Polymicrobial community-acquired Acinetobacter baumannii and Burkholderia pseudomallei bacteremia: opportunistic infections with similar risk factors in northern Australia

Fairhead, Lee; Vardanega, John; Pandey, Rakesh; Smith, Simon

doi:10.1016/j.idcr.2020.e00833

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…However, detection of community-acquired A. baumannii infections with high rates of morbidity and mortality in a number of countries [10–16] has prompted research on the virulence potential and molecular traits of non-clinical environmental strains. Unlike the majority of nosocomial strains, community-acquired infections tend to be more susceptible to antimicrobials [11, 17] and epidemiologically more closely related to strains recovered from environmental sources [11].…”

Section: Introductionmentioning

confidence: 99%

“…baumannii is traditionally considered a nosocomial pathogen that causes hospital-acquired infections, including pneumonia, urinary tract and wound infections and bacteraemia, in critically ill or immunocompromised patients [1] yet rarely is reported to cause community-acquired infections. However, detection of community-acquired A. baumannii infections with high rates of morbidity and mortality in a number of countries [10][11][12][13][14][15][16] has prompted research on the virulence potential and molecular traits of non-clinical environmental strains. Unlike the majority of nosocomial strains, community-acquired infections tend to be more susceptible to antimicrobials [11,17] and epidemiologically more closely related to strains recovered from environmental sources [11].…”

Section: Introductionmentioning

confidence: 99%

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Genomic and phenotypic analyses of diverse non-clinical Acinetobacter baumannii strains reveals strain-specific virulence and resistance capacity

et al. 2022

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Acinetobacter baumannii is a critically important pathogen known for its widespread antibiotic resistance and ability to persist in hospital-associated environments. Whilst the majority of A. baumannii infections are hospital-acquired, infections from outside the hospital have been reported with high mortality. Despite this, little is known about the natural environmental reservoir(s) of A. baumannii and the virulence potential underlying non-clinical strains. Here, we report the complete genome sequences of six diverse strains isolated from environments such as river, soil, and industrial sites around the world. Phylogenetic analyses showed that four of these strains were unrelated to representative nosocomial strains and do not share a monophyletic origin, whereas two had sequence types belonging to the global clone lineages GC1 and GC2. Further, the majority of these strains harboured genes linked to virulence and stress protection in nosocomial strains. These genotypic properties correlated well with in vitro virulence phenotypic assays testing resistance to abiotic stresses, serum survival, and capsule formation. Virulence potential was confirmed in vivo, with most environmental strains able to effectively kill Galleria mellonella greater wax moth larvae. Using phenomic arrays and antibiotic resistance profiling, environmental and nosocomial strains were shown to have similar substrate utilisation patterns although environmental strains were distinctly more sensitive to antibiotics. Taken together, these features of environmental A. baumannii strains suggest the existence of a strain-specific distinct gene pools for niche specific adaptation. Furthermore, environmental strains appear to be equally virulent as contemporary nosocomial strains but remain largely antibiotic sensitive.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Genomic and phenotypic analyses of diverse non-clinical Acinetobacter baumannii strains reveals strain-specific virulence and resistance capacity

et al. 2022

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“…In endemic regions this may influence the selection of empirical antibiotic regimens although, of course, other pathogens may present with BJI as a component of disseminated infection [ 4 , 34 , 35 ]. It should be re-iterated that in most centres, the diagnosis of melioidosis can only be confirmed with culture and this also precludes coinfection [ 1 , 36 ]. Serology is neither sensitive—nor in endemic regions, specific enough—to guide clinical care [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes

Dadwal,

Bonner,

Fraser

et al. 2024

PLoS Negl Trop Dis

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Background Melioidosis, a life-threatening infection caused by the gram negative bacterium Burkholderia pseudomallei, can involve almost any organ. Bone and joint infections (BJI) are a recognised, but incompletely defined, manifestation of melioidosis that are associated with significant morbidity and mortality in resource-limited settings. Methodology/principal findings We identified all individuals with BJI due to B. pseudomallei managed at Cairns Hospital in tropical Australia between January 1998 and June 2023. The patients’ demographics, their clinical findings and their treatment were correlated with their subsequent course. Of 477 culture-confirmed cases of melioidosis managed at the hospital during the study period, 39 (8%) had confirmed BJI; predisposing risk factors for melioidosis were present in 37/39 (95%). However, in multivariable analysis only diabetes mellitus was independently associated with the presence of BJI (odds ratio (95% confidence interval): 4.04 (1.81–9.00), p = 0.001). BJI was frequently only one component of multi-organ involvement: 29/39 (74%) had infection involving other organs and bacteraemia was present in 31/39 (79%). Of the 39 individuals with BJI, 14 (36%) had osteomyelitis, 8 (20%) had septic arthritis and 17 (44%) had both osteomyelitis and septic arthritis; in 32/39 (83%) the lower limb was involved. Surgery was performed in 30/39 (77%). Readmission after the initial hospitalisation was necessary in 11/39 (28%), 5/39 (13%) had disease recrudescence and 3/39 (8%) had relapse; 4/39 (10%) developed pathological fractures. ICU admission was necessary in 11/39 (28%) but all 11 of these patients survived. Only 1/39 (3%) died, 138 days after admission, due to his significant underlying comorbidity. Conclusions The case-fatality rate from melioidosis BJI in Australia’s well-resourced health system is very low. However, recrudescence, relapse and orthopaedic complications are relatively common and emphasise the importance of collaborative multidisciplinary care that includes early surgical review, aggressive source control, prolonged antibiotic therapy, and thorough, extended follow-up.

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Cotrimoxazole/etanercept

2020

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Polymicrobial community-acquired Acinetobacter baumannii and Burkholderia pseudomallei bacteremia: opportunistic infections with similar risk factors in northern Australia

Cited by 3 publications

References 18 publications

Genomic and phenotypic analyses of diverse non-clinical Acinetobacter baumannii strains reveals strain-specific virulence and resistance capacity

Genomic and phenotypic analyses of diverse non-clinical Acinetobacter baumannii strains reveals strain-specific virulence and resistance capacity

Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes

Cotrimoxazole/etanercept

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