Melioidosis

W. Joost Wiersinga, Harjeet S. Virk, Alfredo Torres, Bart J. Currie, Sharon J. Peacock, David A.B. Dance, Direk Limmathurotsakul

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Burkholderia pseudomallei is a Gram-negative environmental bacterium and the aetiological agent of melioidosis, a life-threatening infection that is estimated to account for â 1/489,000 deaths per year worldwide. Diabetes mellitus is a major risk factor for melioidosis, and the global diabetes pandemic could increase the number of fatalities caused by melioidosis. Melioidosis is endemic across tropical areas, especially in southeast Asia and northern Australia. Disease manifestations can range from acute septicaemia to chronic infection, as the facultative intracellular lifestyle and virulence factors of B. pseudomallei promote survival and persistence of the pathogen within a broad range of cells, and the bacteria can manipulate the host's immune responses and signalling pathways to escape surveillance. The majority of patients present with sepsis, but specific clinical presentations and their severity vary depending on the route of bacterial entry (skin penetration, inhalation or ingestion), host immune function and bacterial strain and load. Diagnosis is based on clinical and epidemiological features as well as bacterial culture. Treatment requires long-term intravenous and oral antibiotic courses. Delays in treatment due to difficulties in clinical recognition and laboratory diagnosis often lead to poor outcomes and mortality can exceed 40% in some regions. Research into B. pseudomallei is increasing, owing to the biothreat potential of this pathogen and increasing awareness of the disease and its burden; however, better diagnostic tests are needed to improve early confirmation of diagnosis, which would enable better therapeutic efficacy and survival.

Original languageEnglish (US)
Article number17107
JournalNature Reviews Disease Primers
Volume4
DOIs
StatePublished - Feb 1 2018

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Melioidosis
Burkholderia pseudomallei
Sepsis
Southeastern Asia
Survival
Bacterial Load
Clinical Laboratory Techniques
Pandemics
Virulence Factors
Infection
Gram-Negative Bacteria
Routine Diagnostic Tests
Inhalation
Life Style
Early Diagnosis
Diabetes Mellitus
Therapeutics
Eating
Anti-Bacterial Agents
Bacteria

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wiersinga, W. J., Virk, H. S., Torres, A., Currie, B. J., Peacock, S. J., Dance, D. A. B., & Limmathurotsakul, D. (2018). Melioidosis. Nature Reviews Disease Primers, 4, [17107]. https://doi.org/10.1038/nrdp.2017.107

Melioidosis. / Wiersinga, W. Joost; Virk, Harjeet S.; Torres, Alfredo; Currie, Bart J.; Peacock, Sharon J.; Dance, David A.B.; Limmathurotsakul, Direk.

In: Nature Reviews Disease Primers, Vol. 4, 17107, 01.02.2018.

Research output: Contribution to journalArticle

Wiersinga, WJ, Virk, HS, Torres, A, Currie, BJ, Peacock, SJ, Dance, DAB & Limmathurotsakul, D 2018, 'Melioidosis', Nature Reviews Disease Primers, vol. 4, 17107. https://doi.org/10.1038/nrdp.2017.107
Wiersinga WJ, Virk HS, Torres A, Currie BJ, Peacock SJ, Dance DAB et al. Melioidosis. Nature Reviews Disease Primers. 2018 Feb 1;4. 17107. https://doi.org/10.1038/nrdp.2017.107
Wiersinga, W. Joost ; Virk, Harjeet S. ; Torres, Alfredo ; Currie, Bart J. ; Peacock, Sharon J. ; Dance, David A.B. ; Limmathurotsakul, Direk. / Melioidosis. In: Nature Reviews Disease Primers. 2018 ; Vol. 4.
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