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MicroPublication Biology 2024species belonging to the pseudomallei group include significant human and animal pathogens as well as the non-pathogenic species . These bacteria co-opt the host cell...
species belonging to the pseudomallei group include significant human and animal pathogens as well as the non-pathogenic species . These bacteria co-opt the host cell machinery for their replication and spread between host cells. Thus, it is of interest to understand the structural features of these cells that contribute to host cell colonization and virulence. This study provides high-resolution cryo-electron tomograms of stationary phase . It reveals the presence of compact nucleoids and storage granules, as well as examples of the type III secretion system and chemoreceptor arrays. The data can be used to investigate the near-atomic structure of stationary-phase bacterial macromolecules, such as ribosomes.
PubMed: 38725941
DOI: 10.17912/micropub.biology.001178 -
Heliyon May 2024Intra-abdominal abscesses are a frequent manifestations of melioidosis whereas pancreas is barely affected by this condition. Herein, by delving into the clinical...
BACKGROUND
Intra-abdominal abscesses are a frequent manifestations of melioidosis whereas pancreas is barely affected by this condition. Herein, by delving into the clinical manifestations, diagnostic processes, and the ultimate clinical outcome, we report a case of an unusual presentation of pancreatic melioidosis in a Chinese patient, aiming to shed light on a diagnosis that is not commonly associated with the pancreas.
CASE PRESENTATION
The patient, a 32-year-old male farmer, suffered from persistent burning pain in his upper abdomen, accompanied by nausea, vomiting, fever and other symptoms, presented to the clinic. His body temperature spiked to 38.5 °C without apparent reason for this fever. A thorough examination, including the blood culture and the imaging examination, led to a diagnosis of pancreatic melioidosis. The patient was promptly treated with intravenous meropenem and ceftazidime. As a consequence, his symptoms eased and discharged in stable condition. The patient continued his treatment with oral trimethoprim-sulfamethoxazole (co-trimoxazole) for three months to control the infection. Following 6 months of regular follow-up, the patient fully recovered.
CONCLUSIONS
In tropical regions such as Hainan, it is crucial to consider atypical infection like in the differential diagnosis, even when they present in atypical locations such as a pancreatic pseudocyst. Detecting pancreatic involvement in melioidosis relies heavily on sensitive bacterial culture and imaging examination. This retrospective study of patients' infection diagnosis aims to shed light on the clinical treatment, and prognosis associated with pancreatic melioidosis, thereby raising awareness about the risk of pancreatic affection in melioidosis cases.
PubMed: 38720702
DOI: 10.1016/j.heliyon.2024.e30299 -
European Journal of Case Reports in... 2024Melioidosis is an infection caused by , a Gram-negative bacterium. It is a disease endemic to Southeast Asia and northern Australia although its global incidence has...
BACKGROUND
Melioidosis is an infection caused by , a Gram-negative bacterium. It is a disease endemic to Southeast Asia and northern Australia although its global incidence has been rising. It most commonly infects people with certain identified risk factors such as diabetes, alcoholism, thalassemia, and underlying chronic disease involving lungs, kidney and liver. This bacterium is capable of producing a wide array of clinical manifestations ranging from asymptomatic disease to localised infections such as in the lung, bone or skin to disseminated infection.
CASE DESCRIPTION
This is a case, from United Arab Emirates, of a 40-year-old male recently diagnosed with diabetes who presented with multiple abscesses and was eventually diagnosed with disseminated melioidosis. He was treated successfully with antibiotics and drainage of abscesses.
CONCLUSION
In non-endemic regions, melioidosis can be easily missed in common diagnostic approaches. This gap of awareness could delay the diagnosis and allow further deterioration of the patient due to complications. Thus, case reports like this can enlighten internists about changing incidences and complexity of clinical presentations, thus preparing them to better handle such patients in the future.
LEARNING POINTS
Owing to its considerably rare incidence in non-endemic regions including the United Arab Emirates, melioidosis can easily be overlooked or misdiagnosed.Moreover, due to similarity with multiple other diseases and infections as well as significant absence from standard medical curricula, melioidosis is rarely on the differential list of an internist.This report aims to enhance awareness and alertness to aid earlier detection and avoid severe complications.
PubMed: 38715889
DOI: 10.12890/2024_004415 -
PLoS Neglected Tropical Diseases May 2024Melioidosis, a tropical infectious disease caused by Burkholderia pseudomallei, is epidemic in most region in Southeast Asia with high case fatality. However, there is...
BACKGROUND
Melioidosis, a tropical infectious disease caused by Burkholderia pseudomallei, is epidemic in most region in Southeast Asia with high case fatality. However, there is scanty information regarding the disease's epidemiological pattern, demographics, and underlying risk factors.
METHOD
This 5-year retrospective study of 185 confirmed cases which were taken from the Negeri Sembilan Melioidosis Registry between 2018 and 2022. We aim to describe the incidence, mortality rate, case fatality, relationship with meteorology, and factors that influence mortality in this central region of Peninsular Malaysia.
RESULTS
Incidence rate (IR) of melioidosis in Negeri Sembilan is varied at 1.9 to 5.1 with mean of 3.1 in 100,000 population per year. IR varied between districts in the state from zero to 22.01 in 100,000 population per year. Mortality rate were ranged from 0.17 to 0.74 cases with mean of 0.44 cases in 100,000 population per year. The case fatality rate of this state scattered from 8.70% to 16.67%. There were no significant linear associations between cases and deaths with monthly rainfall and humidity. The mean age of patients was 52.8 years, predominated with age around 41-60 years old. Males (77.8%) predominated, and the majority of cases were Malays (88.9%) and had exposed to soil related activities (74.6%). Mortality from melioidosis was more likely in Bumiputera and non-Malaysians (p<0.05). Patients who had at least one comorbidity were at a higher risk of death from melioidosis (p<0.05). Diabetes mellitus was found in 41.1% of all identified cases, making it a major underlying risk factor for both developing and dying from melioidosis (aOR:19.32, 95%CI:1.91-195.59, p<0.05). Hypertension and mortality status in melioidosis are also significantly correlated (aOR: 7.75, 95% CI: 2.26-26.61, p<0.05).
CONCLUSION
The epidemiological patterns of cases reported from Negeri Sembilan are consistent for the most part from previous studies in other states in Malaysia and global with regard to its incidence, case fatality, demographic and predisposing chronic diseases. Diabetes mellitus and hypertension were significantly linked to increased mortality among all determinants.
Topics: Melioidosis; Humans; Malaysia; Male; Female; Middle Aged; Adult; Retrospective Studies; Burkholderia pseudomallei; Risk Factors; Aged; Incidence; Young Adult; Adolescent; Aged, 80 and over; Child
PubMed: 38709822
DOI: 10.1371/journal.pntd.0012147 -
Cureus Mar 2024Melioidosis is caused by a gram-negative bacillus , which is found in water and soil in endemic areas. There are indicators that is increasing in endemic regions...
Melioidosis is caused by a gram-negative bacillus , which is found in water and soil in endemic areas. There are indicators that is increasing in endemic regions and expanding into new locations. It is unclear whether this is because of expanded boundaries or improved detection capabilities. It is even theorized to be endemic in certain parts of the USA. The most common medical risk factor is diabetes mellitus, and it frequently presents as acute pneumonia, and often progresses to bacteremia. It is designated as a tier 1 select biological agent and toxin by the CDC. In this case report, we present a 67-year-old male with multiple comorbidities, who contracted melioidosis while visiting Honduras, as well as the laboratory's response to the occupational exposure.
PubMed: 38686258
DOI: 10.7759/cureus.57277 -
Medicina (Kaunas, Lithuania) Apr 2024: Melioidosis is an infectious disease caused by , and it has a wide range of clinical symptoms. It is endemic in tropical areas, including Southeast Asia. Despite the...
: Melioidosis is an infectious disease caused by , and it has a wide range of clinical symptoms. It is endemic in tropical areas, including Southeast Asia. Despite the availability of effective treatment, the mortality rate is still high, especially in patients presenting with septic shock. The aim of this study was to determine and explore clinical characteristics, microbiology, treatment outcomes, and factors associated with in-hospital mortality which could predict prognosis and provide a guide for future treatment. : The population in this retrospective cohort study included all 262 patients with a diagnosis of melioidosis who were hospitalized at Surin Hospital, Surin, Thailand, from April 2014 to March 2017. We included patients older than 15 years with a positive culture for Data regarding the clinical characteristics, microbiology, and treatment outcomes of the patients were collected and analyzed. The patients were divided into two groups dependent on outcome, specifically non-survival and survival. Logistic regression was performed to determine the risk factors associated with in-hospital mortality. : Out of the 262 patients with melioidosis during the study period, 117 (44.7%) patients died. The mean age was 57.2 ± 14.4 years, and 193 (73.7%) patients were male. The most common comorbidity was diabetes (123, 46.9%), followed by chronic kidney disease (35, 13.4%) and chronic liver disease (31, 11.8%). Four risk factors were found to be associated with in-hospital mortality, including age (adjusted odds ratio (aOR) 1.04, 95%CI: 1.01-1.07), respiration rate (aOR 1.18, 95%CI: 1.06-1.32), abnormal chest X-ray finding (aOR 4.79, 95%CI: 1.98-11.59), and bicarbonate levels (CO) (aOR 0.92, 95%CI: 0.85-0.99). : Our study identified age, respiration rate, abnormal chest X-ray finding, and CO levels are predictive factors associated with in-hospital mortality in melioidosis patients. Physicians should be aware of these factors, have access to aggressive treatment options, and closely monitor patients with these risk factors.
Topics: Humans; Melioidosis; Male; Female; Middle Aged; Hospital Mortality; Retrospective Studies; Aged; Risk Factors; Adult; Thailand; Cohort Studies; Burkholderia pseudomallei; Prognosis; Logistic Models
PubMed: 38674300
DOI: 10.3390/medicina60040654 -
Tropical Medicine and Infectious Disease Apr 2024The World Health Organization (WHO)'s list of neglected tropical diseases (NTDs) highlights conditions that are responsible for devastating health, social and economic... (Review)
Review
The World Health Organization (WHO)'s list of neglected tropical diseases (NTDs) highlights conditions that are responsible for devastating health, social and economic consequences, and yet, they are overlooked and poorly resourced. The NTD list does not include conditions caused by Gram-negative bacilli (GNB). Infections due to GNB cause significant morbidity and mortality and are prevalent worldwide. Southeast Asia is a WHO region of low- and middle-income countries carrying the largest burden of NTDs. Two significant health threats in Southeast Asia are (causing melioidosis) and hypervirulent (HvKp). Both diseases have high mortality and increasing prevalence, yet both suffer from a lack of awareness, significant under-resourcing, incomplete epidemiological data, limited diagnostics, and a lack of evidence-based treatment. Emerging evidence shows that both melioidosis and HvKp are spreading globally, including in high-income countries, highlighting the potential future global threat they pose. In this article, we review both conditions, identifying current trends and challenges in Southeast Asia and areas for future research. We also argue that melioidosis and HvKp merit inclusion as NTDs, and that mandatory global surveillance and reporting systems should be established, and we make an urgent call for research to better understand, detect, and treat these neglected diseases.
PubMed: 38668541
DOI: 10.3390/tropicalmed9040080 -
Asian Pacific Journal of Allergy and... Apr 2024Melioidosis is an infectious disease caused by Burkholderia pseudomallei. Septicemic melioidosis patients have a high mortality rate within 48 hours.
BACKGROUND
Melioidosis is an infectious disease caused by Burkholderia pseudomallei. Septicemic melioidosis patients have a high mortality rate within 48 hours.
OBJECTIVE
To develop a polymerase chain reaction (PCR) combined with a lateral flow dipstick (LFD) assay for detection of B. pseudomallei in blood samples.
METHODS
The PCR with wcbG gene primers and a PCR-LFD test were developed. The specificity and sensitivity were determined using the B. pseudomallei and other bacterial DNAs. They were evaluated using 43 B. pseudomallei positive blood samples and another 43 blood samples positive for other microbial infections.
RESULTS
The detection limit of the PCR-LFD test was 50 fg of bacterial gDNA or 1.0 CFU per 200 μl of blood. All B. pseudomallei were positive while B. thailandensis and selected gram-negative bacterial strains were negative. The PCR-LFD gave all positives with all 43 B. pseudomallei culture positive patient blood samples and all negative with 43 blood samples that were culture positive for K. pneumoniae, E. gallinarum, E. faecium, E. coli, S. aureus, A. baumannii, A. hydrophila, S. haemolyticus, S. pneumoniae, P. aeruginosa, E. cloacae, S. hominis, E. aerogenes, P. mirabilis, C. neoformans, C. albicans, A. caviae, E. faecalis and K. variicola.
CONCLUSION
The developed PCR-LFD assay provided 100% sensitivity and 100% specificity compared to the conventional blood culture. The technique took only 1.5 hours that is easy and quick to perform compared to the 3-7 days of culture method. The new method of PCR with LFD could facilitate the detection to be a semi-point-of-care testing (POCT).
PubMed: 38642327
DOI: 10.12932/AP-021023-1703 -
Frontiers in Microbiology 2024Bacteriophages (phages), viruses that infect bacteria, are found in abundance not only in the environment but also in the human body. The use of phages for the diagnosis...
Bacteriophages (phages), viruses that infect bacteria, are found in abundance not only in the environment but also in the human body. The use of phages for the diagnosis of melioidosis, a tropical infectious disease caused by , is emerging as a promising novel approach, but our understanding of conditions under which prophages can be induced remains limited. Here, we first demonstrated the isolation of phages from the hemocultures of melioidosis patients. The -positive hemoculture bottles were filtered to remove bacteria, and then phages were isolated and purified by spot and double agar overlay plaque assays. Forty blood samples (hemoculture-confirmed melioidosis) were tested, and phages were found in 30% of the samples. Transmission electron microscopy and genome analysis of the isolated phages, vB_HM387 and vB_HM795, showed that both phages are Myoviruses. These two phages were stable at a pH of 5-7 and temperatures of 25-37°C, suggesting their ability to survive in human blood. The genome sizes of vB_HM387 and vB_HM795 are 36.3 and 44.0 kb, respectively. A phylogenetic analysis indicated that vB_HM387 has homologs, but vB_HM795 is a novel Myovirus, suggesting the heterogeneity of phages in melioidosis patients. The key finding that phages could be isolated from the blood of melioidosis patients highlights the potential application of phage-based assays by detecting phages in blood as a pathogen-derived biomarker of infection.
PubMed: 38633694
DOI: 10.3389/fmicb.2024.1361121 -
Hong Kong Medical Journal = Xianggang... Apr 2024
PubMed: 38629321
DOI: 10.12809/hkmj2310671