Foong Y C, Tan Michelle, Bradbury Richard S
School of Medicine, University of Tasmania, Hobart, Tasmania, Australia .
MRC Keneba, MRC The Gambia, Kiang West, The Gambia.
Rural Remote Health. 2014;14(4):2763. Epub 2014 Oct 30.
The disease melioidosis, caused by the bacterium Burkholderia pseudomallei, remains an important and sometimes neglected cause of disease in tropical regions of Australia. Infection may present in myriad ways, and diagnosis often requires consideration of this organism prior to culture. Laboratory identification of B. pseudomallei requires specialised testing beyond that available in many routine diagnostic microbiology laboratories. For this reason, cases outside of the traditional endemic zone, often occurring years after initial exposure to the organism, may remain undiagnosed or are delayed in diagnosis. Furthermore, the high levels of intrinsic antimicrobial resistance associated with B. pseudomallei often render empirical therapies ineffective. Health professionals, particularly those in rural and remote areas of Australia, must consider melioidosis in their differential diagnoses and remain abreast of advances in the field of this important emerging disease.
类鼻疽病由伪鼻疽伯克霍尔德菌引起，在澳大利亚热带地区仍然是一种重要且有时被忽视的致病原因。感染可能以多种方式呈现，诊断通常需要在培养之前考虑到这种病原体。伪鼻疽伯克霍尔德菌的实验室鉴定需要许多常规诊断微生物实验室无法提供的专门检测。因此，在传统流行区以外的病例，通常在初次接触该病原体数年之后才出现，可能仍未被诊断或诊断延迟。此外，与伪鼻疽伯克霍尔德菌相关的高水平固有抗菌耐药性常常使经验性治疗无效。卫生专业人员，尤其是澳大利亚农村和偏远地区的卫生专业人员，必须在鉴别诊断中考虑类鼻疽病，并及时了解这一重要新出现疾病领域的进展。
