Archive for January 12, 2016

Human melioidosis reported by ProMED.

Int J Infect Dis. 2015 Jun;35:103-6.

Nasner-Posso KM1, Cruz-Calderón S1, Montúfar-Andrade FE2, Dance DA3, Rodriguez-Morales AJ4.

Author information

1Public Health and Infection Research Group and Incubator, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.

2Infectious Disease Section, Department of Internal Medicine, Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia.

3Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Vientiane, Lao People’s Democratic Republic; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.

4Public Health and Infection Research Group and Incubator, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Working Group on Zoonoses, International Society for Chemotherapy, Aberdeen, UK; Committee on Zoonoses and Haemorrhagic Fevers, Asociación Colombiana de Infectología, Bogotá, DC, Colombia. Electronic address: arodriguezm@utp.edu.co

Abstract

OBJECTIVE:

There are limited sources describing the global burden of emerging diseases. A review of human melioidosis reported by ProMED was performed and the reliability of the data retrieved assessed in comparison to published reports. The effectiveness of ProMED was evaluated as a source of epidemiological data by focusing on melioidosis.

METHODS:

Using the keyword ‘melioidosis’ in the ProMED search engine, all of the information from the reports and collected data was reviewed using a structured form, including the year, country, gender, occupation, number of infected individuals, and number of fatal cases.

RESULTS:

One hundred and twenty-four entries reported between January 1995 and October 2014 were identified. A total of 4630 cases were reported, with death reported in 505 cases, suggesting a misleadingly low overall case fatality rate (CFR) of 11%. Of 20 cases for which the gender was reported, 12 (60%) were male. Most of the cases were reported from Australia, Thailand, Singapore, Vietnam, and Malaysia, with sporadic reports from other countries.

CONCLUSIONS:

Internet-based reporting systems such as ProMED are useful to gather information and synthesize knowledge on emerging infections. Although certain areas need to be improved, ProMED provided good information about melioidosis.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508390/pdf/main.pdf

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January 12, 2016 at 3:55 pm

Melioidosis: a review.

Rural Remote Health. 2014;14(4):2763.

Foong YC1, Tan M2, Bradbury RS3.

Author information

1School of Medicine, University of Tasmania, Hobart, Tasmania, Australia . Yichao.Foong@utas.edu.au

2School of Medicine, University of Tasmania, Hobart, Tasmania, Australia . michelletan.lm@gmail.com

3MRC Keneba, MRC The Gambia, Kiang West, The Gambia. r.bradbury@cqu.edu.au

Abstract

The disease melioidosis, caused by the bacterium Burkholderia pseudomallei, remains an important and sometimes neglected cause of disease in tropical regions of Australia. Infection may present in myriad ways, and diagnosis often requires consideration of this organism prior to culture. Laboratory identification of B. pseudomallei requires specialised testing beyond that available in many routine diagnostic microbiology laboratories. For this reason, cases outside of the traditional endemic zone, often occurring years after initial exposure to the organism, may remain undiagnosed or are delayed in diagnosis. Furthermore, the high levels of intrinsic antimicrobial resistance associated with B. pseudomallei often render empirical therapies ineffective. Health professionals, particularly those in rural and remote areas of Australia, must consider melioidosis in their differential diagnoses and remain abreast of advances in the field of this important emerging disease

PDF

http://www.rrh.org.au/publishedarticles/article_print_2763.pdf

January 12, 2016 at 3:53 pm

Treatment and prophylaxis of melioidosis.

Int J Antimicrob Agents. 2014 Apr;43(4):310-8.

Dance D1.

Author information

1Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK. Electronic address: david.d@tropmedres.ac

Abstract

Melioidosis, infection with Burkholderia pseudomallei, is being recognised with increasing frequency and is probably more common than currently appreciated. Treatment recommendations are based on a series of clinical trials conducted in Thailand over the past 25 years. Treatment is usually divided into two phases: in the first, or acute phase, parenteral drugs are given for ≥10 days with the aim of preventing death from overwhelming sepsis; in the second, or eradication phase, oral drugs are given, usually to complete a total of 20 weeks, with the aim of preventing relapse. Specific treatment for individual patients needs to be tailored according to clinical manifestations and response, and there remain many unanswered questions. Some patients with very mild infections can probably be cured by oral agents alone. Ceftazidime is the mainstay of acute-phase treatment, with carbapenems reserved for severe infections or treatment failures and amoxicillin/clavulanic acid (co-amoxiclav) as second-line therapy. Trimethoprim/sulfamethoxazole (co-trimoxazole) is preferred for the eradication phase, with the alternative of co-amoxiclav. In addition, the best available supportive care is needed, along with drainage of abscesses whenever possible. Treatment for melioidosis is unaffordable for many in endemic areas of the developing world, but the relative costs have reduced over the past decade. Unfortunately there is no likelihood of any new or cheaper options becoming available in the immediate future. Recommendations for prophylaxis following exposure to B. pseudomallei have been made, but the evidence suggests that they would probably only delay rather than prevent the development of infection.

PDF

http://www.ijaaonline.com/article/S0924-8579(14)00018-1/pdf

January 12, 2016 at 3:52 pm

Systematic review and consensus guidelines for environmental sampling of Burkholderia pseudomallei.

PLoS Negl Trop Dis. 2013;7(3):e2105.

Limmathurotsakul D1, Dance DA, Wuthiekanun V, Kaestli M, Mayo M, Warner J, Wagner DM, Tuanyok A, Wertheim H, Yoke Cheng T, Mukhopadhyay C, Puthucheary S, Day NP, Steinmetz I, Currie BJ, Peacock SJ.

Author information

1Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. direk@tropmedres.ac

Abstract

BACKGROUND:

Burkholderia pseudomallei, a Tier 1 Select Agent and the cause of melioidosis, is a Gram-negative bacillus present in the environment in many tropical countries. Defining the global pattern of B. pseudomallei distribution underpins efforts to prevent infection, and is dependent upon robust environmental sampling methodology. Our objective was to review the literature on the detection of environmental B. pseudomallei, update the risk map for melioidosis, and propose international consensus guidelines for soil sampling.

METHODS/PRINCIPAL FINDINGS:

An international working party (Detection of Environmental Burkholderia pseudomallei Working Party (DEBWorP)) was formed during the VIth World Melioidosis Congress in 2010. PubMed (January 1912 to December 2011) was searched using the following MeSH terms: pseudomallei or melioidosis. Bibliographies were hand-searched for secondary references. The reported geographical distribution of B. pseudomallei in the environment was mapped and categorized as definite, probable, or possible. The methodology used for detecting environmental B. pseudomallei was extracted and collated. We found that global coverage was patchy, with a lack of studies in many areas where melioidosis is suspected to occur. The sampling strategies and bacterial identification methods used were highly variable, and not all were robust. We developed consensus guidelines with the goals of reducing the probability of false-negative results, and the provision of affordable and ‘low-tech’ methodology that is applicable in both developed and developing countries.

CONCLUSIONS/SIGNIFICANCE:

The proposed consensus guidelines provide the basis for the development of an accurate and comprehensive global map of environmental B. pseudomallei.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3605150/pdf/pntd.0002105.pdf

January 12, 2016 at 3:50 pm

Melioidosis diagnostic workshop, 2013.

Emerg Infect Dis. 2015 Feb;21(2).

Hoffmaster AR, AuCoin D, Baccam P, Baggett HC, Baird R, Bhengsri S, Blaney DD, Brett PJ, Brooks TJ, Brown KA, Chantratita N, Cheng AC, Dance DA, Decuypere S, Defenbaugh D, Gee JE, Houghton R, Jorakate P, Lertmemongkolchai G, Limmathurotsakul D, Merlin TL, Mukhopadhyay C, Norton R, Peacock SJ, Rolim DB, Simpson AJ, Steinmetz I, Stoddard RA, Stokes MM, Sue D, Tuanyok A, Whistler T, Wuthiekanun V, Walke HT.

Abstract

Melioidosis is a severe disease that can be difficult to diagnose because of its diverse clinical manifestations and a lack of adequate diagnostic capabilities for suspected cases. There is broad interest in improving detection and diagnosis of this disease not only in melioidosis-endemic regions but also outside these regions because melioidosis may be underreported and poses a potential bioterrorism challenge for public health authorities. Therefore, a workshop of academic, government, and private sector personnel from around the world was convened to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4313648/pdf/14-1045.pdf

January 12, 2016 at 3:49 pm


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