1
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Im S, Paz y Mino A, Garces E, Altamimi S. Latent melioidosis activation presenting with urinary tract infection and bacteremia. IDCases 2024; 36:e02007. [PMID: 38947559 PMCID: PMC11214284 DOI: 10.1016/j.idcr.2024.e02007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/27/2024] [Accepted: 06/04/2024] [Indexed: 07/02/2024] Open
Abstract
We report a rare case of latent melioidosis activation in a patient with a distant travel history to an endemic region. Melioidosis is an infection caused by Burkholderia pseudomallei which is highly endemic in Southeast Asia and northern Australia. The patient exhibited common clinical risk factors, presenting with urinary tract infection and bacteremia. The treatment course was complicated by the adverse effect of trimethoprim/sulfamethoxazole. This case underscores the importance of early detection and appropriate treatment of melioidosis, particularly given its expanding global distribution.
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Affiliation(s)
- Seohyeon Im
- Department of Medicine, Mass General Brigham-Salem Hospital, Salem, MA, United States
| | - Ariane Paz y Mino
- Department of Medicine, Mass General Brigham-Salem Hospital, Salem, MA, United States
| | - Estefany Garces
- Department of Medicine, Mass General Brigham-Salem Hospital, Salem, MA, United States
| | - Sarah Altamimi
- Department of Infectious Diseases, Mass General Brigham-Salem Hospital, Salem, MA, United States
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2
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Lovelace-Macon L, Baker SM, Ducken D, Seal S, Rerolle G, Tomita D, Smith KD, Schwarz S, West TE. Flagellin-modulated inflammasome pathways characterize the human alveolar macrophage response to Burkholderia pseudomallei, a lung-tropic pathogen. Infect Immun 2024; 92:e0006024. [PMID: 38619302 PMCID: PMC11075458 DOI: 10.1128/iai.00060-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
Melioidosis is an emerging tropical infection caused by inhalation, inoculation, or ingestion of the flagellated, facultatively intracellular pathogen Burkholderia pseudomallei. The melioidosis case fatality rate is often high, and pneumonia, the most common presentation, doubles the risk of death. The alveolar macrophage is a sentinel pulmonary host defense cell, but the human alveolar macrophage in B. pseudomallei infection has never been studied. The objective of this study was to investigate the host-pathogen interaction of B. pseudomallei infection with the human alveolar macrophage and to determine the role of flagellin in modulating inflammasome-mediated pathways. We found that B. pseudomallei infects primary human alveolar macrophages but is gradually restricted in the setting of concurrent cell death. Electron microscopy revealed cytosolic bacteria undergoing division, indicating that B. pseudomallei likely escapes the alveolar macrophage phagosome and may replicate in the cytosol, where it triggers immune responses. In paired human blood monocytes, uptake and intracellular restriction of B. pseudomallei are similar to those observed in alveolar macrophages, but cell death is reduced. The alveolar macrophage cytokine response to B. pseudomallei is characterized by marked interleukin (IL)-18 secretion compared to monocytes. Both cytotoxicity and IL-18 secretion in alveolar macrophages are partially flagellin dependent. However, the proportion of IL-18 release that is driven by flagellin is greater in alveolar macrophages than in monocytes. These findings suggest differential flagellin-mediated inflammasome pathway activation in the human alveolar macrophage response to B. pseudomallei infection and expand our understanding of intracellular pathogen recognition by this unique innate immune lung cell.
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Affiliation(s)
- Lara Lovelace-Macon
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sarah M. Baker
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Deirdre Ducken
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sudeshna Seal
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Guilhem Rerolle
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Diane Tomita
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kelly D. Smith
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Sandra Schwarz
- Interfaculty Institute of Microbiology and Infection Medicine, University of Tuebingen, Tuebingen, Germany
| | - T. Eoin West
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
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3
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Paskey AC, Schully KL, Voegtly LJ, Arnold CE, Cer RZ, Frey KG, Blair PW, Clark DV, Ge H, Richards AL, Farris CM, Bishop-Lilly KA. A proof of concept for a targeted enrichment approach to the simultaneous detection and characterization of rickettsial pathogens from clinical specimens. Front Microbiol 2024; 15:1387208. [PMID: 38659991 PMCID: PMC11039911 DOI: 10.3389/fmicb.2024.1387208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Infection with either Rickettsia prowazekii or Orientia tsutsugamushi is common, yet diagnostic capabilities are limited due to the short window for positive identification. Until now, although targeted enrichment had been applied to increase sensitivity of sequencing-based detection for various microorganisms, it had not been applied to sequencing of R. prowazekii in clinical samples. Additionally, hybridization-based targeted enrichment strategies had only scarcely been applied to qPCR of any pathogens in clinical samples. Therefore, we tested a targeted enrichment technique as a proof of concept and found that it dramatically reduced the limits of detection of these organisms by both qPCR and high throughput sequencing. The enrichment methodology was first tested in contrived clinical samples with known spiked-in concentrations of R. prowazekii and O. tsutsugamushi DNA. This method was also evaluated using clinical samples, resulting in the simultaneous identification and characterization of O. tsutsugamushi directly from clinical specimens taken from sepsis patients. We demonstrated that the targeted enrichment technique is helpful by lowering the limit of detection, not only when applied to sequencing, but also when applied to qPCR, suggesting the technique could be applied more broadly to include other assays and/or microbes for which there are limited diagnostic or detection modalities.
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Affiliation(s)
- Adrian C. Paskey
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
- Leidos, Reston, VA, United States
| | - Kevin L. Schully
- Austere Environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
| | - Logan J. Voegtly
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
- Leidos, Reston, VA, United States
| | - Catherine E. Arnold
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
- Defense Threat Reduction Agency, Fort Belvoir, VA, United States
| | - Regina Z. Cer
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
| | - Kenneth G. Frey
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
| | - Paul W. Blair
- Austere Environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Danielle V. Clark
- Austere Environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Hong Ge
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Command, Silver Spring, MD, United States
| | - Allen L. Richards
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Command, Silver Spring, MD, United States
| | - Christina M. Farris
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Command, Silver Spring, MD, United States
| | - Kimberly A. Bishop-Lilly
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Command, Frederick, MD, United States
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4
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Withatanung P, Janesomboon S, Vanaporn M, Muangsombut V, Charoensudjai S, Baker DJ, Wuthiekanun V, Galyov EE, Clokie MRJ, Gundogdu O, Korbsrisate S. Induced Burkholderia prophages detected from the hemoculture: a biomarker for Burkholderia pseudomallei infection. Front Microbiol 2024; 15:1361121. [PMID: 38633694 PMCID: PMC11022660 DOI: 10.3389/fmicb.2024.1361121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/11/2024] [Indexed: 04/19/2024] Open
Abstract
Bacteriophages (phages), viruses that infect bacteria, are found in abundance not only in the environment but also in the human body. The use of phages for the diagnosis of melioidosis, a tropical infectious disease caused by Burkholderia pseudomallei, is emerging as a promising novel approach, but our understanding of conditions under which Burkholderia prophages can be induced remains limited. Here, we first demonstrated the isolation of Burkholderia phages from the hemocultures of melioidosis patients. The B. pseudomallei-positive hemoculture bottles were filtered to remove bacteria, and then phages were isolated and purified by spot and double agar overlay plaque assays. Forty blood samples (hemoculture-confirmed melioidosis) were tested, and phages were found in 30% of the samples. Transmission electron microscopy and genome analysis of the isolated phages, vB_HM387 and vB_HM795, showed that both phages are Myoviruses. These two phages were stable at a pH of 5-7 and temperatures of 25-37°C, suggesting their ability to survive in human blood. The genome sizes of vB_HM387 and vB_HM795 are 36.3 and 44.0 kb, respectively. A phylogenetic analysis indicated that vB_HM387 has homologs, but vB_HM795 is a novel Myovirus, suggesting the heterogeneity of Burkholderia phages in melioidosis patients. The key finding that Burkholderia phages could be isolated from the blood of melioidosis patients highlights the potential application of phage-based assays by detecting phages in blood as a pathogen-derived biomarker of infection.
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Affiliation(s)
- Patoo Withatanung
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sujintana Janesomboon
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Muthita Vanaporn
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Veerachat Muangsombut
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Dave J. Baker
- Science Operations, Quadram Institute Bioscience, Norwich, United Kingdom
| | - Vanaporn Wuthiekanun
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Edouard E. Galyov
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Martha R. J. Clokie
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Ozan Gundogdu
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sunee Korbsrisate
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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5
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Tantirat P, Chantarawichian Y, Taweewigyakarn P, Kripattanapong S, Jitpeera C, Doungngern P, Phiancharoen C, Tangwangvivat R, Hinjoy S, Sujariyakul A, Amornchai P, Wongsuvan G, Hantakun V, Wuthiekanun V, Thaipadungpanit J, Thomson NR, Dance DAB, Chewapreecha C, Batty EM, Limmathurotsakul D. Melioidosis in Patients with COVID-19 Exposed to Contaminated Tap Water, Thailand, 2021. Emerg Infect Dis 2024; 30:791-794. [PMID: 38526300 PMCID: PMC10977828 DOI: 10.3201/eid3004.231476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
In September 2021, a total of 25 patients diagnosed with COVID-19 developed acute melioidosis after (median 7 days) admission to a COVID-19 field hospital in Thailand. Eight nonpotable tap water samples and 6 soil samples were culture-positive for Burkholderia pseudomallei. Genomic analysis suggested contaminated tap water as the likely cause of illness.
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6
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Meumann EM, Limmathurotsakul D, Dunachie SJ, Wiersinga WJ, Currie BJ. Burkholderia pseudomallei and melioidosis. Nat Rev Microbiol 2024; 22:155-169. [PMID: 37794173 DOI: 10.1038/s41579-023-00972-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/06/2023]
Abstract
Burkholderia pseudomallei, the causative agent of melioidosis, is found in soil and water of tropical and subtropical regions globally. Modelled estimates of the global burden predict that melioidosis remains vastly under-reported, and a call has been made for it to be recognized as a neglected tropical disease by the World Health Organization. Severe weather events and environmental disturbance are associated with increased case numbers, and it is anticipated that, in some regions, cases will increase in association with climate change. Genomic epidemiological investigations have confirmed B. pseudomallei endemicity in newly recognized regions, including the southern United States. Melioidosis follows environmental exposure to B. pseudomallei and is associated with comorbidities that affect the immune response, such as diabetes, and with socioeconomic disadvantage. Several vaccine candidates are ready for phase I clinical trials. In this Review, we explore the global burden, epidemiology and pathophysiology of B. pseudomallei as well as current diagnostics, treatment recommendations and preventive measures, highlighting research needs and priorities.
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Affiliation(s)
- Ella M Meumann
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
| | - Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- NDM Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Susanna J Dunachie
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- NDM Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Willem J Wiersinga
- Division of Infectious Diseases, Center for Experimental Molecular Medicine, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Bart J Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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7
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Petras JK, Elrod MG, Ty MC, Dawson P, O'Laughlin K, Gee JE, Hanson J, Boutwell C, Ainsworth G, Beesley CA, Saile E, Tiller R, Gulvik CA, Ware D, Sokol T, Balsamo G, Taylor K, Salzer JS, Bower WA, Weiner ZP, Negrón ME, Hoffmaster AR, Byers P. Locally Acquired Melioidosis Linked to Environment - Mississippi, 2020-2023. N Engl J Med 2023; 389:2355-2362. [PMID: 38118023 PMCID: PMC10773590 DOI: 10.1056/nejmoa2306448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Melioidosis, caused by Burkholderia pseudomallei, is a rare but potentially fatal bacterial disease endemic to tropical and subtropical regions worldwide. It is typically acquired through contact with contaminated soil or fresh water. Before this investigation, B. pseudomallei was not known to have been isolated from the environment in the continental United States. Here, we report on three patients living in the same Mississippi Gulf Coast county who presented with melioidosis within a 3-year period. They were infected by the same Western Hemisphere B. pseudomallei strain that was discovered in three environmental samples collected from the property of one of the patients. These findings indicate local acquisition of melioidosis from the environment in the Mississippi Gulf Coast region.
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Affiliation(s)
- Julia K Petras
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Mindy G Elrod
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Maureen C Ty
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Patrick Dawson
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Kevin O'Laughlin
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Jay E Gee
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Jennifer Hanson
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Carla Boutwell
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Gail Ainsworth
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Cari A Beesley
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Elke Saile
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Rebekah Tiller
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Christopher A Gulvik
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Daphne Ware
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Theresa Sokol
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Gary Balsamo
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Kathryn Taylor
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Johanna S Salzer
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - William A Bower
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Zachary P Weiner
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - María E Negrón
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Alex R Hoffmaster
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Paul Byers
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
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8
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Yao J, Zhang Z, Tian S, Luo N, Tan J, Zhang Y, Gu S, Xia Q. Synchronous detection of Burkholderia pseudomallei and its ceftazidime resistance mutation based on RNase-HII hydrolysis combined with lateral flow strip assay. Microbiol Spectr 2023; 11:e0112523. [PMID: 37815337 PMCID: PMC10714834 DOI: 10.1128/spectrum.01125-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/19/2023] [Indexed: 10/11/2023] Open
Abstract
IMPORTANCE This study focused on the development of a reaction system using rhPCR to amplify a specific gene, ORF2, of B. pseudomallei and to identify the P174L mutation associated with increased drug resistance to ceftazidime (CAZ). The system incorporated universal primer probes and a simple temperature cycle reaction. The amplified products were then analyzed using lateral flow strip assay (LFSA) for strain identification and mutation interpretation. The developed system provides a reliable basis for diagnosing melioidosis and selecting appropriate drugs. Its potential impact is particularly significant in resource-limited settings where access to advanced diagnostic techniques is limited. This platform stands out for its simplicity, convenience, sensitivity, specificity, and portability. It shows promise as a point-of-care testing method for detecting single nucleotide polymorphism in genes associated with other diseases. By leveraging the advantages of this platform, researchers and healthcare professionals can potentially expand its use beyond melioidosis and apply it to the rapid detection of genetic variations in other disease-related genes.
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Affiliation(s)
- Juan Yao
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
- Nanobiosensing and Microfluidic Point-of-Care Testing Key Laboratory of LuZhou, Luzhou, Sichuan, China
| | - Zhang Zhang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
- Department of Neurosurgery, Neurology Center, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Shen Tian
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
| | - Nini Luo
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
| | - Jun Tan
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
| | - Yue Zhang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
| | - Shuo Gu
- Department of Neurosurgery, Neurology Center, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Qianfeng Xia
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
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9
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Mansour KE, Qi Y, Yan M, Ramström O, Priebe GP, Schaefers MM. Small-molecule activators of a bacterial signaling pathway inhibit virulence. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.02.569726. [PMID: 38076823 PMCID: PMC10705554 DOI: 10.1101/2023.12.02.569726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The Burkholderia genus encompasses multiple human pathogens, including potential bioterrorism agents, that are often extensively antibiotic resistant. The FixLJ pathway in Burkholderia is a two-component system that regulates virulence. Previous work showed that fixLJ mutations arising during chronic infection confer increased virulence while decreasing the activity of the FixLJ pathway. We hypothesized that small-molecule activators of the FixLJ pathway could serve as anti-virulence therapies. Here, we developed a high-throughput assay that screened over 28,000 compounds and identified 11 that could specifically active the FixLJ pathway. Eight of these compounds, denoted Burkholderia Fix Activator (BFA) 1-8, inhibited the intracellular survival of Burkholderia in THP-1-dervived macrophages in a fixLJ-dependent manner without significant toxicity. One of the compounds, BFA1, inhibited the intracellular survival in macrophages of multiple Burkholderia species. Predictive modeling of the interaction of BFA1 with Burkholderia FixL suggests that BFA1 binds to the putative ATP/ADP binding pocket in the kinase domain, indicating a potential mechanism for pathway activation. These results indicate that small-molecule FixLJ pathway activators are promising anti-virulence agents for Burkholderia and define a new paradigm for antibacterial therapeutic discovery.
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Affiliation(s)
- Kathryn E. Mansour
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital; Boston, MA, USA
| | - Yunchuan Qi
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA 01854
| | - Mingdi Yan
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA 01854
| | - Olof Ramström
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA 01854
- Department of Chemistry and Biomedical Sciences, Linnaeus University, SE-39182 Kalmar, Sweden
| | - Gregory P. Priebe
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital; Boston, MA, USA
- Department of Anaesthesia, Harvard Medical School; Boston, MA, USA
| | - Matthew M. Schaefers
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital; Boston, MA, USA
- Department of Anaesthesia, Harvard Medical School; Boston, MA, USA
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10
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Schwartzman G, Reddy SA, Berg SH, Currie BJ, Saavedra AP. Cutaneous melioidosis: An updated review and primer for the dermatologist. J Am Acad Dermatol 2023; 89:1201-1208. [PMID: 37582471 DOI: 10.1016/j.jaad.2023.07.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/11/2023] [Accepted: 07/20/2023] [Indexed: 08/17/2023]
Abstract
Melioidosis is an emerging infection with increasing endemic foci and global distribution. It is underrecognized and underdiagnosed because of factors including limited awareness of the disease, nonspecific clinical presentation, lack of diagnostic facilities in some locations, misidentification in laboratories inexperienced with culture, and identification of Burkholderia pseudomallei. Cutaneous findings are reported in approximately 10% to 20% of melioidosis cases and dermatologists may play a significant role in its recognition and management. The most dynamic situation of melioidosis recognition and/or expansion currently is in the United States. Global modeling had predicted that B. pseudomallei were potentially endemic in the southern United States and endemicity with local cases of melioidosis was confirmed in 2022. With the distribution and prevalence of melioidosis increasing globally and with this recent recognition that melioidosis is now endemic in the southern United States, it is important for dermatologists to maintain high clinical suspicion in appropriate patients and be familiar with its diagnosis and treatment. Here we review the available literature on cutaneous melioidosis to evaluate its epidemiology, etiology, pathophysiology and clinical presentation and provide guidance for diagnosis and management in dermatology practice.
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Affiliation(s)
| | - Soumya A Reddy
- Department of Dermatology, University of Virginia, Charlottesville, Virginia
| | - Scott H Berg
- Department of Dermatology, University of Virginia, Charlottesville, Virginia
| | - Bart J Currie
- Infectious Diseases Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia
| | - Arturo P Saavedra
- Department of Dermatology, University of Virginia, Charlottesville, Virginia
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11
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Li Y, He X, Deng L, Chen H, Chen X, Mao X, Xiang Y. Serodiagnosis of Abdominal Abscess Caused by Burkholderia pseudomallei: Case Report and Literature Review. Infect Drug Resist 2023; 16:5613-5625. [PMID: 37650004 PMCID: PMC10464891 DOI: 10.2147/idr.s421739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023] Open
Abstract
Burkholderia pseudomallei, the causative agent of melioidosis can be responsible for a wide spectrum of clinical manifestations and heterogeneous prognoses, with a high mortality in the acute onset. We report a case of a deep abdominal abscess with sepsis secondary to melioidosis in a young farmer from a non-high-risk population. Emergency medical treatment was administered according to the detection of serum antibodies against Hcp1, the results of which provided etiological evidence of B. pseudomallei infection for the timely and properly antimicrobial therapy in the absence of direct evidence of melioidosis. To our knowledge, this is the first reported case of serodiagnosis of acute exacerbation of melioidosis in China.
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Affiliation(s)
- Yuanli Li
- Department of Clinical Laboratory, Sanya People’s Hospital, Sanya, Hainan, People’s Republic of China
| | - Xiaoyi He
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Ling Deng
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Hai Chen
- Department of Clinical Laboratory, Sanya People’s Hospital, Sanya, Hainan, People’s Republic of China
| | - Xi Chen
- Department of Clinical Laboratory, Sanya People’s Hospital, Sanya, Hainan, People’s Republic of China
| | - Xuhu Mao
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Yang Xiang
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
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12
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Savelkoel J, Tiemensma M, Birnie E, Wiersinga WJ, Currie BJ, Roelofs JJTH. A Graphical Overview of the Histopathology of Human Melioidosis: A Case Series. Open Forum Infect Dis 2023; 10:ofad367. [PMID: 37547853 PMCID: PMC10400137 DOI: 10.1093/ofid/ofad367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Background Melioidosis, caused by the Gram-negative bacterium Burkholderia pseudomallei, has a major global health impact and a wide range of different disease manifestations. Histopathological descriptions of melioidosis remain limited. Granulomatous inflammation with multinucleated giant cells are considered classic features. We aim to present a graphical overview of histopathological manifestations of melioidosis, serving as an aid in diagnosing this disease. Methods We performed a retrospective international multicenter laboratory-based analysis of formalin-fixed paraffin-embedded (FFPE) tissue from culture-confirmed melioidosis autopsy and biopsy cases. Available FFPE tissue was stained with hematoxylin and eosin and immunostainings including a monoclonal antibody targeting the capsular polysaccharide (CPS) of B pseudomallei. Tissue with site-specific cultures and/or positive CPS staining were included in the graphical histopathological overview. Results We identified tissue of 8 autopsy and 5 biopsy cases. Pneumonia and soft tissue abscesses were the leading foci of disease displaying mainly necrosis and suppuration. Infrequent disease manifestations included involvement of bone marrow and adrenal glands in an autopsy case and biopsied mediastinal tissue, the latter being the only case in which we identified multinucleated giant cells. Using the CPS staining, we demonstrated granulomata as part of rare gastric tissue involvement. Conclusions We found fatal melioidosis to be a necrotizing and suppurative inflammation, usually without multinucleated giant cell formation. Gastric and mediastinal involvement points to ingestion and inhalation as possible routes of infection. The CPS staining proved beneficial as an aid to establish a histopathological diagnosis. Our graphical overview can be used by infectious diseases specialists, microbiologists, and pathologists.
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Affiliation(s)
- Jelmer Savelkoel
- Center for Experimental and Molecular Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Marianne Tiemensma
- Territory Pathology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Emma Birnie
- Center for Experimental and Molecular Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - W Joost Wiersinga
- Center for Experimental and Molecular Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Division of Infectious Diseases, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Bart J Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Infectious Diseases Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Joris J T H Roelofs
- Department of Pathology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
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13
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Guterres H, Gusmao C, Pinheiro M, Martins J, Odio G, Maia C, da Conceicao V, Soares M, Osorio C, da Silva ES, Tilman A, Givney R, Oakley T, Yan J, Toto L, Amaral E, James R, Buising K, Mayo M, Kaestli M, Webb JR, Baird RW, Currie BJ, Francis JR, Muhi S. Melioidosis in Timor-Leste: First Case Description and Phylogenetic Analysis. Open Forum Infect Dis 2023; 10:ofad405. [PMID: 37577114 PMCID: PMC10414804 DOI: 10.1093/ofid/ofad405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023] Open
Abstract
Burkholderia pseudomallei, the causative agent of melioidosis, has not yet been reported in Timor-Leste, a sovereign state northwest of Australia. In the context of improved access to diagnostic resources and expanding clinical networks in the Australasian region, we report the first 3 cases of culture-confirmed melioidosis in Timor-Leste. These cases describe a broad range of typical presentations, including sepsis, pneumonia, multifocal abscesses, and cutaneous infection. Phylogenetic analysis revealed that the Timor-Leste isolates belong to the Australasian clade of B. pseudomallei, rather than the Asian clade, consistent with the phylogeographic separation across the Wallace Line. This study underscores an urgent need to increase awareness of this pathogen in Timor-Leste and establish diagnostic laboratories with improved culture capacity in regional hospitals. Clinical suspicion should prompt appropriate sampling and communication with laboratory staff to target diagnostic testing. Local antimicrobial guidelines have recently been revised to include recommendations for empiric treatment of severe sepsis.
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Affiliation(s)
| | - Celia Gusmao
- National Hospital Guido Valadares, Dili, Timor-Leste
| | | | - Joana Martins
- National Hospital Guido Valadares, Dili, Timor-Leste
| | - Gustavo Odio
- National Hospital Guido Valadares, Dili, Timor-Leste
| | | | - Virginia da Conceicao
- National Health Laboratory, Dili, Timor-Leste
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Messias Soares
- National Health Laboratory, Dili, Timor-Leste
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | | | | | - Rodney Givney
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Tessa Oakley
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jennifer Yan
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Lucia Toto
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Elfiana Amaral
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Rodney James
- Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Kirsty Buising
- Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Mark Mayo
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Mirjam Kaestli
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jessica R Webb
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Robert W Baird
- Territory Pathology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Bart J Currie
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Joshua R Francis
- Menzies School of Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Stephen Muhi
- Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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14
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Currie BJ, Meumann EM, Kaestli M. The Expanding Global Footprint of Burkholderia pseudomallei and Melioidosis. Am J Trop Med Hyg 2023; 108:1081-1083. [PMID: 37160279 PMCID: PMC10540122 DOI: 10.4269/ajtmh.23-0223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023] Open
Affiliation(s)
- Bart J. Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Infectious Diseases Department, Royal Darwin Hospital and Northern Territory Medical Program, Darwin, Northern Territory, Australia
| | - Ella M. Meumann
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Infectious Diseases Department, Royal Darwin Hospital and Northern Territory Medical Program, Darwin, Northern Territory, Australia
- Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia
| | - Mirjam Kaestli
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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15
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Norman FF, Chen LH. Travel-associated melioidosis: a narrative review. J Travel Med 2023; 30:7087080. [PMID: 36971472 DOI: 10.1093/jtm/taad039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Melioidosis, caused by Burkholderia pseudomallei, may be considered a neglected tropical disease that remains underdiagnosed in many geographical areas. Travellers can act as the sentinels of disease activity, and data from imported cases may help complete the global map of melioidosis. METHODS A literature search for imported melioidosis for the period 2016-22 was performed in PubMed and Google Scholar. RESULTS In total, 137 reports of melioidosis associated with travel were identified. The majority were males (71%) and associated with exposure in Asia (77%) (mainly Thailand, 41%, and India, 9%). A minority acquired the infection in the Americas-Caribbean area (6%), Africa (5%) and Oceania (2%). The most frequent comorbidity was diabetes mellitus (25%) followed by underlying pulmonary, liver or renal disease (8, 5 and 3%, respectively). Alcohol/tobacco use were noted for seven and six patients, respectively (5%). Five patients (4%) had associated non-human immunodeficiency virus (HIV)-related immunosuppression, and three patients (2%) had HIV infection. One patient (0.8%) had concomitant coronavirus disease 19. A proportion (27%) had no underlying diseases. The most frequent clinical presentations included pneumonia (35%), sepsis (30%) and skin/soft tissue infections (14%). Most developed symptoms <1 week after return (55%), and 29% developed symptoms >12 weeks after. Ceftazidime and meropenem were the main treatments used during the intensive intravenous phase (52 and 41% of patients, respectively) and the majority (82%) received co-trimoxazole alone/combination, for the eradication phase. Most patients had a favourable outcome/survived (87%). The search also retrieved cases in imported animals or cases secondary to imported commercial products. CONCLUSIONS As post-pandemic travel soars, health professionals should be aware of the possibility of imported melioidosis with its diverse presentations. Currently, no licensed vaccine is available, so prevention in travellers should focus on protective measures (avoiding contact with soil/stagnant water in endemic areas). Biological samples from suspected cases require processing in biosafety level 3 facilities.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA, USA
- Faculty of Medicine, Harvard Medical School, Boston, MA, USA
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16
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Speiser LJ, Graf EH, Seville MT, Singbartl K, Dalton ML, Harrington D, Kretschmer M, Kuljanin M, Zabel K, Sunenshine R, Ruberto I, Venkat H, Grys TE. Burkholderia pseudomallei Laboratory Exposure, Arizona, USA. Emerg Infect Dis 2023; 29:1061-1063. [PMID: 37081593 PMCID: PMC10124630 DOI: 10.3201/eid2905.221865] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
We describe an incidental Burkholderia pseudomallei laboratory exposure in Arizona, USA. Because melioidosis cases are increasing in the United States and B. pseudomallei reservoirs have been discovered in the Gulf Coast Region, US laboratory staff could be at increased risk for B. pseudomallei exposure.
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17
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Deng L, He X, Liu K, Li Y, Xia H, Qian H, Lu X, Mao X, Xiang Y. One-pot RPA-Cas12a assay for instant and visual detection of Burkholderia pseudomallei. Anal Chim Acta 2023; 1252:341059. [PMID: 36935157 DOI: 10.1016/j.aca.2023.341059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/10/2023] [Accepted: 03/06/2023] [Indexed: 03/08/2023]
Abstract
Burkholderia pseudomallei is the causative agent of melioidosis, a potentially life-threatening infectious disease, and poses public health risks in endemic areas. Due to the high mortality, intrinsic antibiotic resistance, and atypical manifestations, establishing a rapid, accurate, and sensitive identification of B. pseudomallei enables earlier diagnosis, proper treatments, and better outcomes of melioidosis. Herein, we present a One-Pot CRISPR-integrated assay for Instant and Visual Detection (termed OPC-IVD) of B. pseudomallei. The integration of recombinase polymerase amplification and CRISPR-Cas12a recognition-activated trans-cleavage, achieved a true all-in-one single-tube reaction system, initiating the amplification and cleavage simultaneously, which realized a facile sample-to-answer assay. This approach could be performed with simplified DNA extraction and completed around 30 min by holding the reaction tube in the hand. The detection limit of our OPC-IVD was determined to be 2.19 copy/uL of plasmid DNA, 12.5 CFU/mL of B. pseudomallei, and 61.5 CFU/mL of bacteria in spiked blood samples, respectively. Furthermore, the introduction of internal amplification control effectively reduced the occurrence of false negatives, which was incorporated in the reaction system, and amplified simultaneously with the target and read by naked eyes. The assay exhibited 100% accuracy when evaluated in clinical isolates and samples. The streamlined workflow of our OPC-IVD of B. pseudomallei enables a field-deployable, instrument-free, and ultra-fast approach that can be utilized by non-expert personnel in the field of molecular diagnosis of melioidosis especially in under-resourced setting.
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Affiliation(s)
- Ling Deng
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xiaoyi He
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Ke Liu
- College of Basic Medical Science, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Yuanli Li
- Department of Clinical Laboratory, Sanya People's Hospital, Sanya, Hainan Province, 570100, China
| | - Han Xia
- Department of Clinical Laboratory, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Hang Qian
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xiaoxue Lu
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xuhu Mao
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Yang Xiang
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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Nelson M, Barnes KB, Davies CH, Cote CK, Meinig JM, Biryukov SS, Dyer DN, Frick O, Heine H, Pfefferle DA, Horstman-Smith A, Barbaras J, Harding SV. The BALB/c Mouse Model for the Evaluation of Therapies to Treat Infections with Aerosolized Burkholderia pseudomallei. Antibiotics (Basel) 2023; 12:antibiotics12030506. [PMID: 36978372 PMCID: PMC10044689 DOI: 10.3390/antibiotics12030506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Burkholderia pseudomallei, the causative agent of the disease melioidosis, has been isolated from the environment in 45 countries. The treatment of melioidosis is complex, requiring lengthy antibiotic regimens, which can result in the relapse of the disease following treatment cessation. It is important that novel therapies to treat infections with B. pseudomallei be assessed in appropriate animal models, and discussions regarding the different protocols used between laboratories are critical. A ‘deep dive’ was held in October 2020 focusing on the use of the BALB/c mouse model and the inhalational route of infection to evaluate new antibiotic therapies.
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Affiliation(s)
- Michelle Nelson
- Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ, UK
| | - Kay B. Barnes
- Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ, UK
| | - Carwyn H. Davies
- Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ, UK
| | - Christopher K. Cote
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - J. Matthew Meinig
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - Sergei S. Biryukov
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - David N. Dyer
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - Ondraya Frick
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - Henry Heine
- Institute for Therapeutic Innovation, University of Florida, Orlando, FL 32827, USA
| | | | | | - Julie Barbaras
- Defense Threat Reduction Agency, Fort Belvoir, VA 22060, USA
| | - Sarah V. Harding
- Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ, UK
- School of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK
- Correspondence:
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Zheng W, Kuang S, Zhong C, Zhou J, Long W, Xiao S, Wu B. Risk Factors for Melioidosis Mortality and Epidemics: A Multicentre, 10-Year Retrospective Cohort Study in Northern Hainan. Infect Dis Ther 2023; 12:951-964. [PMID: 36800150 PMCID: PMC9936936 DOI: 10.1007/s40121-023-00768-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION Burkholderia pseudomallei is a gram-negative environmental bacterium and aetiological agent of melioidosis, a tropical infectious disease with diverse clinical presentations. We aimed to describe the epidemiological and clinical characteristics of melioidosis in northern Hainan and to determine the meteorological factors affecting its morbidity. METHODS We conducted a retrospective, multicentre, observational cohort study of 90 patients with melioidosis admitted to four general hospitals in northern Hainan from 2010 to 2020. Epidemiological, clinical presentation, laboratory and treatment outcome data were collected and analysed. The monthly incidence of melioidosis and meteorological data, including precipitation, temperature, humidity, air pressure and wind speed, for the same period were collected to analyse the relationship between meteorological factors and the incidence of melioidosis. RESULTS Of the 90 patients included in the study, 79 (87.78%) were male. Patient age ranged from 10 to 81 years old, but most patients, namely, 78 (86.67%), were middle-aged and elderly people aged 41-81 years old. Forty-six patients (51.11%) were farmers. The number of cases increased significantly after 2014, with the highest numbers occurring in 2014 and 2016. The highest number of cases occurred in summer and autumn and were associated with abundant rainfall, and 58 cases (64.44%) occurred from July to December. The patients showed diverse presentations and abnormal laboratory parameters: 69 patients (76.67%) had a history of diabetes mellitus; bacteremia was present in 50 patients (55.56%), sepsis was present in 39 patients (43.33%) and pneumonia in 19 patients (21.11%). An average high-sensitivity C-reactive protein (hs-CRP) level of 149.57 ± 13.65 mg/L and a median procalcitonin (PCT) level of 1.31 (0.39, 6.21) ng/mL were observed. Among all the cases, 21 (23.33%) were identified as acute infections, 51 (56.67%) as subacute infections and 18 (20.00%) as chronic infections. Six patients (6.67%) died of illness; five of these patients were male, and five of these patients were middle-aged and elderly patients. The monthly average precipitation was significantly positively correlated with the monthly average incidence of melioidosis (r = 0.74, P < 0.01). CONCLUSION Male patients, farmers and especially middle-aged and elderly individuals with a history of diabetes mellitus accounted for most of the patients. The majority of cases were concentrated in coastal areas. Most cases of melioidosis occurred during the rainy seasons, and the monthly average precipitation was an independent factor affecting the average monthly incidence of melioidosis.
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Affiliation(s)
- Wanting Zheng
- International School of Public Health and One Health, Heinz Mehlhorn Academician Workstation, Hainan Medical University, Haikou, 571199, China
| | - Shicheng Kuang
- Department of Pharmacy, Hainan Affiliated Hospital of Hainan Medical University, Hainan General Hospital, Haikou, 570311, China
| | - Chengwang Zhong
- International School of Public Health and One Health, Heinz Mehlhorn Academician Workstation, Hainan Medical University, Haikou, 571199, China
| | - Jing Zhou
- International School of Public Health and One Health, Heinz Mehlhorn Academician Workstation, Hainan Medical University, Haikou, 571199, China
| | - Wenfang Long
- International School of Public Health and One Health, Heinz Mehlhorn Academician Workstation, Hainan Medical University, Haikou, 571199, China
| | - Sha Xiao
- International School of Public Health and One Health, Heinz Mehlhorn Academician Workstation, Hainan Medical University, Haikou, 571199, China.
| | - Biao Wu
- Department of Hospital Infection Management and Diseases Control and Prevention, Center for Infection Diseases, Hainan Affiliated Hospital of Hainan Medical University, Hainan General Hospital, Haikou, 570311, China.
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20
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Petras JK, Elrod MG, Ty M, Adams P, Zahner D, Adams A, Calfee MW, Tomlinson C, Serre S, Ryan S, Jakabhazy E, Gee JE, Weiner Z, Bower WA, Negron ME, Hoffmaster AR, Honza H. Notes from the Field: Burkholderia pseudomallei Detected in a Raccoon Carcass Linked to a Multistate Aromatherapy-Associated Melioidosis Outbreak - Texas, 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:1597-1598. [PMID: 36520678 PMCID: PMC9762901 DOI: 10.15585/mmwr.mm7150a5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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21
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Melioidosis and Burkholderia pseudomallei : progress in epidemiology, diagnosis, treatment and vaccination. Curr Opin Infect Dis 2022; 35:517-523. [PMID: 35942848 DOI: 10.1097/qco.0000000000000869] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Melioidosis and its causative bacterium Burkholderia pseudomallei are being found in unexpected locations and bacterial genotyping is providing new insights into global spread and where and how individuals are being infected. This review summarizes recent studies covering the epidemiology, diagnosis, treatment, and prevention of melioidosis. RECENT FINDINGS Whole-genome sequencing of B. pseudomallei from patients and environmental sampling is informing the phylogeography of B. pseudomallei at regional, continental, and global levels, while also defining the epidemiology for individual cases. The situation in Africa remains the most unresolved, while the evolving story of B. pseudomallei in the Americas may establish that B. pseudomallei is endemic in parts of southern USA. Guidelines for diagnosis and treatment of melioidosis are well established, and published mortality has decreased from 50% or higher to 10% or lower in some countries but access to laboratory and therapeutic resources are not available or are extremely limited in many melioidosis-endemic regions. SUMMARY The enormous clinical diversity of melioidosis and the complexities of laboratory diagnosis and of treatment make it a sentinel disease for highlighting the continuing global disparities in access to and provision of healthcare.
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22
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Borton D. Melioidosis: Emerging beyond endemic areas. Nursing 2022; 52:29-34. [PMID: 36129502 DOI: 10.1097/01.nurse.0000872460.50198.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT Recent cases suggest that melioidosis, an infection caused by Burkholderia pseudomallei, is an emerging infectious disease. Nurses have a key role in the care of patients with melioidosis. This article provides an overview of the epidemiology, clinical presentation, diagnosis, treatment, and prevention of melioidosis, and discusses unusual, non-travel-related cases of melioidosis.
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Affiliation(s)
- Dorothy Borton
- Dorothy Borton is an independent infection prevention consultant based in Philadelphia, Pa
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23
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Klimko CP, Shoe JL, Rill NO, Hunter M, Dankmeyer JL, Talyansky Y, Schmidt LK, Orne CE, Fetterer DP, Biryukov SS, Burtnick MN, Brett PJ, DeShazer D, Cote CK. Layered and integrated medical countermeasures against Burkholderia pseudomallei infections in C57BL/6 mice. Front Microbiol 2022; 13:965572. [PMID: 36060756 PMCID: PMC9432870 DOI: 10.3389/fmicb.2022.965572] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Burkholderia pseudomallei, the gram-negative bacterium that causes melioidosis, is notoriously difficult to treat with antibiotics. A significant effort has focused on identifying protective vaccine strategies to prevent melioidosis. However, when used as individual medical countermeasures both antibiotic treatments (therapeutics or post-exposure prophylaxes) and experimental vaccine strategies remain partially protective. Here we demonstrate that when used in combination, current vaccine strategies (recombinant protein subunits AhpC and/or Hcp1 plus capsular polysaccharide conjugated to CRM197 or the live attenuated vaccine strain B. pseudomallei 668 ΔilvI) and co-trimoxazole regimens can result in near uniform protection in a mouse model of melioidosis due to apparent synergy associated with distinct medical countermeasures. Our results demonstrated significant improvement when examining several suboptimal antibiotic regimens (e.g., 7-day antibiotic course started early after infection or 21-day antibiotic course with delayed initiation). Importantly, this combinatorial strategy worked similarly when either protein subunit or live attenuated vaccines were evaluated. Layered and integrated medical countermeasures will provide novel treatment options for melioidosis as well as diseases caused by other pathogens that are refractory to individual strategies, particularly in the case of engineered, emerging, or re-emerging bacterial biothreat agents.
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Affiliation(s)
- Christopher P. Klimko
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Jennifer L. Shoe
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Nathaniel O. Rill
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Melissa Hunter
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Jennifer L. Dankmeyer
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Yuli Talyansky
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Lindsey K. Schmidt
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, NV, United States
| | - Caitlyn E. Orne
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, NV, United States
| | - David P. Fetterer
- Biostatistics Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Sergei S. Biryukov
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Mary N. Burtnick
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, NV, United States
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paul J. Brett
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, NV, United States
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - David DeShazer
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
| | - Christopher K. Cote
- Bacteriology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, United States
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24
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Meumann EM, Krause VL, Baird R, Currie BJ. Using Genomics to Understand the Epidemiology of Infectious Diseases in the Northern Territory of Australia. Trop Med Infect Dis 2022; 7:tropicalmed7080181. [PMID: 36006273 PMCID: PMC9413455 DOI: 10.3390/tropicalmed7080181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
The Northern Territory (NT) is a geographically remote region of northern and central Australia. Approximately a third of the population are First Nations Australians, many of whom live in remote regions. Due to the physical environment and climate, and scale of social inequity, the rates of many infectious diseases are the highest nationally. Molecular typing and genomic sequencing in research and public health have provided considerable new knowledge on the epidemiology of infectious diseases in the NT. We review the applications of genomic sequencing technology for molecular typing, identification of transmission clusters, phylogenomics, antimicrobial resistance prediction, and pathogen detection. We provide examples where these methodologies have been applied to infectious diseases in the NT and discuss the next steps in public health implementation of this technology.
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Affiliation(s)
- Ella M. Meumann
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin 0810, Australia
- Correspondence:
| | - Vicki L. Krause
- Northern Territory Centre for Disease Control, Northern Territory Government, Darwin 0810, Australia
| | - Robert Baird
- Territory Pathology, Royal Darwin Hospital, Darwin 0810, Australia
| | - Bart J. Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin 0810, Australia
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25
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Wang Y, Li X, Dance DAB, Xia H, Chen C, Luo N, Li A, Li Y, Zhu Q, Sun Q, Wu X, Zeng Y, Chen L, Tian S, Xia Q. A novel lytic phage potentially effective for phage therapy against Burkholderia pseudomallei in the tropics. Infect Dis Poverty 2022; 11:87. [PMID: 35927751 PMCID: PMC9351088 DOI: 10.1186/s40249-022-01012-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Burkholderia pseudomallei is a tropical pathogen that causes melioidosis. Its intrinsic drug-resistance is a leading cause of treatment failure, and the few available antibiotics require prolonged use to be effective. This study aimed to assess the clinical potential of B. pseudomallei phages isolated from Hainan, China.
Methods Burkholderia pseudomallei strain (HNBP001) was used as the isolation host, and phages were recovered from domestic environmental sources, which were submitted to the host range determination, lytic property assays, and stability tests. The best candidate was examined via the transmission electron microscope for classification. With its genome sequenced and analyzed, its protective efficacy against B. pseudomallei infection in A549 cells and Caenorhabditis elegans was evaluated, in which cell viability and survival rates were compared using the one-way ANOVA method and the log-rank test. Results A phage able to lyse 24/25 clinical isolates was recovered. It was classified in the Podoviridae family and was found to be amenable to propagation. Under the optimal multiplicity of infection (MOI) of 0.1, an eclipse period of around 20 min and a high titer (1012 PFU/ml) produced within 1 h were demonstrated. This phage was found stabile at a wide range of temperatures (24, 37, 40, 50, and 60 °C) and pH values (3–12). After being designated as vB_BpP_HN01, it was fully sequenced, and the 71,398 bp linear genome, containing 93 open reading frames and a tRNA-Asn, displayed a low sequence similarity with known viruses. Additionally, protective effects of applications of vB_BpP_HN01 (MOI = 0.1 and MOI = 1) alone or in combination with antibiotics were found to improve viability of infected cells (70.6 ± 6.8%, 85.8 ± 5.7%, 91.9 ± 1.8%, and 96.8 ± 1.8%, respectively). A significantly reduced mortality (10%) and a decreased pathogen load were demonstrated in infected C. elegans following the addition of this phage. Conclusions As the first B. pseudomallei phage was isolated in Hainan, China, phage vB_BpP_HN01 was characterized by promising lytic property, stability, and efficiency of bacterial elimination during the in vitro/vivo experiments. Therefore, we can conclude that it is a potential alternative agent for combating melioidosis. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-01012-9.
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Affiliation(s)
- Yanshuang Wang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China.,Department of Clinical Laboratory, The Second Affiliated Hospital, Hainan Medical University, Haikou, China
| | - Xuemiao Li
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - David A B Dance
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao People's Democratic Republic.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Han Xia
- Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, Hubei, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Chen Chen
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Nini Luo
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Anyang Li
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Yanmei Li
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Qiao Zhu
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Qinghui Sun
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Xingyong Wu
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Yingfei Zeng
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Lin Chen
- Department of Clinical Laboratory, The Second Affiliated Hospital, Hainan Medical University, Haikou, China
| | - Shen Tian
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China.
| | - Qianfeng Xia
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China.
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26
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Hall CM, Romero-Alvarez D, Martz M, Santana-Propper E, Versluis L, Jiménez L, Alkishe A, Busch JD, Maness T, Stewart J, Sidwa T, Gee JE, Elrod MG, Weiner Z, Hoffmaster AR, Sahl JW, Salzer JS, Peterson AT, Kieffer A, Wagner DM. Low risk of acquiring melioidosis from the environment in the continental United States. PLoS One 2022; 17:e0270997. [PMID: 35905049 PMCID: PMC9337633 DOI: 10.1371/journal.pone.0270997] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022] Open
Abstract
Melioidosis is an underreported human disease of tropical and sub-tropical regions caused by the saprophyte Burkholderia pseudomallei. Although most global melioidosis cases are reported from tropical regions in Southeast Asia and northern Australia, there are multiple occurrences from sub-tropical regions, including the United States (U.S.). Most melioidosis cases reported from the continental U.S. are the result of acquiring the disease during travel to endemic regions or from contaminated imported materials. Only two human melioidosis cases from the continental U.S. have likely acquired B. pseudomallei directly from local environments and these cases lived only ~7 km from each other in rural Texas. In this study, we assessed the risk of acquiring melioidosis from the environment within the continental U.S. by surveying for B. pseudomallei in the environment in Texas where these two human melioidosis cases likely acquired their infections. We sampled the environment near the homes of the two cases and at additional sampling locations in surrounding counties in Texas that were selected based on ecological niche modeling. B. pseudomallei was not detected at the residences of these two cases or in the surrounding region. These negative data are important to demonstrate that B. pseudomallei is rare in the environment in the U.S. even at locations where locally acquired human cases likely have occurred, documenting the low risk of acquiring B. pseudomallei infection from the environment in the continental U.S.
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Affiliation(s)
- Carina M. Hall
- Pathogen Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Daniel Romero-Alvarez
- University of Kansas, Lawrence, Kansas, United States of America
- OneHealth Research Group, Facultad de Medicina, Universidad de las Américas, Quito, Ecuador
| | - Madison Martz
- Pathogen Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Ella Santana-Propper
- Pathogen Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Lora Versluis
- Pathogen Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Laura Jiménez
- University of Kansas, Lawrence, Kansas, United States of America
| | | | - Joseph D. Busch
- Pathogen Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Trevor Maness
- Texas Department of State Health Services, San Antonio, Texas, United States of America
| | - Jonathan Stewart
- Texas Department of State Health Services, San Antonio, Texas, United States of America
| | - Tom Sidwa
- Texas Department of State Health Services, Austin, Texas, United States of America
| | - Jay E. Gee
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mindy G. Elrod
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Zachary Weiner
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alex R. Hoffmaster
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jason W. Sahl
- Pathogen Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Johanna S. Salzer
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Amanda Kieffer
- Texas Department of State Health Services, San Antonio, Texas, United States of America
| | - David M. Wagner
- Pathogen Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
- * E-mail:
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27
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Mohapatra PR, Mishra B. Burden of melioidosis in India and South Asia: Challenges and ways forward. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 2:100004. [PMID: 37383295 PMCID: PMC10306050 DOI: 10.1016/j.lansea.2022.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Melioidosis is caused by the environmental bacterium Burkholderia pseudomallei. South Asia is estimated to have 44% of the global disease burden. Among South Asian countries, Bangladesh and Sri Lanka are considered endemic for melioidosis; a few cases have been reported from Nepal, and a few imported cases from Pakistan have also been reported. India has experienced an increase in numbers of melioidosis cases in the recent years. The bacteria is inherently present in the soil and enters the human body via skin abrasions, inhalation, or ingestion. As clinicians are often ignorant about the similar characteristics of this disease and several other common tropical diseases, it causes a major delay in the timely diagnosis and management. The organism is easily mistaken as Pseudomonas spp in microbiology laboratories and may be dismissed as a common laboratory contaminant. The poor diagnostic sensitivity of blood culture also leads to missed diagnosis. Hence, both clinical ignorance and missed laboratory diagnosis have misrepresented melioidosis as a rare entity. The key preventive interventions are avoiding contact with loose and muddy soils of meliodosis-endemic areas, and provision of safe drinking water. The present article describes the various possible attributes for melioidosis underdiagnosis and the challenges of improving the diagnosis in conjunction with viable solutions. Funding None.
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Affiliation(s)
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India-751019
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28
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Birnie E, Biemond JJ, Wiersinga WJ. Drivers of melioidosis endemicity: epidemiological transition, zoonosis, and climate change. Curr Opin Infect Dis 2022; 35:196-204. [PMID: 35665713 PMCID: PMC10128909 DOI: 10.1097/qco.0000000000000827] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Melioidosis, caused by the soil-dwelling bacterium Burkholderia pseudomallei, is a tropical infection associated with high morbidity and mortality. This review summarizes current insights into melioidosis' endemicity, focusing on epidemiological transitions, zoonosis, and climate change. RECENT FINDINGS Estimates of the global burden of melioidosis affirm the significance of hot-spots in Australia and Thailand. However, it also highlights the paucity of systematic data from South Asia, The Americas, and Africa. Globally, the growing incidence of diabetes, chronic renal and (alcoholic) liver diseases further increase the susceptibility of individuals to B. pseudomallei infection. Recent outbreaks in nonendemic regions have further exposed the hazard from the trade of animals and products as potential reservoirs for B. pseudomallei. Lastly, global warming will increase precipitation, severe weather events, soil salinity and anthrosol, all associated with the occurrence of B. pseudomallei. SUMMARY Epidemiological transitions, zoonotic hazards, and climate change are all contributing to the emergence of novel melioidosis-endemic areas. The adoption of the One Health approach involving multidisciplinary collaboration is important in unraveling the real incidence of B. pseudomallei, as well as reducing the spread and associated mortality.
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Affiliation(s)
- Emma Birnie
- Amsterdam UMC location University of Amsterdam, Center for Experimental and Molecular Medicine
- Amsterdam UMC location University of Amsterdam, Division of Infectious Diseases, Meibergdreef 9, Amsterdam, Netherlands
| | - Jason J. Biemond
- Amsterdam UMC location University of Amsterdam, Center for Experimental and Molecular Medicine
| | - W. Joost Wiersinga
- Amsterdam UMC location University of Amsterdam, Center for Experimental and Molecular Medicine
- Amsterdam UMC location University of Amsterdam, Division of Infectious Diseases, Meibergdreef 9, Amsterdam, Netherlands
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Multistate outbreak of melioidosis associated with imported aromatherapy spray. J Paediatr Child Health 2022. [PMID: 35338757 DOI: 10.1111/jpc.15956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chieng R. Melioidosis. WIKIJOURNAL OF MEDICINE 2022. [DOI: 10.15347/wjm/2022.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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