Sep 2026· Diagnostic microbiology and infectious disease· Vol 116 1, pp.
117447
· 0 citations
Medicine
TL;DR
This case highlights the technical challenges of identifying melioidosis in a non-endemic region and confirms the diagnosis of melioidosis was difficult due to the misreporting of this isolate with a MALDI-TOF high score as B. thailandensis.
Abstract
We report the isolation Burkholderia pseudomallei from a 69-year-old of Thai descent who presented in our hospital in central Sydney, Ausralia. This case highlights the technical challenges of identifying melioidosis in a non-endemic region. In our case confirming the diagnosis of melioidosis was difficult due to the misreporting of this isolate with a MALDI-TOF high score as B. thailandensis by MALDI-TOF-MS without the proper laboratory Maldi-Biotyper Security-Relevant library database software. The initial diagnosis of melioidosis was founded on suspicion from the clinical microbiologists based on history and an understanding of the mis-categorisation of B. pseudomallei as B. thailandensis. While EUCAST have antibiotic susceptibility testing for B. pseudomallei isolates, correctly reading the inhibition zone especially for trimethoprim/sulfamethoxazole, is important to ensure AST is appropriately reported, since this is the antibiotic used for the eradication phase of treatment for melioidosis.
Background: The genus Burkholderia, which was previously believed to be a soil saprophyte, is now gaining attention as a human disease. Pathogenic species include B. pseudomallei, B. cepacia, B. mallei, B. gladioli, and B. thailandensis. Ongoing studies on Bukholderia have led to the isolation of more recent subspecies from human samples. The purpose of this study is to assess the antibiogram of the clinical isolates and determine the prevalence of Burkholderia spp. Methods: Demographic data and a variety of patient clinical samples were analyzed. All specimens were processed using recognized microbiological techniques. Results: Of the 8230 culture-positive samples, 1902 (23.11%) included Non-Fermenting Gram Negative Bacilli (NFGNB). It was discovered that 60 (3.2%) of these NFGNB were Burkholderia spp. Furthermore, it was found that 24 (40%) and 36 (60%) were B. pseudomallei and B. cepacia complex, respectively. Of the patients, 76.7% were over 40, and 80% were men. Diabetes mellitus was the primary risk factor (60%), and fever was the most common manifestation (53.3%). Imipenam had the lowest sensitivity, while Minocycline and Cotrimoxazole had the highest, according to antibiotic sensitivity testing. Conclusion: This study provides baseline data on the present Burkholderia infection situation at our hospital. An ongoing investigation will be useful in identifying several cases because this organism is extremely underreported.
Kalyani Pawar, Ashish Kumar· International Journal of Cur...· 0 citations
Melioidosis, caused by the gram-negative bacillus Burkholderia pseudomallei - a Tier 1 Select Biological agent - remains a significant cause of severe community-acquired infection in tropical regions, but with recent expanding recognition in temperate climates, including the United States. Pulmonary involvement is the most frequent clinical manifestation, ranging from subclinical nodules to fulminant necrotizing pneumonia and acute respiratory distress syndrome. Despite its clinical severity, melioidosis remains underdiagnosed due to its radiologic mimicry of tuberculosis, broad clinical manifestations, and limited laboratory capacity in many endemic areas. Special Operations Forces (SOF) participating in field exercises or operations in B. pseudomallei endemic countries are at significantly increased risk of infection. Accordingly, SOF medical providers should maintain a high index of suspicion for melioidosis and be familiar with its clinical recognition, diagnosis, and management.
Chase Goldberg, Akira A. Shishido· Journal of special operation...· 0 citations
This study substantiates an escalated incidence of carbapenem-resistant, MDR A. baumannii in post-surgical infections in Pakistan, highlighting the exigency for strengthened antimicrobial stewardship and infection control strategies in the hospitals of the region.
Sana Gul, Nawab Ali, M. Qasim et al.· Antibiotics· 0 citations
Clinicians should maintain a high index of suspicion in patients presenting with severe pneumonia or sepsis, particularly during the rainy season and among individuals with diabetes mellitus or chronic liver disease, and strengthening conventional microbiological capacity remains essential for improving diagnosis and patient outcomes in geographically isolated settings.
Duy-Cuong Le, Dinh-Dung Nguyen, T. Nguyen et al.· BMC Infectious Diseases· 0 citations
This case series aimed to increase physicians' awareness of melioidosis in high-risk patients presenting with diverse clinical symptoms, thereby improving diagnostic accuracy and ensuring timely and appropriate treatment.
Arulananthi Venkataraman Arumugham, Sabarinathan Thiyagarajan, S. Ali et al.· 0 citations
The case of a 65-year-old man with a history of recent travel to a tropical country who was found to have multiple hepatic abscesses is presented and the clinical and microbiological picture was most consistent with amoebic liver abscess secondary to E. histolytica; however, the presence of Blastocystis species introduces uncertainty around its clinical significance.
Si Qi Cao, Hasan Hamze, R. Lester· Access Microbiology· 0 citations
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