Prevalence of Antibodies to <i>Pseudomonas pseudomallei</i> Exotoxin and Whole Cell Antigens in Military Personnel in Sabah and Sarawak, Malaysia

Embi, Noor; Suhaimi, Adlan; Mohamed, Rahmah; Ismail, Ghazally

doi:10.1111/j.1348-0421.1992.tb02092.x

Cited by 11 publications

(10 citation statements)

References 14 publications

(11 reference statements)

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“…Serosurveillance data on multiple population groups from 1969 reported a seroprevalence of 1.9 to 15.8% (91). A 1992 survey of army personnel in Sabah and Sarawak reported a prevalence of up to 65.7% (92). Notably, these studies appear to have included predominantly men and used different serological assays (91,92).…”

Section: Southeast Asiamentioning

confidence: 99%

“…A 1992 survey of army personnel in Sabah and Sarawak reported a prevalence of up to 65.7% (92). Notably, these studies appear to have included predominantly men and used different serological assays (91,92). Melioidosis is thought to account for approximately 2,000 deaths annually in Malaysia, which surpasses the mortality rates of both dengue and tuberculosis infections (93).…”

Section: Southeast Asiamentioning

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: Southeast Asiamentioning

confidence: 99%

Section: Southeast Asiamentioning

confidence: 99%

Human Melioidosis

2020

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“…Sarawak, in Malaysian Borneo, is endemic for melioidosis; although data have largely been limited to seroprevalence studies and case reports in adults [15, 16]. Of note, a recent study from Central Sarawak reported an unusually high isolation rate of gentamicin-susceptible B .…”

Section: Introductionmentioning

confidence: 99%

Pediatric melioidosis in Sarawak, Malaysia: Epidemiological, clinical and microbiological characteristics

et al. 2017

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BackgroundMelioidosis is a serious, and potentially fatal community-acquired infection endemic to northern Australia and Southeast Asia, including Sarawak, Malaysia. The disease, caused by the usually intrinsically aminoglycoside-resistant Burkholderia pseudomallei, most commonly affects adults with predisposing risk factors. There are limited data on pediatric melioidosis in Sarawak.MethodsA part prospective, part retrospective study of children aged <15 years with culture-confirmed melioidosis was conducted in the 3 major public hospitals in Central Sarawak between 2009 and 2014. We examined epidemiological, clinical and microbiological characteristics.FindingsForty-two patients were recruited during the 6-year study period. The overall annual incidence was estimated to be 4.1 per 100,000 children <15 years, with marked variation between districts. No children had pre-existing medical conditions. Twenty-three (55%) had disseminated disease, 10 (43%) of whom died. The commonest site of infection was the lungs, which occurred in 21 (50%) children. Other important sites of infection included lymph nodes, spleen, joints and lacrimal glands. Seven (17%) children had bacteremia with no overt focus of infection. Delays in diagnosis and in melioidosis-appropriate antibiotic treatment were observed in nearly 90% of children. Of the clinical isolates tested, 35/36 (97%) were susceptible to gentamicin. Of these, all 11 isolates that were genotyped were of a single multi-locus sequence type, ST881, and possessed the putative B. pseudomallei virulence determinants bimABp, fhaB3, and the YLF gene cluster.ConclusionsCentral Sarawak has a very high incidence of pediatric melioidosis, caused predominantly by gentamicin-susceptible B. pseudomallei strains. Children frequently presented with disseminated disease and had an alarmingly high death rate, despite the absence of any apparent predisposing risk factor.

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“…However, the UMC082 was a new infection, which was probably acquired during his vacation in Sabah. Cases have been reported in adults from Sabah, and a sero-prevalence study of military personnel in Sabah found that almost 60% had antibodies to B.pseudomallei [ 16 ]. Or it could also be possible that the patient was infected with two (or possibly more) strains during the original infection event, but due to minimal sampling and culturing efforts, this mixture was not detected until ST1644 was identified one year later.…”

Section: Discussionmentioning

confidence: 99%

Relapse of chronic melioidosis in a paediatric cystic fibrosis patient: first case report from Malaysia

et al. 2018

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BackgroundBurkholderia pseudomallei is the causative agent of melioidosis, which is a potentially life threatening disease endemic in Southeast Asian countries. In Malaysia, cystic fibrosis (CF) is an uncommon condition. The association between CF and B.pseudomallei infections has been reported previously. However, this is the first case report of a pediatric melioidosis relapse and co-infection with other Gram-negative bacteria in Malaysia.Case presentationA 14-year-old Chinese Malaysian boy presented with a history of recurrent pneumonia, poor growth and steatorrhoea since childhood, and was diagnosed with CF. B. pseudomallei was cultured from his sputum during three different admissions between 2013 and 2016. However, the patient succumbed to end stage of respiratory failure in 2017 despite antibiotics treatment against B.pseudomallei. The isolates were compared using multilocus-sequence typing and repetitive-element polymerase chain reaction (PCR), and confirmed that two of the isolates were of same sequence type, which may indicate relapse.ConclusionsCF patients should be aware of melioidosis in endemic regions, as it is an emerging infectious disease, especially when persistent or recurrent respiratory symptoms and signs of infection occur. The high prevalence rates of melioidosis in Malaysia warrants better management options to improve quality of life, and life expectancy in patients with CF. Travel activities to endemic regions should also be given more consideration, as this would be crucial to identify and initiate appropriate empiric treatment.

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Prevalence of Antibodies to Pseudomonas pseudomallei Exotoxin and Whole Cell Antigens in Military Personnel in Sabah and Sarawak, Malaysia

Cited by 11 publications

References 14 publications

Human Melioidosis

Human Melioidosis

Pediatric melioidosis in Sarawak, Malaysia: Epidemiological, clinical and microbiological characteristics

Relapse of chronic melioidosis in a paediatric cystic fibrosis patient: first case report from Malaysia

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