Burden and Risk Factors of Melioidosis in Southeast Asia: A Scoping Review

Selvam, Kasturi; Ganapathy, Thanasree; Najib, Mohamad Ahmad; Khalid, Muhammad Fazli; Abdullah, Nor Azlina; Harun, Azian; Mohammad, Wan Mohd Zahiruddin Wan; Ismail, Asma

doi:10.3390/ijerph192315475

Cited by 7 publications

(6 citation statements)

References 76 publications

(62 reference statements)

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“…A more recent review paper estimated the overall prevalence of B. pseudomallei in Southeast Asia to be between 0.02% and 74.4% [ 9 ]. There is variation in the burden of disease between different geographic locations and patient groups; for example, in rural northeast Thailand, a study found an annual incidence of bacteraemic melioidosis to be 14–17 per 100,000 [ 10 ], whereas a study of children with suppurative parotitis in Cambodia found 74% had culture-confirmed B. pseudomallei [ 11 ].…”

Section: Melioidosismentioning

confidence: 99%

The Rapid Emergence of Hypervirulent Klebsiella Species and Burkholderia pseudomallei as Major Health Threats in Southeast Asia: The Urgent Need for Recognition as Neglected Tropical Diseases

Kain,

Reece,

Parry

et al. 2024

TropicalMed

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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 Burkholderia pseudomallei (causing melioidosis) and hypervirulent Klebsiella pneumoniae (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.

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Section: Melioidosismentioning

confidence: 99%

The Rapid Emergence of Hypervirulent Klebsiella Species and Burkholderia pseudomallei as Major Health Threats in Southeast Asia: The Urgent Need for Recognition as Neglected Tropical Diseases

Kain,

Reece,

Parry

et al. 2024

TropicalMed

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“…Unless looked with suspicion, these features can be easily misinterpreted as Pseudomonas or aerobic spore bearers. Automated tools like MALDI -TOF or VITEK 2 may not be definitive in Most cases presented in the critical stages of illness with multiple internal organ abscesses, pneumonia and sepsis [7]. The chronic disease occurs because of the organism's ability to survive inside macrophages, and can mimic granulomatous diseases [8].…”

Section: Radiological Investigationsmentioning

confidence: 99%

What is cheesier than a Whitmore’s liver? An accidental diagnosis of melioidosis

Vangara,

Rangineni,

Vutukuru

et al. 2023

ASEAN J Radiol

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Despite the endemicity of Melioidosis in India, there were no official reports of the same case in our area which can be attributed to a lack of awareness of its occurrence in this geographic region, varied manifestations and consequent misdiagnosis. We report a case of Melioidosis from Tirupati, Andhra Pradesh. A diabetic male presented with fever, jaundice, and breathlessness. Radiological investigations revealed abscesses in the liver and spleen with a swiss cheese or honey comb appearance on CECT abdomen. The patient rapidly succumbed to the illness even with appropriate antibiotics in view of delayed presentation. Pus aspirated from the patient isolated Burkholderia species which was later confirmed through molecular methods as Burkhloderia pseudomallei. Hence, it is advised to consider Melioidosis as a potential infection in this region, for a timely and appropriate management of the patient’s conditions.

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“…thailandensis and B. pseudomallei. B. pseudomallei , the causative agent of melioidosis, is an environmental pathogen known to inhabit both soil and water in sub-tropical and tropical regions, especially in Southeast Asia and Northern Australia [5–8]. The potential of B.…”

Section: Introductionmentioning

confidence: 99%

“…cepacia, B. mallei, B. thailandensis and B. pseudomallei. B. pseudomallei, the causative agent of melioidosis, is an environmental pathogen known to inhabit both soil and water in sub-tropical and tropical regions, especially in Southeast Asia and Northern Australia [5][6][7][8]. The potential of B. pseudomallei for use as a bioterrorism agent earns it its classification as a category B agent (second highest priority) by the Centers for Disease Control and Prevention (CDC) [9,10].…”

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confidence: 99%

Showing the limitations of available phenotypic assays to detect Burkholderia pseudomallei from clinical specimens in Nigeria

Orababa,

Adesida,

Peters

et al. 2023

Access Microbiology

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The genus Burkholderia comprises Gram-negative bacteria that are metabolically complex and versatile, often thriving in hostile settings. Burkholderia pseudomallei , the causative agent of melioidosis, is a prominent member of the genus and a clinical pathogen in tropical and sub-tropical regions. This pathogen is well known for its multidrug resistance and possible bioweapon potential. There is currently no report of the pathogen from clinical specimens in Nigeria, which might be due to misdiagnosis with phenotypic assays. This study aims to explore the accuracy of the use of phenotypic assays to diagnose B. pseudomallei in Nigeria. Two hundred and seventeen clinical samples and 28 Gram-negative clinical isolates were collected and analysed using Ashdown’s selective agar and monoclonal antibody-based latex agglutination. Species-level identification was achieved using the analytical profile index (API) 20NE system. The susceptibility of the isolates to nine different antimicrobial agents was determined using the disc diffusion method. A total of seventy-four culture-positive isolates were obtained using Ashdown’s selective agar. Twenty-two of these isolates were believed to be B. pseudomallei through the monoclonal antibody-based latex agglutination test and the API 20NE system subsequently identified 14 isolates as Burkholderia . The predominant Burkholderia species was B. cepacia with an isolation rate of 30.8 % (8/26). No isolate was distinctively identified as B. pseudomallei but five isolates were strongly suspected to be B. pseudomallei with similarity indices ranging from 81.9–91.3 %. Other bacterial species with definitive identity include Aeromonas sp., Sphingomonas sp. and Pseudomonas aeruginosa . The antibiotic susceptibility results revealed an overall resistance to amoxicillin–clavullanic acid of 71.4 %, to cefepime of 33.3 %, to trimethoprim–sulfamethoxazole of 38.1 %, to piperacillin–tazobactam of 33.3 %, to imipenem of 66.7 %, to doxycycline of 57.1% and to ceftazidime of 66.7 %. The highest intermediate resistance was observed for cefepime and piperacillin–tazobactam with a value of 66.7 % each, while there was no intermediate resistance for gentamicin, colistin and imipenem. Our findings, therefore, show that phenotypic assays alone are not sufficient in the diagnosis of melioidosis. Additionally, they provide robust support for present and future decisions to expand diagnostic capability for melioidosis beyond phenotypic assays in low-resource settings.

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Burden and Risk Factors of Melioidosis in Southeast Asia: A Scoping Review

Cited by 7 publications

References 76 publications

The Rapid Emergence of Hypervirulent Klebsiella Species and Burkholderia pseudomallei as Major Health Threats in Southeast Asia: The Urgent Need for Recognition as Neglected Tropical Diseases

The Rapid Emergence of Hypervirulent Klebsiella Species and Burkholderia pseudomallei as Major Health Threats in Southeast Asia: The Urgent Need for Recognition as Neglected Tropical Diseases

What is cheesier than a Whitmore’s liver? An accidental diagnosis of melioidosis

Showing the limitations of available phenotypic assays to detect Burkholderia pseudomallei from clinical specimens in Nigeria

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