Melioidosis research in China

Sun, Yansong

doi:10.1016/s0001-706x(00)00139-x

Cited by 44 publications

(31 citation statements)

References 13 publications

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“…On mainland China, B. pseudomallei has been isolated from 4.2% of soil and water specimens in Hainan Island and adjoining coastal provinces as far north as 25°N (500), as confirmed by human cases and seroprevalences (IHA titers of Ͼ1:40) of up to 34% in farmers in the region (499,501). In the seven isolates from culture-positive cases tested, a high rate of ceftazidime resistance (57%) was observed (501).…”

Section: Vietnam Melioidosis Was First Noted In What Is Now Southernmentioning

confidence: 99%

Melioidosis: Epidemiology, Pathophysiology, and Management

2005

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Melioidosis, caused by the gram-negative saprophyte Burkholderia pseudomallei, is a disease of public health importance in southeast Asia and northern Australia that is associated with high case-fatality rates in animals and humans. It has the potential for epidemic spread to areas where it is not endemic, and sporadic case reports elsewhere in the world suggest that as-yet-unrecognized foci of infection may exist. Environmental determinants of this infection, apart from a close association with rainfall, are yet to be elucidated. The sequencing of the genome of a strain of B. pseudomallei has recently been completed and will help in the further identification of virulence factors. The presence of specific risk factors for infection, such as diabetes, suggests that functional neutrophil defects are important in the pathogenesis of melioidosis; other studies have defined virulence factors (including a type III secretion system) that allow evasion of killing mechanisms by phagocytes. There is a possible role for cell-mediated immunity, but repeated environmental exposure does not elicit protective humoral or cellular immunity. A vaccine is under development, but economic constraints may make vaccination an unrealistic option for many regions of endemicity. Disease manifestations are protean, and no inexpensive, practical, and accurate rapid diagnostic tests are commercially available; diagnosis relies on culture of the organism. Despite the introduction of ceftazidime- and carbapenem-based intravenous treatments, melioidosis is still associated with a significant mortality attributable to severe sepsis and its complications. A long course of oral eradication therapy is required to prevent relapse. Studies exploring the role of preventative measures, earlier clinical identification, and better management of severe sepsis are required to reduce the burden of this disease

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Section: Vietnam Melioidosis Was First Noted In What Is Now Southernmentioning

confidence: 99%

Melioidosis: Epidemiology, Pathophysiology, and Management

2005

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“…The clinical manifestations of melioidosis are varied and present as pneumonia, septicemia, single, or multiple abscess. The geographical distribution of B. pseudomallei in China is characterized by the climates, and positive isolation mainly occurs in southern areas like Guangdong, Hainan and Guangxi where the temperature in January is above 12 °C [5], and cases of melioidosis are usually published as case report. The study conducted by Jiang ZJ [6] reported that B. pseudomallei was discovered in water samples collected from Huizhou, Guangdong province.…”

Section: Introductionmentioning

confidence: 99%

First co-infection case of melioidosis and Japanese encephalitis in China

Chen³

et al. 2018

BMC Infect Dis

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BackgroundMelioidosis is endemic in Southeast Asia and northern Australia. Infection usually follows percutaneous inoculation or inhalation or ingestion of the causative bacterium, Burkholderia pseudomallei, which is present in soil and surface water in endemic regions. Japanese encephalitis (JE) is a vector-borne viral zoonosis caused by Japanese encephalitis virus (JEV), leading to epidemic encephalitis in Southeast Asia. Both B. pseudomallei and JEV have spread dominantly in the Hainan and Guangdong provinces in China. Here we reported the first case of co-infection of B. pseudomallei and JEV, which was discovered in Huizhou in the Guangdong province in June 2016.Case presentationA 52-year-old man was admitted to the hospital with acute febrile illness and headache, diagnosed as respiratory infection, central nervous system (CNS) infection, septicemia, and hepatic dysfunction. Based on B. pseudomallei-positive blood and cerebrospinal fluid (CSF) cultures, the patient was diagnosed with melioidosis and treated aggressively with antibiotics. However, the patient failed to make a full recovery. Further laboratory tests focused on CNS infection were conducted. The co-infection of B. pseudomallei and JEV was confirmed after the positive IgM antibodies of JEV were detected in both CSF and blood. After diagnosis of co-infection with B. pseudomallei and JEV, the patient was provided supportive care in hospital and recovered after approximately 3 weeks.ConclusionGiven the possibility of co-infection of B. pseudomallei and JEV, as well as variable case presentations, it is critical to enhance the awareness, detection, and treatment of co-infection in regard to melioidosis.

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“…Incidence is particularly high in southeast Asia and northern Australia (6)(7)(8)(9), although the disease is becoming increasingly prevalent in China (32) and the Indian subcontinent (7).…”

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confidence: 99%

Humoral and Cell-Mediated Adaptive Immune Responses Are Required for Protection againstBurkholderia pseudomalleiChallenge and Bacterial Clearance Postinfection

et al. 2005

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Burkholderia pseudomallei, the causative agent of melioidosis, is a gram-negative bacillus endemic to areas of southeast Asia and northern Australia. Presently, there is no licensed vaccine for B. pseudomallei and the organism is refractive to antibiotic therapy. The bacterium is known to survive and multiply inside both phagocytic and nonphagocytic host cells and may be able to spread directly from cell to cell. Current vaccine delivery systems are unlikely to induce the correct immune effectors to stimulate a protective response to the organism. In this study, we have developed a procedure to utilize dendritic cells as a vaccine delivery vector to induce cell-mediated immune responses to B. pseudomallei. Dendritic cells were produced by culturing murine bone marrow progenitor cells in medium containing granulocyte-macrophage colony-stimulating factor and tumor necrosis factor alpha. Purified dendritic cells were pulsed with heat-killed whole-cell B. pseudomallei and used to immunize syngeneic mice. Strong cellular immune responses were elicited by this immunization method, although antibody responses were low. Booster immunizations of either a second dose of dendritic cells or heat-killed B. pseudomallei were administered to increase the immune response. Immunized animals were challenged with fully virulent B. pseudomallei, and protection was demonstrated in those with strong humoral and cell-mediated immunity. These results indicate the importance of both cell-mediated and humoral immune mechanisms in protection against intracellular pathogens.

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Melioidosis research in China

Cited by 44 publications

References 13 publications

Melioidosis: Epidemiology, Pathophysiology, and Management

Melioidosis: Epidemiology, Pathophysiology, and Management

First co-infection case of melioidosis and Japanese encephalitis in China

Humoral and Cell-Mediated Adaptive Immune Responses Are Required for Protection againstBurkholderia pseudomalleiChallenge and Bacterial Clearance Postinfection

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