Melioidosis and Burkholderia pseudomallei: progress in epidemiology, diagnosis, treatment and vaccination

Abstract

Purpose of reviewMelioidosis and its causative bacterium Burkholderia pseudomallei are being found in unexpected locations and bacterial genotyping is providing new insights into global spread and where and how individuals are being infected. This review summarizes recent studies covering the epidemiology, diagnosis, treatment, and prevention of melioidosis. Recent findingsWhole-genome sequencing of B. pseudomallei from patients and environmental sampling is informing the phylogeography of B. pseudomallei at regional, continental, and global levels, while also defining the epidemiology for individual cases. The situation in Africa remains the most unresolved, while the evolving story of B. pseudomallei in the Americas may establish that B. pseudomallei is endemic in parts of southern USA. Guidelines for diagnosis and treatment of melioidosis are well established, and published mortality has decreased from 50% or higher to 10% or lower in some countries but access to laboratory and therapeutic resources are not available or are extremely limited in many melioidosis-endemic regions.

Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains

“…Burkholderia pseudomallei and Burkholderia mallei are the two NFGNB of great public health importance and cause serious community-acquired infections. B. pseudomallei is a soil saprophyte causing serious infections, predominantly in tropical and subtropical regions of Southern hemisphere [38 ▪ ]. B. mallei is a rare zoonotic infection transmitted from infected solipeds [39].…”

Exploring the advancements of Australian OPAT

“…This is a challenging infection in the OPAT setting because it consists of long-duration IV antibiotics (most often ceftazidime or meropenem > 2 weeks), where stability at hot temperatures is controversial but has been proven safe and effective in Australia. 37,38…”

“…This is a challenging infection in the OPAT setting because it consists of longduration IV antibiotics (most often ceftazidime or meropenem > 2 weeks), where stability at hot temperatures is controversial but has been proven safe and effective in Australia. 37,38 OPAT utilization in Australia Antimicrobial utilization surveillance in Australian hospitals is conducted by the National Antimicrobial Utilisation Surveillance Program (NAUSP) using World Health Organization Daily Defined Doses (DDD) as the metric and pharmacy dispensing data. NAUSP was initially started in 2004, monitoring inpatient antimicrobials that excluded OPAT data; however, since 2021, Australian hospitals have contributed OPAT usage to NAUSP to enable them to monitor their usage over time and identify any unexpected trends.…”

Challenges in Clinical Diagnosis and Management of Chronic Endometritis

“…Burkholderia is a genus of Proteobacteria that shows resistance to multiple antibiotic agents [ 66 ]. Some Burkholderia species, including Burkholderia pseudomallei and Burkholderia cepacian , cause serious lethal infectious diseases, such as melioidosis and severe pneumonia in patients with cystic fibrosis [ 67 , 68 ]. On the other hand, Burkholderia species are known to be common environmental contaminants.…”