Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University.
Infectious Diseases Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Curr Opin Infect Dis. 2022 Dec 1;35(6):517-523. doi: 10.1097/QCO.0000000000000869. Epub 2022 Aug 3.
Melioidosis and its causative bacterium Burkholderia pseudomallei are being found in unexpected locations and bacterial genotyping is providing new insights into global spread and where and how individuals are being infected. This review summarizes recent studies covering the epidemiology, diagnosis, treatment, and prevention of melioidosis.
Whole-genome sequencing of B. pseudomallei from patients and environmental sampling is informing the phylogeography of B. pseudomallei at regional, continental, and global levels, while also defining the epidemiology for individual cases. The situation in Africa remains the most unresolved, while the evolving story of B. pseudomallei in the Americas may establish that B. pseudomallei is endemic in parts of southern USA. Guidelines for diagnosis and treatment of melioidosis are well established, and published mortality has decreased from 50% or higher to 10% or lower in some countries but access to laboratory and therapeutic resources are not available or are extremely limited in many melioidosis-endemic regions.
The enormous clinical diversity of melioidosis and the complexities of laboratory diagnosis and of treatment make it a sentinel disease for highlighting the continuing global disparities in access to and provision of healthcare.
类鼻疽病及其病原体伯克霍尔德菌在人们意想不到的地方被发现，细菌基因分型为全球传播以及个体的感染地点和方式提供了新的见解。本综述总结了最近关于类鼻疽病的流行病学、诊断、治疗和预防的研究。
对来自患者和环境样本的伯克霍尔德菌进行全基因组测序，有助于在区域、大陆和全球范围内了解伯克霍尔德菌的系统地理学，同时也确定了个别病例的流行病学情况。非洲的情况仍然最不清楚，而在美洲，伯克霍尔德菌的演变故事可能表明，伯克霍尔德菌在美国南部的某些地区流行。类鼻疽病的诊断和治疗指南已经完善，在一些国家，类鼻疽病的死亡率已从 50%或更高降至 10%或更低，但在许多类鼻疽病流行地区，获得实验室和治疗资源的机会有限或极其有限。
类鼻疽病临床表现多样，实验室诊断和治疗复杂，使其成为突出全球在获得和提供医疗保健方面持续存在差距的一个警示性疾病。
