Melioidosis in the Philippines

Martin, Peter Franz M. San; Chua, J; Bautista, Ralph Louie P.; Nailes, Jennifer; Panaligan, Mario M.; Dance, David A. B.

doi:10.3390/tropicalmed3030099

Cited by 5 publications

(6 citation statements)

References 33 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our multicenter study during 2015–2018 defined 1.2% of patients as relapsing and 0.7% as having persistent infection. Relapse melioidosis was previously reported in endemic regions, including 4.3% in Darwin Australia ( Sarovich et al, 2014 ), 3.7% in South India ( Halim et al, 2017 ), 4.9% in the Philippines ( San Martin et al, 2018 ), and 0.7% in Laos ( Rachlin et al, 2016 ). In Northeast Thailand, 15% of cases between 1986 and 1991 were identified as relapses, but the rate reduced to 9.7% when the study was prolonged from 1986 to 2005 ( Chaowagul et al, 1993 ; Limmathurotsakul et al, 2006 ).…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of melioidosis is difficult because B. pseudomallei possesses various virulence factors to invade host cells, providing a sheltered survival niche to protect from the circulating immune system and antibiotics, which may result in severe disease and relapse infection ( Finlay and McFadden, 2006 ; Limmathurotsakul et al, 2006 ; Wiersinga et al, 2018 ; Lennings et al, 2019 ). Relapse is a subgroup of recurrent infection that is defined as when a patient had signs of infection and remained culture positive at subsequent episodes for the same B. pseudomallei clone as initial episode ( Chaowagul et al, 1993 ; Limmathurotsakul et al, 2006 ; Sarovich et al, 2014 ; Rachlin et al, 2016 ; Halim et al, 2017 ; San Martin et al, 2018 ). During 1986–1991, 15% of melioidosis cases were identified as relapses at Sunpasitthiprasong Hospital, Ubon Ratchathani, Northeast Thailand ( Chaowagul et al, 1993 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Phenotypic and genetic alterations of Burkholderia pseudomallei in patients during relapse and persistent infections

et al. 2023

View full text Add to dashboard Cite

The bacterium Burkholderia pseudomallei is the causative agent of melioidosis, a severe tropical disease associated with high mortality and relapse and persistent infections. Treatment of melioidosis requires prolonged antibiotic therapy; however, little is known about relapse and persistent infections, particularly the phenotypic and genetic alterations of B. pseudomallei in patients. In this study, we performed pulsed-field gel electrophoresis (PFGE) to compare the bacterial genotype between the initial isolate and the subsequent isolate from each of 23 suspected recurrent and persistent melioidosis patients in Northeast Thailand. We used whole-genome sequencing (WGS) to investigate multilocus sequence types and genetic alterations of within-host strain pairs. We also investigated the bacterial phenotypes associated with relapse and persistent infections, including multinucleated giant cell (MNGC) formation efficiency and intracellular multiplication. We first identified 13 (1.2%) relapse, 7 (0.7%) persistent, and 3 (0.3%) reinfection patients from 1,046 survivors. Each of the 20 within-host strain pairs from patients with relapse and persistent infections shared the same genotype, suggesting that the subsequent isolates arise from the infecting isolate. Logistic regression analysis of clinical data revealed regimen and duration of oral antibiotic therapies as risk factors associated with relapse and persistent infections. WGS analysis demonstrated 17 within-host genetic alteration events in 6 of 20 paired isolates, including a relatively large deletion and 16 single-nucleotide polymorphism (stocktickerSNP) mutations distributed across 12 genes. In 1 of 20 paired isolates, we observed significantly increased cell-to-cell fusion and intracellular replication in the second isolate compared with the initial isolate from a patient with persistent infection. WGS analysis suggested that a non-synonymous mutation in the tssB-5 gene, which encoded an essential component of the type VI secretion system, may be associated with the increased intracellular replication and MNGC formation efficiency of the second isolate of the patient. This information provides insights into genetic and phenotypic alterations in B. pseudomallei in human melioidosis, which may represent a bacterial strategy for persistent and relapse infections.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Phenotypic and genetic alterations of Burkholderia pseudomallei in patients during relapse and persistent infections

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Annually, an average of 227 TB cases were recorded in Brunei Darussalam of awareness of these coinfections. [5][6][7][8][9][10][11][12][13][14] This report documents a case of coinfection with pulmonary TB (PTB) and melioidosis in a patient with poorly controlled DM in Brunei Darussalam.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary tuberculosis and melioidosis coinfection in Brunei Darussalam: the importance of awareness and screening

Rubel

Mani

Kishore

et al. 2022

WPSAR

View full text Add to dashboard Cite

Both tuberculosis (TB) and melioidosis are endemic to certain parts of the world, including Brunei Darussalam, with TB being more widespread. Despite this, coinfection with TB and melioidosis is rarely encountered and reported. Although still uncommon, there has been an increase in the number of cases of this coinfection reported during the past 10 years, all of which have been in India and the World Health Organization’s Western Pacific Region. We report a case of coinfection with pulmonary TB and melioidosis in a patient with poorly controlled diabetes mellitus. This 64-year-old man presented with symptoms and radiological features of pulmonary TB, confirmed by sputum smear, but sputum culture also yielded Burkholderia pseudomallei, the pathogen that causes melioidosis. Coinfection was detected due to our practice of routinely screening for other infections in patients suspected or confirmed to have pulmonary TB. This highlights the importance of awareness of melioidosis and the need to consider screening for infection, especially in endemic regions.

show abstract

“…pseudomallei , one residing in Manila city and the other in a city beside Metro Manila. Melioidosis is probably under reported in the Philippines because of lack of awareness and limited diagnostic laboratory capacity [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

A prospective observational study of community-acquired bacterial bloodstream infections in Metro Manila, the Philippines

et al. 2022

View full text Add to dashboard Cite

Community-acquired bacterial bloodstream infections are caused by diverse pathogens with changing antimicrobial-resistance patterns. In low-middle income countries in Southeast Asia, where dengue fever is endemic and a leading cause of fever, limited information is available about bacterial bloodstream infections due to challenges of implementing a blood culture service. This study describes bacterial bloodstream pathogens and antimicrobial-resistance patterns in Metro Manila, the Philippines. We aimed to identify the proportion of patients with a positive blood culture, the bacteria isolated and their antimicrobial resistance patterns, and the clinical characteristics of these patients, in this dengue endemic area. We conducted a prospective observational study in a single hospital enrolling febrile patients clinically suspected of having a community-acquired bacterial bloodstream infection between 1st July 2015 and 30th June 2019. Each patient had a blood culture and additional diagnostic tests according to their clinical presentation. We enrolled 1315 patients and a significant positive blood culture was found in 77 (5.9%) including Staphylococcus aureus (n = 20), Salmonella enterica Typhi (n = 18), Escherichia coli (n = 16), Streptococcus pneumoniae (n = 3) and Burkholderia pseudomallei (n = 2). Thirty-four patients had meningococcal disease diagnosed by culture (n = 8) or blood PCR (n = 26). Additional confirmed diagnoses included leptospirosis (n = 177), dengue virus infection (n = 159) and respiratory diphtheria (n = 50). There were 79 (6.0%, 95%CI 4.8%−7.4%) patients who died within 28 days of enrollment. Patients with a positive blood culture were significantly more likely to die than patients with negative culture (15.2% vs 4.4%, P<0.01). Among S. aureus isolates, 11/20 (55%) were methicillin-resistant (MRSA) and ST30: USA1100 was dominant sequence type (88.9%). Antimicrobial-susceptibility was well preserved in S. enterica Typhi. Among hospitalized patients with clinically suspected community-acquired bacterial bloodstream infection in Metro Manila, the Philippines, 5.9% had a blood culture confirmed infection of whom 15.6% died. S. aureus, including a significant number of MRSA (USA1100 clones), S. enterica Typhi, E.coli and Neisseria meningitidis were frequently identified pathogens.

show abstract

Melioidosis in the Philippines

Cited by 5 publications

References 33 publications

Phenotypic and genetic alterations of Burkholderia pseudomallei in patients during relapse and persistent infections

Phenotypic and genetic alterations of Burkholderia pseudomallei in patients during relapse and persistent infections

Pulmonary tuberculosis and melioidosis coinfection in Brunei Darussalam: the importance of awareness and screening

A prospective observational study of community-acquired bacterial bloodstream infections in Metro Manila, the Philippines

Contact Info

Product

Resources

About