Melioidosis in South America

Rolim, Dionne Bezerra; Lima, Rachel Ximenes Ribeiro; Ribeiro, Ana Karoline C.; Colares, Rafael M.; Lima, Leoniti D. Q.; Rodríguez‐Morales, Alfonso J.; Montúfar, Franco; Dance, David A. B.

doi:10.3390/tropicalmed3020060

Cited by 21 publications

(10 citation statements)

References 27 publications

(35 reference statements)

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“…Five South American countries have reported cases of proven melioidosis: Brazil, Colombia, Venezuela, Ecuador, and Peru (137). Currently, Brazil accounts for two-thirds of melioidosis cases in South America (138).…”

Section: The Americasmentioning

confidence: 99%

“…The estimated annual incidence in South America is 1,200 cases and 500 deaths (21). However, the true incidence is uncertain, as Ceará, a state in Brazil, is the only region with compulsory notification of cases, and few laboratories in this region can identify B. pseudomallei (137).…”

Section: The Americasmentioning

confidence: 99%

“…Within the region of Latin America and the Caribbean, the population at risk is 246 million people, with an estimate of 2,000 cases of melioidosis and up to 1,000 deaths annually (21,149). This discrepancy in incidence compared to that in the rest of the world may be a combination of predictive variables, including environment, climate, and patient risk factors, as well as worldwide underreporting (21,137). Genetic analysis has demonstrated a diversity of molecular types suggesting potential endemicity (139).…”

Section: The Americasmentioning

confidence: 99%

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Human Melioidosis

2020

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SUMMARY The causative agent of melioidosis, Burkholderia pseudomallei, a tier 1 select agent, is endemic in Southeast Asia and northern Australia, with increased incidence associated with high levels of rainfall. Increasing reports of this condition have occurred worldwide, with estimates of up to 165,000 cases and 89,000 deaths per year. The ecological niche of the organism has yet to be clearly defined, although the organism is associated with soil and water. The culture of appropriate clinical material remains the mainstay of laboratory diagnosis. Identification is best done by phenotypic methods, although mass spectrometric methods have been described. Serology has a limited diagnostic role. Direct molecular and antigen detection methods have limited availability and sensitivity. Clinical presentations of melioidosis range from acute bacteremic pneumonia to disseminated visceral abscesses and localized infections. Transmission is by direct inoculation, inhalation, or ingestion. Risk factors for melioidosis include male sex, diabetes mellitus, alcohol abuse, and immunosuppression. The organism is well adapted to intracellular survival, with numerous virulence mechanisms. Immunity likely requires innate and adaptive responses. The principles of management of this condition are drainage and debridement of infected material and appropriate antimicrobial therapy. Global mortality rates vary between 9% and 70%. Research into vaccine development is ongoing.

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Section: The Americasmentioning

confidence: 99%

Section: The Americasmentioning

confidence: 99%

Section: The Americasmentioning

confidence: 99%

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Human Melioidosis

2020

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“…Southeast Asia and Northern Australia are hyperendemic regions (Cheng and Currie, 2005). However, reports of environmental B. pseudomallei isolates or melioidosis cases from Central and South America, Africa and South Asia indicate that the bacteria are found in the tropics worldwide (Mukhopadhyay et al, 2018; Rolim et al, 2018; Steinmetz et al, 2018; Torres et al, 2018). Furthermore, a recent comprehensive modeling study suggests vast underreporting of melioidosis cases and highlights the need to assess the true global burden and epidemiology of the disease (Limmathurotsakul et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

The Burkholderia Type VI Secretion System 5: Composition, Regulation and Role in Virulence

2019

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The soil saprophyte and Tier I select agent Burkholderia pseudomallei can cause rapidly fatal infections in humans and animals. The capability of switching to an intracellular life cycle during infection appears to be a decisive trait of B. pseudomallei for causing disease. B. pseudomallei harbors multiple type VI secretion systems (T6SSs) orthologs of which are present in the surrogate organism Burkholderia thailandensis. Upon host cell entry and vacuolar escape into the cytoplasm, B. pseudomallei and B. thailandensis manipulate host cells by utilizing the T6SS-5 (also termed T6SS1) to form multinucleated giant cells for intercellular spread. Disruption of the T6SS-5 in B. thailandensis causes a drastic attenuation of virulence in wildtype but not in mice lacking the central innate immune adapter protein MyD88. This result suggests that the T6SS-5 is deployed by the bacteria to overcome innate immune responses. However, important questions in this field remain unsolved including the mechanism underlying T6SS-5 activity and its physiological role during infection. In this review, we summarize the current knowledge on the components and regulation of the T6SS-5 as well as its role in virulence in mammalian hosts.

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“…The cases also prompted environmental sampling to identify potential sites of exposure to the bacterium, especially for the four siblings infected in 2003. Melioidosis was determined to be endemic in Ceara based on the cases found during improved surveillance as well as isolates recovered during environmental sampling (4)(5)(6)(7).…”

mentioning

confidence: 99%

Genomic Diversity of Burkholderia pseudomallei in Ceara, Brazil

Gee

Gulvik

Castelo‐Branco

et al. 2021

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Burkholderia pseudomallei is a Gram-negative bacterium that causes the sapronotic disease melioidosis. An outbreak in 2003 in the state of Ceara, Brazil, resulted in subsequent surveillance and environmental sampling which led to the recognition of B. pseudomallei as an endemic pathogen in that area. From 2003 to 2015, 24 clinical and 12 environmental isolates were collected across Ceara along with one from the state of Alagoas. Using next-generation sequencing, multilocus sequence typing, and single nucleotide polymorphism analysis, we characterized the genomic diversity of this collection to better understand the population structure of B. pseudomallei associated with Ceara. We found that the isolates in this collection form a distinct subclade compared to other examples from the Western Hemisphere. Substantial genetic diversity among the clinical and environmental isolates was observed, with 14 sequence types (STs) identified among the 37 isolates. Of the 31,594 core single-nucleotide polymorphisms (SNPs) identified, a high proportion (59%) were due to recombination. Because recombination events do not follow a molecular clock, the observation of high occurrence underscores the importance of identifying and removing recombination SNPs prior to evolutionary reconstructions and inferences in public health responses to B. pseudomallei outbreaks. Our results suggest long-term B. pseudomallei prevalence in this recently recognized region of melioidosis endemicity. IMPORTANCE B. pseudomallei causes significant morbidity and mortality, but its geographic prevalence and genetic diversity are not well characterized, especially in the Western Hemisphere. A better understanding of the genetic relationships among clinical and environmental isolates will improve knowledge of the population structure of this bacterium as well as the ability to conduct epidemiological investigations of cases of melioidosis.

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Melioidosis in South America

Cited by 21 publications

References 27 publications

Human Melioidosis

Human Melioidosis

The Burkholderia Type VI Secretion System 5: Composition, Regulation and Role in Virulence

Genomic Diversity of Burkholderia pseudomallei in Ceara, Brazil

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