Alvarez-Hernandez Gerardo, Cruz-Loustaunau Denica, Ibarra J Antonio, Rascon-Alcantar Adela, Contreras-Soto Jesús, Meza-Radilla Georgina, Torres Alfredo G, Estrada-de Los Santos Paulina
Department of Medicine and Health Sciences, University of Sonora, Hermosillo, Sonora, Mexico.
Ministry of Health of Sonora, Hermosillo, Sonora, Mexico.
BMC Infect Dis. 2021 Feb 23;21(1):204. doi: 10.1186/s12879-021-05910-5.
Melioidosis is an infectious disease caused by Burkholderia pseudomallei. In Mexico, the disease is rarely diagnosed in humans and there is no evidence of simultaneous environmental isolation of the pathogen. Here, we describe clinical profiles of fatal cases of melioidosis in two children, in a region without history of that disease.
About 48 h before onset of symptoms, patients swam in a natural body of water, and thereafter they rapidly developed fatal septicemic illness. Upon necropsy, samples from liver, spleen, lung, cerebrospinal fluid, and bronchial aspirate tissues contained Burkholderia pseudomallei. Environmental samples collected from the locations where the children swam also contained B. pseudomallei. All the clinical and environmental strains showed the same BOX-PCR pattern, suggesting that infection originated from the area where the patients were swimming.
The identification of B. pseudomallei confirmed that melioidosis disease exists in Sonora, Mexico. The presence of B. pseudomallei in the environment may suggest endemicity of the pathogen in the region. This study highlights the importance of strengthening laboratory capacity to prevent and control future melioidosis cases.
类鼻疽是由类鼻疽伯克霍尔德菌引起的一种传染病。在墨西哥，人类很少被诊断出患有这种疾病，也没有证据表明该病原体能在环境中同时被分离出来。在此，我们描述了在一个没有该疾病病史的地区，两名儿童类鼻疽致死病例的临床特征。
在症状出现前约48小时，患者在一个天然水体中游泳，此后迅速发展为致命的败血症。尸检时，肝脏、脾脏、肺、脑脊液和支气管吸出物组织的样本中都含有类鼻疽伯克霍尔德菌。从儿童游泳地点采集的环境样本中也含有类鼻疽伯克霍尔德菌。所有临床菌株和环境菌株都显示出相同的BOX-PCR图谱，表明感染源自患者游泳的区域。
类鼻疽伯克霍尔德菌的鉴定证实了墨西哥索诺拉州存在类鼻疽病。该病原体在环境中的存在可能表明该地区存在地方病。本研究强调了加强实验室能力以预防和控制未来类鼻疽病例的重要性。
