis. Historically believed to be a relatively rare human disease in tropical countries, a recent study estimated that, worldwide, there are approximately 165 000 human melioidosis cases per year, more than half of whom die. The bacterium is inherently resistant to many antibiotics and treatment of the disease is often protracted and ineffective. There is no licensed vaccine against melioidosis, but a vaccine is predicted to be of value if used in high-risk populations. There has been progress over the last decade in the pursuit of an effective vaccine against melioidosis. Animal models of disease including mouse and non-human primates have been developed, and these models show that antibody responses play a key role in protection against melioidosis. Surprisingly, although B. pseudomallei is an intracellular pathogen there is limited evidence that CD8 + T cells play a role in protection. It is evident that a multi-component vaccine, incorporating one or more protective antigens, will probably be essential for protection because of the pathogen's sophisticated virulence mechanisms as well as strain heterogeneity. Multi-component vaccines in development include glycoconjugates, multivalent subunit preparations, outer membrane vesicles and other nano/microparticle platforms and live-attenuated or inactivated bacteria. A consistent finding with vaccine candidates tested in mice is the ability to induce sterilizing immunity at low challenge doses and extended time to death at higher challenge doses. Further research to identify ways of eliciting more potent immune responses might provide a path for licensing an effective vaccine.

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“…Using WGS data for phylogenomic analyses has also been instrumental in unravelling the early origins of B. pseudomallei in Australia, and its subsequent dissemination to tropical regions across the globe, including the western Indian Ocean region. Three studies to date have used WGS to investigate B. pseudomallei strains from western Indian Ocean islands [ 19 , 20 , 21 ]. Sarovich and colleagues [ 19 ] were the first to identify an Asian origin for the Madagascan B. pseudomallei strains included in the phylogenetic analysis.…”

Section: Review Of the Human Casesmentioning

confidence: 99%

Melioidosis in the Western Indian Ocean and the Importance of Improving Diagnosis, Surveillance, and Molecular Typing

et al. 2018

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Melioidosis, caused by the bacterium Burkholderia pseudomallei, is an infectious disease of humans or animals, and the specific environmental conditions that are present in western Indian Ocean islands are particularly suitable for the establishment/survival of B. pseudomallei. Indeed, an increasing number of new cases have been reported in this region (Madagascar, Mauritius, Réunion (France), and Seychelles, except Comoros and Mayotte (France)), and are described in this review. Our review clearly points out that further studies are needed in order to investigate the real incidence and burden of melioidosis in the western Indian Ocean and especially Madagascar, since it is likely to be higher than currently reported. Thus, research and surveillance priorities were recommended (i) to improve awareness of melioidosis in the population and among clinicians; (ii) to improve diagnostics, in order to provide rapid and effective treatment; (iii) to implement a surveillance and reporting system in the western Indian Ocean; and (iv) to investigate the presence of B. pseudomallei in environmental samples, since we have demonstrated its presence in soil samples originating from the yard of a Madagascan case.

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Phylogeography ofBurkholderia pseudomalleiIsolates, Western Hemisphere

Cited by 40 publications

References 34 publications

Melioidosis: A Neglected Cause of Community-Acquired Pneumonia

Melioidosis: A Neglected Cause of Community-Acquired Pneumonia

Novel multi-component vaccine approaches for Burkholderia pseudomallei

Melioidosis in the Western Indian Ocean and the Importance of Improving Diagnosis, Surveillance, and Molecular Typing

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