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Doxycycline
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Melioidosis, caused by Burkholderia pseudomallei, has a spectrum of manifestations, from septic shock with a mortality rate of > 60%, to other signs and symptoms with lesser degrees of mortality, such as pneumonia (White et al., 1989; Sookpranee et al., 1992; Simpson et al., 1999; White, 2003). Treatment courses consist of at least 10 days of intravenous therapy, prior to the eradication phase, with ceftazidime or a carbapenem, followed by a long eradication phase of oral antimicrobials. Co-trimoxazole is first-line eradication treatment, with amoxicillin–clavulanate as an alternative. Doxycycline is an alternative eradication agent used in Northern Australian melioidosis-treatment protocols (Dawson and Schachter, 1985; Rajchanuvong et al., 1995; Chaowagul et al., 1999; Chetchotisakd et al., 2001; Mabey and Solomon, 2003; Mabey et al., 2005; Chaowagul et al., 2005; Pitman et al., 2015).
Case 15: A Confused Traveller
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
Melioidosis is endemic in parts of South East Asia, including Thailand, China and Malaysia. It is among the most common causes of sepsis in these countries (up to 20% in Thailand). The causative agent, Burkholderia pseudomallei, is a gram-negative saprophyte that is present in wet soil and rice paddy fields. The history from the patient should include exposure to such factors, such as working in rice-growing fields, and also whether the patient is diabetic, as this is a major risk factor for melioidosis.
Burkholderia
Published in Dongyou Liu, Laboratory Models for Foodborne Infections, 2017
Danielle L. Peters, Fatima Kamal, Jonathan J. Dennis
B. pseudomallei causes melioidosis, a potentially fatal condition with a variety of symptoms including pneumonia, skin lesions, and septic shock.7 Most melioidosis cases are seen in Southeast Asia (especially Thailand) and northern Australia, although incidents also occur in nonendemic areas such as Brazil.7,37 In Southeast Asia, approximately 80% of the population tests seropositive by the age of 4 years,38 although only a small percentage of these seropositive individuals go on to develop melioidosis. This finding suggests that the dose and frequency of inoculum influences the infectivity and severity of the symptoms. In support of this idea, increased rates of melioidosis follow the monsoon and typhoon seasons,39,40 when prolonged inhalation of storm-generated aerosols of B. pseudomallei-contaminated particles would be highest.7
FAM26F: An Enigmatic Protein Having a Complex Role in the Immune System
Published in International Reviews of Immunology, 2023
Melioidosis, caused by Burkholderia pseudomallei, is a severe infectious disease with a 40% mortality rate even with appropriate treatments. The results of a microarray based study identified FAM26F to be a top classifier gene and thus a candidate diagnostic signature discriminating septicemic melioidosis caused by B. pseudomallei from sepsis caused by other pathogens [11]. Another transcriptome analysis study indicated that treatment of human PBMCs with increasing concentrations of the Staphylococcus aureus super antigens induced >10 fold increase in FAM26F transcription along with other inflammation-associated gene networks, corresponding to a very strong Th1- and Th17 dominated immune response [12]. Similarly, a genome-wide, temporal response of mice to lethal intranasal challenge of staphylococcal enterotoxin B (SEB) causing toxic shock syndrome was investigated in six tissues. FAM26F was identified as one of the 11 unique genes (Irf1, Irf8, Fam26f, Irgm2, Cxcl9, Cxcl10, Cxcl11, Cd274, Parp14, Stat1, and Serpina3g) showing highest expression at 5 hours post-SEB challenge in PBMCs and/or spleen [13]. Interestingly all other members in the group include genes whose secreted products induce the IFN pathway and thus are part of a host-wide IFN-response, proposing a similar function for FAM26F as well.
Identification of candidate blood biomarkers for the diagnosis of septicaemic melioidosis based on WGCNA
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2022
Li Yin, Yuanyuan Chen, Tingting Fu, Lin Liu, Qianfeng Xia
Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a kind of Gram-negative bacillus. Cases have been reported in different regions around the world, including Thailand, China, and Australia etc. In China, it is mainly distributed in provinces of Hainan, Guangdong and Guangxi. People infected with B.pseudomallei are those who have been exposed mainly through inhalation or skin wounds to contaminated soil and water. Sepsis is the most prevalent type of melioidosis and MiRNAs are extensively explored in the diagnosis of sepsis as serum sepsis biomarkers [1]. The misdiagnosis rate could reach 80–90% due to factors such as lack of specificity and slow presentation of bacterial culture results [2]. The patients could be misdiagnosed as pulmonary infection, pulmonary tuberculosis, hepatitis, malaria, and general sepsis, etc. Compared with other infections, B. pseudomallei-induced sepsis has a high mortality rate. Therefore, better diagnostic tests are needed to improve the earlier diagnosis, initiation of appropriate therapy and increase the survival rate of sepsis caused by B. pseudomallei. The ideal biomarkers should be able to rapidly and specifically screen patients with sepsis caused by B. pseudomallei from those patients caused by other pathogens.
A study of inhibitors of d -glycero-β-d -manno-heptose-1-phosphate adenylyltransferase from Burkholderia pseudomallei as a potential antibiotic target
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2021
Suwon Kim, Seri Jo, Mi-Sun Kim, Dong Hae Shin
Burkholderia is a genus of Gram-negative bacteria, which has ecological, metabolic, and morphological diversity1–4. The Burkholderia genus belongs to the family β-proteobacteria, and Burkholderia has two major species, the Clade I and the Clade II. The most clinically important in these groups are the B. cepacia complex (BCC) and the B. pseudomallei group in the Clade I4. The BCC are pathogens that are opportunistic to immunodeficient patients and infection from those bacteria can be prevalent and fatal to cystic fibrosis patients5–7. Meanwhile, the B. pseudomallei group composes of four species, which are closely related (B. pseudomallei, B. mallei, B. thailandensis, and B. oklahomensis). The incidence of melioidosis has been reported in Thailand and northern Australia. In Thailand, it is in the high ranks among infectious diseases that cause the death of patients who had HIV/AIDS and tuberculosis. In northern Australia, it is the general reason for community-acquired pneumonia8.