RESUMO
Phylogenetic analysis of a clinical isolate associated with subclinical Burkholderia pseudomallei infection revealed probable exposure in the British Virgin Islands, where reported infections are limited. Clinicians should consider this geographic distribution when evaluating possible infection among persons with compatible travel history.
Assuntos
Burkholderia pseudomallei , Melioidose , Ilhas Virgens Britânicas , Burkholderia pseudomallei/genética , Humanos , Melioidose/diagnóstico , Melioidose/epidemiologia , Filogenia , ViagemRESUMO
Burkholderia pseudomallei is a Gram-negative bacterium that causes the sapronotic disease melioidosis. An outbreak in 2003 in the state of Ceara, Brazil, resulted in subsequent surveillance and environmental sampling which led to the recognition of B. pseudomallei as an endemic pathogen in that area. From 2003 to 2015, 24 clinical and 12 environmental isolates were collected across Ceara along with one from the state of Alagoas. Using next-generation sequencing, multilocus sequence typing, and single nucleotide polymorphism analysis, we characterized the genomic diversity of this collection to better understand the population structure of B. pseudomallei associated with Ceara. We found that the isolates in this collection form a distinct subclade compared to other examples from the Western Hemisphere. Substantial genetic diversity among the clinical and environmental isolates was observed, with 14 sequence types (STs) identified among the 37 isolates. Of the 31,594 core single-nucleotide polymorphisms (SNPs) identified, a high proportion (59%) were due to recombination. Because recombination events do not follow a molecular clock, the observation of high occurrence underscores the importance of identifying and removing recombination SNPs prior to evolutionary reconstructions and inferences in public health responses to B. pseudomallei outbreaks. Our results suggest long-term B. pseudomallei prevalence in this recently recognized region of melioidosis endemicity.IMPORTANCEB. pseudomallei causes significant morbidity and mortality, but its geographic prevalence and genetic diversity are not well characterized, especially in the Western Hemisphere. A better understanding of the genetic relationships among clinical and environmental isolates will improve knowledge of the population structure of this bacterium as well as the ability to conduct epidemiological investigations of cases of melioidosis.
Assuntos
Burkholderia pseudomallei/classificação , Burkholderia pseudomallei/genética , Variação Genética , Genoma Bacteriano , Técnicas de Tipagem Bacteriana , Brasil/epidemiologia , DNA Bacteriano/genética , Surtos de Doenças/estatística & dados numéricos , Genômica/métodos , Genótipo , Humanos , Masculino , Melioidose/epidemiologia , Melioidose/microbiologia , Filogenia , Análise de Sequência de DNARESUMO
We report an analysis of the genomic diversity of isolates of Burkholderia pseudomallei, the cause of melioidosis, recovered in Colombia from routine surveillance during 2016-2017. B. pseudomallei appears genetically diverse, suggesting it is well established and has spread across the region.
Assuntos
Burkholderia pseudomallei , Melioidose , Burkholderia pseudomallei/genética , Colômbia/epidemiologia , Genômica , Humanos , Melioidose/epidemiologia , Tipagem de Sequências MultilocusRESUMO
The distribution of Burkholderia pseudomallei in the Caribbean is poorly understood. We isolated B. pseudomallei from US Virgin Islands soil. The soil isolate was genetically similar to other isolates from the Caribbean, suggesting that B. pseudomallei might have been introduced to the islands multiple times through severe weather events.
Assuntos
Burkholderia pseudomallei , Melioidose , Microbiologia do Solo , Burkholderia pseudomallei/genética , Humanos , Ilhas , Melioidose/epidemiologia , Filogenia , Ilhas Virgens AmericanasRESUMO
BACKGROUND: Burkholderia pseudomallei is a soil-dwelling bacterium and the causative agent of melioidosis. The global burden and distribution of melioidosis is poorly understood, including in the Caribbean. B. pseudomallei was previously isolated from humans and soil in eastern Puerto Rico but the abundance and distribution of B. pseudomallei in Puerto Rico as a whole has not been thoroughly investigated. METHODOLOGY/PRINCIPAL FINDINGS: We collected 600 environmental samples (500 soil and 100 water) from 60 sites around Puerto Rico. We identified B. pseudomallei by isolating it via culturing and/or using PCR to detect its DNA within complex DNA extracts. Only three adjacent soil samples from one site were positive for B. pseudomallei with PCR; we obtained 55 isolates from two of these samples. The 55 B. pseudomallei isolates exhibited fine-scale variation in the core genome and contained four novel genomic islands. Phylogenetic analyses grouped Puerto Rico B. pseudomallei isolates into a monophyletic clade containing other Caribbean isolates, which was nested inside a larger clade containing all isolates from Central/South America. Other Burkholderia species were commonly observed in Puerto Rico; we cultured 129 isolates from multiple soil and water samples collected at numerous sites around Puerto Rico, including representatives of B. anthina, B. cenocepacia, B. cepacia, B. contaminans, B. glumae, B. seminalis, B. stagnalis, B. ubonensis, and several unidentified novel Burkholderia spp. CONCLUSIONS/SIGNIFICANCE: B. pseudomallei was only detected in three soil samples collected at one site in north central Puerto Rico with only two of those samples yielding isolates. All previous human and environmental B. pseudomallei isolates were obtained from eastern Puerto Rico. These findings suggest B. pseudomallei is ecologically established and widely dispersed in the environment in Puerto Rico but rare. Phylogeographic patterns suggest the source of B. pseudomallei populations in Puerto Rico and elsewhere in the Caribbean may have been Central or South America.
Assuntos
Burkholderia pseudomallei/isolamento & purificação , Burkholderia/classificação , Burkholderia/isolamento & purificação , Burkholderia pseudomallei/genética , Ilhas Genômicas , Melioidose , Filogenia , Reação em Cadeia da Polimerase/métodos , Porto Rico , Análise de Sequência de DNA , Microbiologia do Solo , Microbiologia da ÁguaRESUMO
We report 2 cases of melioidosis in women with diabetes admitted to an emergency department in the US Virgin Islands during October 2017. These cases emerged after Hurricanes Irma and Maria and did not have a definitively identified source. Poor outcomes were observed when septicemia and pulmonary involvement were present.
Assuntos
Tempestades Ciclônicas , Melioidose/epidemiologia , Desastres Naturais , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Burkholderia pseudomallei/efeitos dos fármacos , Feminino , Humanos , Melioidose/diagnóstico , Melioidose/tratamento farmacológico , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Ilhas Virgens Americanas/epidemiologiaRESUMO
Melioidosis is caused by the gram-negative bacillus Burkholderia pseudomallei, endemic to northern Australia and Southeast Asia. We present a patient who traveled to Mexico, returned to the United States, and developed progressive manifestations of melioidosis, culminating as central nervous system disease. Standard therapy was contraindicated, and a prolonged intensive phase was employed.
RESUMO
Melioidosis, a disease caused by the pathogen Burkholderia pseudomallei, is a significant underreported endemic disease found in tropical countries worldwide. Recent studies have demonstrated that human melioidosis cases have been increasingly recognized in the Americas. Therefore, the first Scientific Reunion of Melioidosis in the Americas was organized in Colombia, with the participation of health authorities of 11 Latin American countries and the United States. This report summarizes the topics reviewed during the meeting, including how to identify human infections and properly diagnose them, with the goal of increasing recognition of the disease in the Americas.
Assuntos
Antibacterianos/uso terapêutico , Burkholderia pseudomallei/efeitos dos fármacos , Melioidose/diagnóstico , Melioidose/tratamento farmacológico , América/epidemiologia , Antibacterianos/administração & dosagem , Bacteriemia/diagnóstico , Bacteriemia/epidemiologia , Colômbia , Humanos , Melioidose/epidemiologia , Viagem , Estados Unidos/epidemiologiaRESUMO
Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, a gram-negative saprophytic bacillus. Cases occur sporadically in the Americas with an increasing number of cases observed among people with no travel history to endemic countries. To better understand the incidence of the disease in the Americas, we reviewed the literature, including unpublished cases reported to the Centers for Disease Control and Prevention. Of 120 identified human cases, occurring between 1947 and June 2015, 95 cases (79%) were likely acquired in the Americas; the mortality rate was 39%. Burkholderia pseudomallei appears to be widespread in South, Central, and North America.