Central nervous system melioidosis: Systematic review of case reports and case series

Wongwandee, Monton; Linasmita, Patcharasarn

doi:10.1016/j.jns.2017.08.2861

Cited by 2 publications

(1 citation statement)

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“…Based on the fact that accurate and specific gold standard culture method is paramount for the an accurate treatment and effective management of infection in melioidosis patients to prevent mortality, the B. pseudomallei screening agars are mostly supplemented with GEN antibiotic to expedite laboratory diagnosis by preventing the growth of other gram-negative microorganisms and improve the agar's specificity (2)(3)(4)(5). However, there are certain regions that have been reported to isolate gentamicin-susceptible (GEN s ) B. pseudomallei strains, particularly in Sarawak, Malaysia (6,7) and North-eastern Thailand (8,9), which may complicate the melioidosis diagnosis due to the occurrence of false-negative culture results, causing B. pseudomallei infection diagnosed as other bacterial infections with melioidosis-like symptoms such as tuberculosis (10)(11)(12)(13)(14)(15), community-acquired pneumoniae infection (16) or Pseudomonas sp. infection (17).…”

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confidence: 99%

A Novel Amino Acid Deletion and Substitution inamrBGene Associated with Gentamicin Susceptibility inBurkholderia pseudomalleifrom Malaysian Borneo

Hussin,

Nathan,

Shahidan

et al. 2023

Preprint

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Burkholderia pseudomalleiis a highly pathogenic saprophyte that is intrinsically resistant to a wide variety of antibiotics. Resistance to gentamicin is considered as an earmark ofB. pseudomallei. However, rare susceptible strains have been isolated in certain regions due to gene mutations. Currently, data on the susceptible strains’ prevalence and the actual causal mutations are still scarce, particularly in Malaysian Borneo. A pool ofB. pseudomalleiisolates (n= 46) were screened for gentamicin susceptibility and phenotypically confirmed using the gradient minimal inhibitory concentration method. Three isolates were gentamicin-susceptible strains and were identified as having originated from Bintulu, Sarawak, Malaysian Borneo. TheamrBgene mutation in these mutant strains was analysed, and the effect of amino acid substitution on the stability of the amrB protein was determined by usingin silicoanalysis. The mutagenesis analysis identified a polymorphism-associated mutation, g.1056T>G, and two susceptible-associated mutations identified as novel in-frame amino acid deletion p.Val412del and amino acid substitution p.Thr368Arg that compromised gentamicin resistance.In silicoanalysis using amrB homology-modelled and AlphaFold-solved structures proposed the role of p.Thr368Arg amino acid substitution in conferring GEN susceptibility by other mechanisms than destabilising the structure of amrB protein, which is most probably due to the mutation’s location in the highly conserved region. The findings have shed light on the phenotypic characteristics and mutations involved in theamrBgene of thegentamicin-susceptibleB. pseudomallei.

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Section: Introductionmentioning

confidence: 99%

A Novel Amino Acid Deletion and Substitution inamrBGene Associated with Gentamicin Susceptibility inBurkholderia pseudomalleifrom Malaysian Borneo

Hussin,

Nathan,

Shahidan

et al. 2023

Preprint

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Melioidosis of the nervous system: atypical presentation of a rare disease in a 48-year-old man

et al. 2020

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A 48-year-old man who worked in mining in remote, northern Australia was transferred from a rural hospital 5 days after the onset of headaches, subjective fevers and flaccid paralysis of the left upper limb. Initial investigations demonstrated inflammatory cerebrospinal fluid (CSF) changes and a longitudinally extensive cervical cord lesion. Given two serial negative blood and CSF cultures, he was treated as inflammatory myelitis with intravenous methylprednisolone. Despite the initial improvement in pain and left arm power, the patient’s neurological deficit plateaued and then deteriorated with worsening neck pain, diaphragmatic dysfunction and dysphagia requiring intubation and respiratory support. A third CSF culture isolated Burkholderia pseudomallei confirming a diagnosis of neuro-melioidosis. Repeat imaging revealed the rostral extension of the original spinal cord lesion into the medulla and pons. Over the next 4 weeks, the patient’s neurological deficits slowly improved with continued intravenous antibiotic therapy with meropenem and oral trimethoprim/sulfamethoxazole.

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Central nervous system melioidosis: Systematic review of case reports and case series

Cited by 2 publications

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A Novel Amino Acid Deletion and Substitution inamrBGene Associated with Gentamicin Susceptibility inBurkholderia pseudomalleifrom Malaysian Borneo

A Novel Amino Acid Deletion and Substitution inamrBGene Associated with Gentamicin Susceptibility inBurkholderia pseudomalleifrom Malaysian Borneo

Melioidosis of the nervous system: atypical presentation of a rare disease in a 48-year-old man

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