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Melioidosis

Melioidosis: An Emerging Infectious Disease Caused by Burkholderia pseudomallei.
A serious and potentially fatal condition endemic to Southeast Asia and northern Australia, melioidosis presents with diverse clinical manifestations, including pneumonia, sepsis, and localized abscesses.
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Most cited protocols related to «Melioidosis»

1
Melioidosis Epidemiology in Northern Australia
This study was approved by the Human Research Ethics Committee of the Northern Territory Department of Health and Families and the Menzies School of Health Research (HREC 02/38) and data were analysed anonymously. The Top End has a population of around 150,000 in an area of 516,945 km2, with almost 125,000 living in the Northern Territory capital city of Darwin (12°S). All patients with culture-confirmed melioidosis in the Top End from October 1st 1989 until September 30th 2009 were included. Investigation, treatment and follow-up were supervised in all cases in consultation with the Infectious Disease Department at Royal Darwin Hospital, the 350 bed referral hospital for the Top End. We followed all patients until death or after completion of therapy. Hazardous alcohol use was defined as greater than an average daily consumption of six standard drinks (60 g alcohol total) for males and four (40g alcohol total) for females. Chronic lung disease was defined as a documented diagnosis of chronic obstructive airways disease. Chronic renal disease was defined as a creatinine of >150 umol/L (N. R.<90 umol/L) before the melioidosis illness or after completion of therapy if not previously documented. Septic shock was defined as the presence of hypotension not responsive to fluid replacement together with hypoperfusion abnormalities manifest as end organ dysfunction [8] (link).
Patient details were stored in a database and analysed using Stata version 10 (Stata Corporation, Texas). Chi-squared or Fisher exact tests were used to assess categorical variables; p<0.05 was considered significant and risk ratios and 95% confidence intervals were then calculated. To identify associations with a fatal outcome and with presentation with pneumonia and with bacteremia we conducted multivariable logistic regression analyses with stepwise backwards elimination of patient demographic and risk factor variables, with odds ratios and 95% confidence intervals calculated.
Currie B.J., Ward L, & Cheng A.C. (2010). The Epidemiology and Clinical Spectrum of Melioidosis: 540 Cases from the 20 Year Darwin Prospective Study. PLoS Neglected Tropical Diseases, 4(11), e900.
Publication 2010
Bacteremia Chronic Kidney Diseases Chronic Obstructive Airway Disease Communicable Diseases Congenital Abnormality Creatinine Diagnosis Disease, Chronic Ethanol Ethics Committees, Research Fatal Outcome Females Homo sapiens Hospital Referral Lung Lung Diseases Males Melioidosis Patients Pneumonia Septic Shock Therapeutics
2
Bayesian Statistical Analysis of Diagnostic Tests
The web application is located at http://mice.tropmedres.ac. The interface was developed using Microsoft Visual Studio 2008 and ASP.NET 3.5 (Microsoft; Washington, US). The Bayesian statistics were processed using R version 2.11.1, RtoWinBUGS application version 2.1.16, and WinBUGS version 1.4.3 (Cambridge UK) [25 ,26 ]. All data were stored in Microsoft SQL Server 2008 R2. The applications were tested with multiple data sets including the Hui and Walter data set [12 (link)], Walter and Irwig data set [13 (link)] and melioidosis data sets [22 (link)]. Web pages were tested with Internet Explorer 9.0, Firefox 6.0.2 and Safari 5.0.2.
Lim C., Wannapinij P., White L., Day N.P., Cooper B.S., Peacock S.J, & Limmathurotsakul D. (2013). Using a Web-Based Application to Define the Accuracy of Diagnostic Tests When the Gold Standard Is Imperfect. PLoS ONE, 8(11), e79489.
Publication 2013
Melioidosis Mice, House
3
Evaluating BOX-PCR's Discriminatory Power in Melioidosis
To assess the discriminatory power of BOX-PCR, direct comparisons were made between the MLST dendrogram for 54 separate STs and the BOX-PCR dendrogram for these isolates. The 54 B. pseudomallei, each with a distinct ST, were all from Australia and included human, animal and environmental isolates. Amongst these were 11 pairs of single locus variants (SLVs; two isolates sharing identical alleles at 6/7 loci).
To assess the ability of BOX-PCR to identify clonal clusters direct comparisons were then made between the PFGE dendrogram for five defined clonal groups and the BOX-PCR dendrogram for these isolates. Clonal cluster I and clonal cluster II consist of 7 and 8 isolates, respectively, from Australia's tropical Northern Territory and were previously identified as clustering by PFGE[14 (link)]. These two clonal clusters represent geographically linked but epidemiologically unrelated isolates from our prospective melioidosis studies in northern Australia. Clonal cluster III consists of 3 isolates of identical ST from a detergent container implicated in an outbreak of melioidosis in the Northern Territory involving two garage mechanics[10 (link)]. Clonal cluster IV consists of 3 isolates from an outbreak of melioidosis involving hobby farms in a temperate location in southwest Western Australia. This outbreak spanned 25 years and was attributed to possible importation of an infected animal into a region not endemic for melioidosis[15 (link),16 (link)]. Clonal cluster V is 6 isolates from an outbreak of melioidosis in a remote Northern Territory indigenous community. The outbreak was linked to contamination of the unchlorinated community water supply, with several deaths reported[8 (link)].
Currie B.J., Gal D., Mayo M., Ward L., Godoy D., Spratt B.G, & LiPuma J.J. (2007). Using BOX-PCR to exclude a clonal outbreak of melioidosis. BMC Infectious Diseases, 7, 68.
Publication 2007
Alleles Animals Clone Cells Detergents Electrophoresis, Gel, Pulsed-Field Homo sapiens Mechanics Melioidosis
4
Melioidosis Cohort and Controls
In-patients at Sappasitthiprasong Hospital, Ubon Ratchathani over 18 years of age with melioidosis were recruited (Melioid Cohort) following positive culture of B. pseudomallei from a clinical specimen, alongside healthy control subjects attending the hospital’s blood donation clinic (Healthy Control Cohort) and subjects attending the hospital’s diabetes outpatient clinic (Diabetes Control Cohort). For patients who did not attend follow-up, their 28 day survival status was determined by using the hospital mortality records and by telephone.
Jenjaroen K., Chumseng S., Sumonwiriya M., Ariyaprasert P., Chantratita N., Sunyakumthorn P., Hongsuwan M., Wuthiekanun V., Fletcher H.A., Teparrukkul P., Limmathurotsakul D., Day N.P, & Dunachie S.J. (2015). T-Cell Responses Are Associated with Survival in Acute Melioidosis Patients. PLoS Neglected Tropical Diseases, 9(10), e0004152.
Publication 2015
Blood Donation Diabetes Mellitus Healthy Volunteers Inpatient Melioidosis Patients
5
Environmental Surveillance of Burkholderia pseudomallei
The presence of environmental B. pseudomallei in each country was categorized as being (i) definite, (ii) probable, or (iii) possible (Table 1). ‘Definite’ was defined by the detection of B. pseudomallei from the environment using culture or a specific PCR for B. pseudomallei with or without evidence of melioidosis having been acquired in that country. ‘Probable’ was defined when no reports were identified in the published literature of environmental sampling but clinical reports indicated in-country disease acquisition. This drew on data from the most recent reviews of the distribution of human melioidosis [4] , [12] . ‘Possible’ was defined as the detection of B. pseudomallei from the environment using culture or PCR methodology that did not include a confirmatory test for B. pseudomallei in a setting that lacked evidence of melioidosis having been acquired in that area/country. This included several countries where the detection of environmental B. pseudomallei was reported prior to the description of the highly related Burkholderia thailandensis as a separate species in 1998 [13] (link)–[21] (link). Prior to this, B. thailandensis was referred to as ‘non-pathogenic’ or ‘arabinose-positive’ B. pseudomallei[22] (link). B. pseudomallei and B. thailandensis are indistinguishable on the basis of colony morphology, antimicrobial susceptibility pattern and many biochemical tests (arabinose assimilation being an important exception) [22] (link), [23] (link). A few early studies inoculated suspected B. pseudomallei colonies or environmental samples into an animal model to isolate the organism or determine virulence. This would be predicted to distinguish between B. pseudomallei and non-virulent Burkholderia spp. [22] (link), and was accepted as ‘definite’ evidence of B. pseudomallei. The global map showing the distribution of B. pseudomallei was generated by ArcGIS (10.0, Redlands, CA)
Limmathurotsakul D., Dance D.A., Wuthiekanun V., Kaestli M., Mayo M., Warner J., Wagner D.M., Tuanyok A., Wertheim H., Yoke Cheng T., Mukhopadhyay C., Puthucheary S., Day N.P., Steinmetz I., Currie B.J, & Peacock S.J. (2013). Systematic Review and Consensus Guidelines for Environmental Sampling of Burkholderia pseudomallei. PLoS Neglected Tropical Diseases, 7(3), e2105.
Publication 2013
Animal Model Arabinose Burkholderia Burkholderia thailandensis Homo sapiens Melioidosis Microbicides Pathogenicity Susceptibility, Disease Virulence

Most recents protocols related to «Melioidosis»

1
Evaluating Diagnostic Test Performance in Melioidosis
We illustrate the impact of different conditional dependence structures on estimates of sensitivity and specificity using data from a study that utilised LCM to estimate the sensitivity and specificity of five different diagnostic tests used in the diagnosis of Melioidosis [16 (link)]. Melioidosis is an infectious disease caused by the bacterium Burkholderia pseudomallei. The data are from a cohort of 320 febrile adult patients recruited over a 6 month period from a hospital in the northeast of Thailand in 2004 [18 (link)]. The five tests included four serological tests (indirect hemagglutination test (IHA), IgM immunochromogenic cassette test (ICT), IgG ICT, and ELISA) and culture test which was assumed 100% specific throughout all their analyses. For comparability we made the same assumption.
In the original analysis, Limmathurotsakul et al. implemented four different LCM with various conditional dependence structures as well as an analysis which assumed culture was a perfect gold standard. The LCM models varied from a model assuming conditional independence between all tests (Model 0) to those considering conditional dependence between a single pair of serological tests using fixed effects (Models 1 and 2) and finally those that use random effects to represent dependence between all serological tests within a disease class (Models 3 and 4) but they did not consider a model that simultaneously accounted for conditional dependence within both true positive and true negative individuals. See Table 1 for a summary of the models considered in the original paper. We extend their analysis to consider a ‘Model 5’ which allows dependence between all four serological tests among those individuals truly infected and those individuals truly not infected using random effects. Before reporting the results of this analysis we describe a simulation study used to explore the impact on estimates of sensitivity and specificity of using the wrong conditional dependence structure.

Models and conditional dependence structures compared

ModelDependence StructureEffect Type UsedIncluded in this paper’s simulation
Model 0Conditional Independence between all testsNAYes
Model 1Dependence between IHA and IgM ICT in disease positive individualsFixedNo
Model 2Dependence between IHA and IgG ICT in disease positive individualsFixedNo
Model 3Dependence between all serological tests in disease positive individualsRandomYes
Model 4Dependence between all serological tests in disease negative individualsRandomYes
MODEL 5Dependence between all serological tests in disease positive and disease negative individualsRandomYes

Models 0–4 considered in Limmathurotsakul et al. [14 (link)]. Model 5 an extension not considered in the previous analyses. The last column highlights the scenarios that are considered in the simulation in this paper

Keddie S.H., Baerenbold O., Keogh R.H, & Bradley J. (2023). Estimating sensitivity and specificity of diagnostic tests using latent class models that account for conditional dependence between tests: a simulation study. BMC Medical Research Methodology, 23, 58.
Publication 2023
3'-O-methyl-nordihydroguaiaretic acid Adult Bacteria Burkholderia pseudomallei Communicable Diseases Diagnosis Enzyme-Linked Immunosorbent Assay Fever Gold Melioidosis Patients Test, Hemagglutination Tests, Diagnostic Tests, Serologic
2
Longitudinal Collection of Burkholderia pseudomallei
Two B. pseudomallei isolates were longitudinally collected from any positive specimens of each melioidosis patient at two time points: on the first day of enrolment (first isolate) and on the day of the recurrent or persistent episode (second isolate). The identification of B. pseudomallei was performed in the microbiology laboratory at each hospital using culture, Gram staining, immunofluorescence assay (IFA), latex agglutination, and standard biochemical tests (Duval et al., 2014 (link); Dulsuk et al., 2016 (link)). The bacterial identification was confirmed at the Faculty of Tropical Medicine, Mahidol University, using Matrix-Laser Absorption Ionization Mass Spectrometry (MALDI-TOF MS) as previously described (Suttisunhakul et al., 2017 (link)). Bacteria were sub-cultured on Ashdown agar plates, incubated at 37°C overnight, and stored at −80°C in trypticase soy broth containing 20% glycerol.
Seng R., Phunpang R., Saiprom N., Dulsuk A., Chewapreecha C., Thaipadungpanit J., Batty E.M., Chantratita W., West T.E, & Chantratita N. (2023). Phenotypic and genetic alterations of Burkholderia pseudomallei in patients during relapse and persistent infections. Frontiers in Microbiology, 14, 1103297.
Publication 2023
Agar Bacteria Faculty, Medical Glycerin Immunofluorescence Latex Fixation Tests Mass Spectrometry Melioidosis Patients Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization trypticase-soy broth
3
Genotyping of Paired B. pseudomallei Isolates
Genotypes of B. pseudomallei paired isolates collected at the first and second episodes of melioidosis were characterized by PFGE as previously described (Chantratita et al., 2008 (link)).
Seng R., Phunpang R., Saiprom N., Dulsuk A., Chewapreecha C., Thaipadungpanit J., Batty E.M., Chantratita W., West T.E, & Chantratita N. (2023). Phenotypic and genetic alterations of Burkholderia pseudomallei in patients during relapse and persistent infections. Frontiers in Microbiology, 14, 1103297.
Publication 2023
Electrophoresis, Gel, Pulsed-Field Genotype Melioidosis
4
Prospective Observational Study of Melioidosis
A prospective observational study was conducted in 9 hospitals in Northeast Thailand from July 2015 to December 2018 (Chantratita et al., 2023 (link)). Written consents were obtained from the 1,361 adult male and female patients (age ≥ 15 years) with any specimens taken from any sites positive for B. pseudomallei by bacterial culture. Melioidosis patients who were pregnant, receiving palliative care, or incarceration were not enrolled in the study. B. pseudomallei were collected on the day of enrolment (day 0), and participants were followed up on days 5, 12, and 28 and every 2 months via phone call to collect data on the use of antibiotic therapy, clinical outcomes, and the occurrence of recurrent infections. Demographics and clinical data (age, sex, current illness, symptoms, vital signs, underlying morbidity, diagnosis, laboratory results, antimicrobial therapy, and clinical outcomes) of each participant were collected from medical records and hospital microbiology databases. Clinical and follow-up data were recorded in case report forms (CRFs).
Acute melioidosis was defined as the recent manifestation of melioidosis symptoms with a clinical sample culture growing B. pseudomallei, without any evidence of having (i) melioidosis before enrolment and (ii) recurrent infection during follow-up (Currie et al., 2000 (link)). Recurrent melioidosis was defined when a patient had (i) signs of infection determined by the attending physician and (ii) remained culture positive for B. pseudomallei at subsequent episodes after completion of antibiotic therapy. A patient with recurrent infection with the same B. pseudomallei genotype that was collected at the first episode was defined as relapse, whereas a patient who had recrudescence of a different genotype was defined as reinfection or was infected with multiple strains (Chantratita et al., 2023 (link)). A patient with no evidence of clinical response to oral antibiotic therapy and who subsequently remained culture positive for B. pseudomallei that shared the same genotype clone as the first isolate while undergoing antibiotic therapy was defined as having a persistent infection (Vargas et al., 2021 (link)).
Seng R., Phunpang R., Saiprom N., Dulsuk A., Chewapreecha C., Thaipadungpanit J., Batty E.M., Chantratita W., West T.E, & Chantratita N. (2023). Phenotypic and genetic alterations of Burkholderia pseudomallei in patients during relapse and persistent infections. Frontiers in Microbiology, 14, 1103297.
Publication 2023
Adult Antibiotics Bacteria Clone Cells Diagnosis Genotype Infection Males Melioidosis Microbicides Palliative Care Patients Persistent Infection Physicians Recrudescence Reinfection Relapse Signs, Vital Strains Therapeutics Woman
5
Melioidosis Epidemiology in Northern Hainan
Patients with melioidosis admitted to four general hospitals in northern Hainan from 2010 to 2020, namely, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), The First Affiliated Hospital of Hainan Medical University, The Second Affiliated Hospital of Hainan Medical University, and Haikou People’s Hospital, were identified. According to the inclusion and exclusion criteria, 90 patients with melioidosis in northern Hainan were included in the study. The study was approved by the Ethics Committee of Hainan General Hospital, the First Affiliated Hospital of Hainan Medical University, the Second Affiliated Hospital of Hainan Medical University and Haikou People’s Hospital ([2021] No. 319).
The inclusion criteria were as follows: (1) the research subjects were living in northern Hainan, including Haikou, Wenchang, Chengmai, Danzhou, Lingao, Ding’an and Tunchang. (2) The patient data were complete. (3) The bacterial culture results of the patients were reported to be B. pseudomallei positive; the diagnosis was confirmed to be melioidosis, and bacterial culture specimens included blood, sputum, pus, bone marrow or urine.
The exclusion criteria were as follows: (1) the research subjects were not living in northern Hainan. (2) The subjects were inpatients without melioidosis. (3) The patient data were incomplete.
Zheng W., Kuang S., Zhong C., Zhou J., Long W., Xiao S, & Wu B. (2023). Risk Factors for Melioidosis Mortality and Epidemics: A Multicentre, 10-Year Retrospective Cohort Study in Northern Hainan. Infectious Diseases and Therapy, 12(3), 951-964.
Publication 2023
Bacteria Blood Bone Marrow Diagnosis Ethics Committees, Clinical Inpatient Melioidosis Patients Sputum Urine

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More about "Melioidosis"

Melioidosis, also known as Whitmore's disease, is an emerging infectious disease caused by the bacterium Burkholderia pseudomallei.
This serious and potentially fatal condition is endemic to Southeast Asia and northern Australia, with diverse clinical manifestations including pneumonia, sepsis, and localized abscesses.
The disease can be difficult to diagnose due to its varied symptoms, which can mimic other illnesses such as tuberculosis or the flu.
Accurate diagnosis often requires specialized laboratory tests, including culture, serology, and molecular methods like PCR.
Treatment typically involves prolonged antibiotic therapy, which can be challenging due to the bacteria's resistance to many common antibiotics.
Researchers studying melioidosis may utilize various tools and techniques, such as the HiSeq 2500 or HiSeq system for high-throughput DNA sequencing, the DNeasy blood and tissue kit for genomic DNA extraction, and STATA version 12 for statistical analysis.
Cell culture media like RPMI 1640 and penicillin-streptomycin solution may also be employed.
Proper handling and filtering techniques, such as using 0.45-μm filters and sterile microtubes, are crucial to ensure the integrity of research samples and prevent contamination.
The PubCompare.ai platform can be a valuable resource for melioidosis researchers, as it helps locate the best protocols and products by comparing data across literature, preprints, and patents.
This AI-driven tool can enhance the reproducibility and accuracy of melioidosis studies, enabling researchers to uncover the insights they need to drive their work forward.