Disease relevance of Melioidosis

• To determine whether IP-10 and Mig are released during bacterial infection in humans, we measured plasma levels of IP-10 and Mig in patients with melioidosis, a severe gram-negative infection caused by Burkholderia pseudomallei [1].
• Pseudomonas pseudomallei, the causative agent of melioidosis, is generally susceptible to some of the newer extended-spectrum cephalosporins or to combinations of a beta-lactam and clavulanic acid, a beta-lactamase inhibitor [2].
• The use of meropenem may be associated with improved outcomes in patients with severe sepsis associated with melioidosis [3].
• Comparison of efficacy of ciprofloxacin and doxycycline against experimental melioidosis and glanders [4].
• Although it has been postulated that a neurotropic exotoxin may account for melioidosis encephalomyelitis, the recent findings and comparison with the animal data suggest that direct organism spread within the CNS may be primarily responsible [5].

Psychiatry related information on Melioidosis

• Current hypotheses about the cause of SUDS have included stress, genetic factors, dietary deficiency (particularly thiamine), potassium deficiency, melioidosis and sleep disorders [6].

High impact information on Melioidosis

• Chronic prostatic melioidosis treated with trimethoprim-sulfamethoxazole [7].
• Ceftazidime is the treatment of choice for severe melioidosis, but response to high dose parenteral treatment is slow (median time to abatement of fever 9 days) [8].
• Ceftazidime for melioidosis [9].
• An open randomised trial was conducted to compare ceftazidime (120 mg/kg/day) with "conventional therapy" (chloramphenicol 100 mg/kg/day, doxycycline 4 mg/kg/day, trimethoprim 10 mg/kg/day, and sulphamethoxazole 50 mg/kg/day) in the treatment of severe melioidosis [10].
• A pilA deletion mutant has reduced adherence to human epithelial cells and is less virulent in the nematode model of virulence and the murine model of melioidosis, suggesting a role for type IV pili in B. pseudomallei virulence [11].

Chemical compound and disease context of Melioidosis

• A combination of TMP-SMX and doxycycline is as effective as and better tolerated than the conventional four-drug regimen for the oral treatment phase of melioidosis [12].
• We conclude that meropenem (1 g or 25 mg/kg every 8 h intravenously for >/=14 days) is an alternative to ceftazidime and imipenem in the treatment of melioidosis [3].
• Outcomes of patients with melioidosis treated with meropenem [3].
• Tumor necrosis factor in septicemic melioidosis [13].
• A prospective, open, randomized, comparative treatment trial was conducted to compare the therapeutic efficacy of the conventional four-drug combination (chloramphenicol, trimethoprim-sulfamethoxazole, and doxycycline) with that of doxycycline alone in oral maintenance treatment of melioidosis [14].

Biological context of Melioidosis

• In a prospective study of 160 consecutive sera samples sent for melioidosis serology, respective specificities were 91, 90, and 69, positive predictive values were 41, 32, and 18, and negative predictive values were 99, 98, and 100% [15].
• This was a study of IgG antibody responses to two S-type lipopolysaccharides (LPS I and LPS II) and flagellin of Burkholderia pseudomallei in patients with melioidosis [16].
• We have previously shown that Burkholderia pseudomallei, the causative pathogen of melioidosis, may be discriminated from the closely related non-pathogenic species Burkholderia thailandensis by the presence of a 15 base pair deletion in the flagellin gene of B. thailandensis [17].
• 0. Of greater importance, in tuberculous patients and patients with melioidosis treated with levamisole, 150 mg/day, twice a week, along with a specific antitubercular or antimicrobial agent for appropriate duration, improved faster both clinically, microbiologically and in cellular immunity [18].

Anatomical context of Melioidosis

• Assessment of the extent and activity of melioidosis with Technetium labelled leukocyte scanning [19].
• One patient with melioidosis involving the T9 to T11 vertebrae caused by P pseudomallei died of empyema and septicaemia 22 months after presentation [20].

Gene context of Melioidosis

• Prognostic value of cytokine concentrations (tumor necrosis factor-alpha, interleukin-6, and interleukin-10) and clinical parameters in severe melioidosis [21].
• Cytokine assays (TNF-alpha, IL-6, and IL-10) were performed on admission plasma samples from 172 adult Thai patients with severe melioidosis [21].
• Among 24 DRB1 alleles, 7 DQA1 alleles, and 13 DQB1 alleles identified in this population, an association with melioidosis was observed with DRB1*1602 which was increased in melioidosis patients (10.1%) compared to normal controls (4.8%), p = 0.047 (odds ratio (OR) = 2.25) [22].
• The CXC chemokines gamma interferon (IFN-gamma)-inducible protein 10 and monokine induced by IFN-gamma are released during severe melioidosis [1].
• IP-10 and Mig were markedly elevated in patients with melioidosis on admission, particularly in blood culture-positive patients, and remained elevated during the 72-h study period [1].

Analytical, diagnostic and therapeutic context of Melioidosis

• All antigens were used for detecting antibody in sera from patients with septicemic melioidosis by indirect enzyme-linked immunosorbent assay [23].
• An immunochromatographic test for the rapid determination of immunoglobulin M (IgM) and IgG antibodies to Burkholderia pseudomallei was evaluated by using sera from bacteriologically confirmed melioidosis patients and high-risk and clinically suspected patients, along with disease control groups [24].
• Western blot analysis with sera from melioidosis patients indicated that they produced immunoglobulin M antibodies against this PC-PLC protein [25].
• The overall therapeutic failure rate (i.e., treatment failure or death due to uncontrolled melioidosis) was significantly higher for the amoxicillin/clavulanate group than for the ceftazidime group (P = .02) [26].
• This animal model was used in this study to compare the efficacy of ceftazidime and cefepime alone or with co-trimoxazole, in the therapy of melioidosis [27].

References