The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.
Department of Infectious Diseases, Mater Hospital Brisbane, South Brisbane, Queensland, Australia.
PLoS Negl Trop Dis. 2023 Oct 12;17(10):e0011697. doi: 10.1371/journal.pntd.0011697. eCollection 2023 Oct.
The clinical and genomic epidemiology of melioidosis varies across regions.
To describe the clinical and genetic diversity of B. pseudomallei across Queensland, Australia.
Whole genome sequencing of clinical isolates stored at the melioidosis reference lab from 1996-2020 was performed and analysed in conjunction with available clinical data.
Isolates from 292 patients were analysed. Bacteraemia was present in 71% and pneumonia in 65%. The case-fatality rate was 25%. Novel sequence types (ST) accounted for 51% of all isolates. No association was identified between the variable virulence factors assessed and patient outcome. Over time, the proportion of First Nation's patients declined from 59% to 26%, and the proportion of patients aged >70 years rose from 13% to 38%.
This study describes a genomically diverse and comparatively distinct collection of B. pseudomallei clinical isolates from across Queensland, Australia. An increasing incidence of melioidosis in elderly patients may be an important factor in the persistently high case-fatality in this region and warrants further investigation and directed intervention.
类鼻疽病的临床和基因组流行病学在不同地区有所不同。
描述澳大利亚昆士兰州假鼻疽伯克霍尔德菌的临床和遗传多样性。
对 1996 年至 2020 年间储存在类鼻疽参考实验室的临床分离株进行全基因组测序，并结合可用的临床数据进行分析。
分析了 292 名患者的分离株。71%的患者有菌血症，65%的患者有肺炎。病死率为 25%。新型序列类型（ST）占所有分离株的 51%。评估的可变毒力因子与患者预后之间没有关联。随着时间的推移，第一民族患者的比例从 59%下降到 26%，年龄>70 岁的患者比例从 13%上升到 38%。
本研究描述了来自澳大利亚昆士兰州的一组具有遗传多样性且相对独特的假鼻疽伯克霍尔德菌临床分离株。老年患者中类鼻疽病发病率的增加可能是该地区病死率持续居高不下的一个重要因素，值得进一步调查和有针对性的干预。
