MyMedR

Fulltext Evaluation of recombinant antigens for diagnosis of melioidosis

Allwood EM, Logue CA, Hafner GJ, Ketheesan N, Norton RE, Peak IR, et al.

FEMS Immunol. Med. Microbiol., 2008 Oct;54(1):144-53.

PMID: 18657105 DOI: 10.1111/j.1574-695X.2008.00464.x

Burkholderia pseudomallei, the causative agent of melioidosis, is endemic to Southeast Asia and northern Australia. Clinical manifestations of the disease are diverse, ranging from chronic localized infection to acute septicaemia, with death occurring within 24-48 h after the onset of symptoms. Definitive diagnosis of melioidosis involves bacterial culture and identification, with results obtained within 3-4 days. This delayed diagnosis is a major contributing factor to high mortality rates. Rapid diagnosis is vital for successful management of the disease. This study describes the purification and evaluation of three recombinant antigenic proteins, BPSL0972, BipD and OmpA from B. pseudomallei 08, for their potential in the serodiagnosis of melioidosis using an indirect enzyme-linked immunosorbent assay (ELISA) method. The recombinant proteins were evaluated using 74 serum samples from culture-confirmed melioidosis patients from Malaysia, Thailand and Australia. In addition, 62 nonmelioidosis controls consisting of serum samples from clinically suspected melioidosis patients (n=20) and from healthy blood donors from an endemic region (n=18) and a nonendemic region (n=24) were included. The indirect ELISAs using BipD and BPSL0972 as antigens demonstrated poor to moderate sensitivities (42% and 51%, respectively) but good specificity (both 100%). In contrast, the indirect ELISA using OmpA as an antigen achieved 95% sensitivity and 98% specificity. These results highlight the potential for OmpA to be used in the serodiagnosis of melioidosis in an endemic area.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Neonatal meliodosis: very rare but be aware

Ang YM

Med J Malaysia, 2005 Mar;60(1):99-102.

PMID: 16250291 MyJurnal

Meliodosis is an infectious disease encountered mainly in tropics. It is not an uncommon problem in Malaysia especially in areas with agricultural activities. Although it can occur in all age groups, there have been few reported cases in children. Men are more commonly affected than women due to outdoor activities. Neonatal cases have been reported in Hawaii and Thailand. These infants presented with neonatal sepsis or meningitis. The mode of transmission to these infants has not been elucidated. This is the report of such a case first reported in Hospital Tengku Ampun Afzan, Kuantan.

Matched MeSH terms: Melioidosis/diagnosis*

Cutaneous melioidosis and necrotizing fasciitis with pulmonary involvement in a chicken seller

Ariza A

Southeast Asian J. Trop. Med. Public Health, 2008 Jul;39(4):656-8.

PMID: 19058602

Melioidosis is endemic in Malaysia. Cutaneous melioidosis is one manifestation and it may progress to necrotizing fasciitis. The case highlights a 46-year-old male, a chicken-seller who presented with scalp cellulitis which later progressed to necrotizing fasciitis and pneumonia are presented here. It illustrates several key features of the presentation, prompt laboratory diagnosis and early treatment of melioidosis which saved the patient's life.

Matched MeSH terms: Melioidosis/diagnosis*

Unrecognised infection in a cystic fibrosis patient

Asiah K, Hanifah YA, Norzila MZ, Hasniah L, Rusanida A

J Paediatr Child Health, 2006 Apr;42(4):217-8.

PMID: 16630326

We report a 17-year-old Malay boy with cystic fibrosis who over a 14-month period experienced worsening respiratory symptoms and deteriorating lung function. Burkholderia pseudomallei was eventually isolated from his sputum. He improved clinically following treatment for meliodosis and his lung function returned to normal.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!

Auvens C, Neuwirth C, Piroth L, Blot M

BMJ Case Rep, 2019 May 22;12(5).

PMID: 31122956 DOI: 10.1136/bcr-2018-228856

Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Cutaneous melioidosis in a healthy Danish man after travelling to South-East Asia

Bodilsen J, Langgaard H, Nielsen HL

BMJ Case Rep, 2015 Jan 16;2015.

PMID: 25596295 DOI: 10.1136/bcr-2014-207340

A healthy Danish man presented with infected prepatellar bursitis 8 months after being involved in a car accident in Malaysia resulting in exposure of a laceration of his knee to stagnant water. Tissue samples grew Burkholderia pseudomallei and diagnostic work up revealed no secondary foci. The patient was successfully treated with surgical debridement and 3 months of oral trimethoprim-sulfamethoxazole. At 6 months follow-up the patient was without relapse.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Disseminated melioidosis in early pregnancy - an unproven cause of foetal loss

Chang CY, Lau NLJ, Currie BJ, Podin Y

BMC Infect Dis, 2020 Mar 06;20(1):201.

PMID: 32143598 DOI: 10.1186/s12879-020-4937-8

BACKGROUND: Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is difficult to diagnose due to its diverse clinical manifestations, which often delays administration of appropriate antibiotic therapy.

CASE PRESENTATION: Melioidosis is uncommon in pregnancy but both spontaneous abortion and neonatal melioidosis have been reported. We report a case of bacteraemic melioidosis in a young woman with a subsequent spontaneous abortion, with B. pseudomallei cultured from a high vaginal swab as well as blood.

CONCLUSION: It remains unclear in this and previously reported cases as to whether the maternal melioidosis was sexually transmitted.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Systemic lupus erythematosus and melioidosis

Che Rahim MJ, Mohammad N, Kamaruddin MI, Wan Ghazali WS

BMJ Case Rep, 2019 Jul 01;12(7).

PMID: 31266760 DOI: 10.1136/bcr-2019-229974

We reported a case of a young female patient presented with sepsis and diagnosed with melioidosis and systemic lupus erythematosus (SLE) within the same admission. She presented with 1-week history of productive cough, progressive dyspnoea together with prolonged fever, arthralgia, rashes and oral ulcers. She had septicemic shock, respiratory failure requiring intubation and ventilation in intensive care unit and subsequently developed acute renal failure requiring haemodialysis. Antibiotics and immunosuppressive treatment including low-dose intravenous cyclophosphamide were commenced. She had a remarkable recovery and was discharged after 6 weeks. There was no evidence of active SLE or relapse of melioidosis during clinic follow-ups.

Matched MeSH terms: Melioidosis/diagnosis*

Detection of immunoglobulins M and G using culture filtrate antigen of Burkholderia pseudomallei

Chenthamarakshan V, Vadivelu J, Puthucheary SD

Diagn Microbiol Infect Dis, 2001 Jan;39(1):1-7.

PMID: 11173184

IgM and IgG based ELISA systems were developed using the culture filtrate antigen (CFA) of Burkholderia pseudomallei. The assays were evaluated using 95 sera from 66 septicemic cases and 47 sera from 20 cases with localized melioidosis. In addition 65 sera from culture negative cases that were also serologically negative for other endemic infections clinically suspected of melioidosis were included. These were compared with sera from 260 non-melioidosis cases, 169 sera from individuals with high risk of acquiring the infection and 48 sera from healthy controls. The IgG-ELISA was 96% sensitive and 94% specific. All sera from cases with septicemic and localized infections and 61 of 63 sera from clinically suspected melioidosis cases were positive for IgG antibody. The geometric mean titre index (GMTI) values of IgG antibody in melioidosis cases were significantly higher (p < 0.0005) compared to that of healthy subjects, high risk group and subjects with non-melioidosis infections. The sensitivity and specificity of IgM ELISA was 74 and 99% respectively. The GMTI value of IgM antibody in the sera of melioidosis cases was significantly higher as compared to that of non-melioidosis disease controls (p < or = 0.001). These results demonstrate that the detection of IgG is a better indicator of the disease in the diagnosis of melioidosis.

Matched MeSH terms: Melioidosis/diagnosis*

Transcriptome analysis of Burkholderia pseudomallei T6SS identifies Hcp1 as a potential serodiagnostic marker

Chieng S, Mohamed R, Nathan S

Microb Pathog, 2015 Feb;79:47-56.

PMID: 25616255 DOI: 10.1016/j.micpath.2015.01.006

Burkholderia pseudomallei, the causative agent of melioidosis, is able to survive extreme environments and utilizes various virulence factors for survival and pathogenicity. To compete and survive within these different ecological niches, B. pseudomallei has evolved specialized pathways, including the Type VI secretion systems (T6SSs), that have a role in pathogenesis as well as interbacterial interactions. We examined the expression profile of B. pseudomallei T6SS six gene clusters during infection of U937 macrophage cells. T6SS-5 was robustly transcribed while the other five clusters were not significantly regulated proposing the utility of T6SS-5 as a potential biomarker of exposure to B. pseudomallei. Transcription of T6SS regulators VirAG and BprB was also not significant during infection when compared to bacteria grown in culture. Guided by these findings, three highly expressed T6SS genes, tssJ-4, hcp1 and tssE-5, were expressed as recombinant proteins and screened against melioidosis patient sera by western analysis and ELISA. Only Hcp1 was reactive by both types of analysis. The recombinant Hcp1 protein was further evaluated against a cohort of melioidosis patients (n = 32) and non-melioidosis individuals (n = 20) sera and the data clearly indicates a higher sensitivity (93.7%) and specificity (100%) for Hcp1 compared to bacterial lysate. The detection of anti-Hcp1 antibodies in patients' sera indicating the presence of B. pseudomallei highlights the potential of Hcp1 to be further developed as a serodiagnostic marker for melioidosis.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Burkholderia pseudomallei Detection among Hospitalized Patients, Sarawak

Choi JY, Hii KC, Bailey ES, Chuang JY, Tang WY, Yuen Wong EK, et al.

Am J Trop Med Hyg, 2020 02;102(2):388-391.

PMID: 31769397 DOI: 10.4269/ajtmh.19-0625

Burkholderia pseudomallei infections are prevalent in Southeast Asia and northern Australia and often misdiagnosed. Diagnostics are often neither sensitive nor rapid, contributing up to 50% mortality rate. In this 2018 pilot study, we enrolled 100 patients aged 6 months-79 years from Kapit Hospital in Sarawak, Malaysia, with symptoms of B. pseudomallei infection. We used three different methods for the detection of B. pseudomallei: a real-time polymerase chain reaction (PCR) assay, a rapid lateral flow immunoassay, and the standard-of-care bacterial culture-the gold standard. Among the 100 participants, 24 (24%) were positive for B. pseudomallei by one or more of the detection methods. Comparing the two individual diagnostic methods against the gold standard-bacterial culture-of any positive test, there was low sensitivity for each test (25-44%) but high specificity (93-98%). It seems clear that more sensitive diagnostics or a sensitive screening diagnostic followed by specific confirmatory diagnostic is needed for this disease.

Matched MeSH terms: Melioidosis/diagnosis*

Clinical characteristics and outcomes of bacteraemic melioidosis in a teaching hospital in a northeastern state of Malaysia: a five-year review

Deris ZZ, Hasan H, Siti Suraiya MN

J Infect Dev Ctries, 2010 Aug 04;4(7):430-5.

PMID: 20818090

BACKGROUND: Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia.

METHODOLOGY: From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia.

RESULTS: Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission.

CONCLUSIONS: The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Molecular investigations of a locally acquired case of melioidosis in Southern AZ, USA

Engelthaler DM, Bowers J, Schupp JA, Pearson T, Ginther J, Hornstra HM, et al.

PLoS Negl Trop Dis, 2011 Oct;5(10):e1347.

PMID: 22028940 DOI: 10.1371/journal.pntd.0001347

Melioidosis is caused by Burkholderia pseudomallei, a Gram-negative bacillus, primarily found in soils in Southeast Asia and northern Australia. A recent case of melioidosis in non-endemic Arizona was determined to be the result of locally acquired infection, as the patient had no travel history to endemic regions and no previous history of disease. Diagnosis of the case was confirmed through multiple microbiologic and molecular techniques. To enhance the epidemiological analysis, we conducted several molecular genotyping procedures, including multi-locus sequence typing, SNP-profiling, and whole genome sequence typing. Each technique has different molecular epidemiologic advantages, all of which provided evidence that the infecting strain was most similar to those found in Southeast Asia, possibly originating in, or around, Malaysia. Advancements in new typing technologies provide genotyping resolution not previously available to public health investigators, allowing for more accurate source identification.

Matched MeSH terms: Melioidosis/diagnosis*

In situ hybridization to detect and identify Burkholderia pseudomallei in human melioidosis

Eu LC, Ong KC, Hiu J, Vadivelu J, Nathan S, Wong KT

Mod Pathol, 2014 May;27(5):657-64.

PMID: 24186135 DOI: 10.1038/modpathol.2013.184

Burkholderia pseudomallei causes a potentially fatal infection called melioidosis. We have developed a nonfluorescent, colorimetric in situ hybridization assay using a specific probe to target 16s rRNA of B. pseudomallei in formalin-fixed, paraffin-embedded infected tissues for diagnostic purposes and to study infectious disease pathology. A 63-base pair DNA probe was synthesized and labeled with digoxigenin by PCR. Probe specificity was confirmed by BLAST analysis and by testing on appropriate microbial controls. The in situ hybridization assay was specifically and consistently positive for B. pseudomallei, showing strongly and crisply stained, single bacillus and bacilli clusters in mainly inflamed tissues in seven human acute melioidosis cases and experimentally infected mouse tissues. Intravascular and extravascular bacilli were detected in both intracellular and extracellular locations in various human organs, including lung, spleen, kidney, liver, bone marrow, and aortic mycotic aneurysm, particularly in the inflamed areas. Intravascular, intracellular bacteria in melioidosis have not been previously reported. Although the identity of infected intravascular leukocytes has to be confirmed, extravascular, intracellular bacilli appear to be found mainly within macrophages and neutrophils. Rarely, large intravascular, extracellular bacillary clusters/emboli could be detected in both human and mouse tissues. B. cepacia and non-Burkholderia pathogens (16 microbial species) all tested negative. Nonpathogenic B. thailandensis showed some cross-hybridization but signals were less intense. This in situ hybridization assay could be usefully adapted for B. pseudomallei identification in other clinical specimens such as pus and sputum.

Matched MeSH terms: Melioidosis/diagnosis*

An improved selective and differential medium for the isolation of Burkholderia pseudomallei from clinical specimens

Francis A, Aiyar S, Yean CY, Naing L, Ravichandran M

Diagn Microbiol Infect Dis, 2006 Jun;55(2):95-9.

PMID: 16626918

Isolation and culture of Burkholderia pseudomallei remains the main stay in the diagnosis of melioidosis. Thus, the search for selective and differential media for B. pseudomallei has been ongoing. A number of such media have been reported with varying efficacy. Ashdown medium is the most established selective medium for the isolation of B. pseudomallei. There are no reports of differential media differentiating B. pseudomallei from Burkholderia cepacia. This report documents such a selective and differentiating medium for B. pseudomallei. Of a total of 1042 clinical specimens containing mixed flora and gram-negative isolates that were tested on this medium, 16 of the specimens yielded B. pseudomallei. The isolation rate was found to be 1.5%. This medium was found to be simple and inexpensive, can be made by small laboratories, and called as Francis medium. Based on the colony morphology and color, a preliminary report can be made within 18-24 h for the presence of B. pseudomallei. Our study showed that this medium had an overall sensitivity of 78.4% with a specificity of 92.2%. The use of this medium as an early diagnostic tool will help to reduce mortality and morbidity of melioidosis patients.

Matched MeSH terms: Melioidosis/diagnosis

Melioidosis presenting as spinal epidural abscess

Ganesan D, Puthucheary SD, Waran V

Br J Neurosurg, 2003 Dec;17(6):568-71.

PMID: 14756491

Central nervous system melioidosis is an unusual infection in humans. This article reports a case of melioidosis presenting as an acute spinal epidural abscess. A discussion of this case and its management together with a brief review of melioidosis of the central nervous system is presented.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Multiple-antigen ELISA for melioidosis--a novel approach to the improved serodiagnosis of melioidosis

Hara Y, Chin CY, Mohamed R, Puthucheary SD, Nathan S

BMC Infect Dis, 2013;13:165.

PMID: 23556548 DOI: 10.1186/1471-2334-13-165

Burkholderia pseudomallei, the causative agent of melioidosis, is endemic to Southeast Asia and northern Australia. Clinical manifestations of disease are diverse, ranging from chronic infection to acute septicaemia. The current gold standard of diagnosis involves bacterial culture and identification which is time consuming and often too late for early medical intervention. Hence, rapid diagnosis of melioidosis is crucial for the successful management of melioidosis.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Comparison of in-house IgM and IgG ELISAs for the serodiagnosis of melioidosis in Malaysia

Hii SYF, Ali NA, Ahmad N, Amran F

J Med Microbiol, 2017 Nov;66(11):1623-1627.

PMID: 29048275 DOI: 10.1099/jmm.0.000611

Melioidosis is an endemic infectious disease in Southeast Asia and northern Australia, caused by Burkholderia pseudomallei. However, the incidence rate in Malaysia is not well documented. The high mortality rate and broad range of clinical presentations require rapid and accurate diagnosis for appropriate treatment. This study compared the efficacy of in-house IgM and IgG ELISA methods using a local B. pseudomallei strain. The diagnostic accuracy of the in-house IgG ELISA was better than that of the IgM ELISA: sensitivity (IgG: 84.71 %, IgM: 76.14 %) and specificity (IgG: 93.64 %, IgM: 90.17 %); positive predictive value (IgG: 86.75 %, IgM: 79.76 %) and negative predictive value (IgG: 92.57 %, IgM: 89.66 %); likelihood ratio (LR) [IgG: 13.32, IgM: 7.75 (LR+); IgG: 0.16, IgM: 0.26 (LR-)], and was supported by the observation of the absorbance value in comparisons between culture and serology sampling. In-house IgG ELISA was shown to be useful as an early diagnostic tool for melioidosis.

Matched MeSH terms: Melioidosis/diagnosis*

Imported melioidosis in a British native

Jenkins DR, Lewis AM, Strachan CJ

J Infect, 1990 Sep;21(2):221-2.

PMID: 2230183

Matched MeSH terms: Melioidosis/diagnosis*

Melioidosis presenting as prostatitis--a case report from Sabah

Kan SPK, Kay RWW

Trans R Soc Trop Med Hyg, 1978;72(5):522-4.

PMID: 725999 DOI: 10.1016/0035-9203(78)90175-X

Previous reports of melioidosis in Sabah are reviewed and a detailed account of a case, presenting as prostatitis, in a 40-year-old British male is given. The history suggested that the organism, Pseudomonas pseudomallei, was transmitted by a fly which entered the eye. Diagnosis was delayed and treatment presented some difficulty, the organism being relatively insensitive to amplicillin and gentamicin. Co-trimoxazole was the most effective, followed by minocycline. Cure was eventually achieved and after four years the patient was fit and normal, except for sterility.

Matched MeSH terms: Melioidosis/diagnosis*

Displaying publications 1 - 20 of 55 in total