Epidemiology and genetic diversity of Burkholderia pseudomallei from Riau Province, Indonesia.

Autor: Anggraini, Dewi, Siregar, Fajri Marindra, Rosdiana, Dani, Kemal, Rahmat Azhari, Yovi, Indra, Triani, Zhana Daisya, Jasmin, Novira, Dwijelita, Norsila, Webb, Jessica R., Mayo, Mark, Kaestli, Mirjam, Currie, Bart J.
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Zdroj: PLoS Neglected Tropical Diseases; 5/28/2024, Vol. 18 Issue 5, p1-14, 14p
Abstrakt: Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, that is common in tropical and subtropical countries including Southeast Asia and Northern Australia. The magnitude of undiagnosed and untreated melioidosis across the country remains unclear. Given its proximity to regions with high infection rates, Riau Province on Sumatera Island is anticipated to have endemic melioidosis. This study reports retrospectively collected data on 68 culture-confirmed melioidosis cases from two hospitals in Riau Province between January 1, 2009, and December 31, 2021, with full clinical data available on 41 cases. We also describe whole genome sequencing and genotypic analysis of six isolates of B. pseudomallei. The mean age of the melioidosis patients was 49.1 (SD 11.5) years, 85% were male and the most common risk factor was diabetes mellitus (78%). Pulmonary infection was the most common presentation (39%), and overall mortality was 41%. Lung as a focal infection (aOR: 6.43; 95% CI: 1.13–36.59, p = 0.036) and bacteremia (aOR: 15.21; 95% CI: 2.59–89.31, p = 0.003) were significantly associated with death. Multilocus sequence typing analysis conducted on six B.pseudomallei genomes identified three sequence types (STs), namely novel ST1794 (n = 3), ST46 (n = 2), and ST289 (n = 1). A phylogenetic tree of Riau B. pseudomallei whole genome sequences with a global dataset of genomes clearly distinguished the genomes of B. pseudomallei in Indonesia from the ancestral Australian clade and classified them within the Asian clade. This study expands the known presence of B. pseudomallei within Indonesia and confirms that Indonesian B. pseudomallei are genetically linked to those in the rest of Southeast Asia. It is anticipated that melioidosis will be found in other locations across Indonesia as laboratory capacities improve and standardized protocols for detecting and confirming suspected cases of melioidosis are more widely implemented. Author summary: Melioidosis is a disease caused by the bacterium Burkholderia pseudomallei. This disease can affect various organs such as the lungs, skin and soft tissues, central nervous system, internal organs, and others. The clinical manifestations vary, and the lack of laboratory examination support in some countries leads to underreporting of the disease. This also results in a varied death rate, ranging from 10–40% and even higher in some countries. The disease is endemic in the Southeast Asian region and northern Australia and is increasingly recognised in other tropical and sub-tropical locations globally. Indonesia has reported over 100 cases from at least 5 diverse regions. One province in Indonesia, Riau, located on the island of Sumatera bordering Malaysia, has been experiencing a relatively high number of melioidosis cases. This study reports melioidosis cases obtained from two referral hospitals in the province of Riau. The research explores the characteristics of patients, clinical manifestations, and outcomes in these cases. Additionally, the study analyzes factors influencing mortality from melioidosis in Riau. Phylogenetic analysis of six isolates of B. pseudomallei determined that B. pseudomallei in the province of Riau, Indonesia is genetically linked to those from neighbouring countries in Southeast Asia. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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