Burkholderia Taxonomy

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The Burkholderia Taxonomy and Genomics

Burkholderia pseudomallei (Bp) belongs to the Burkholderia genus which contains over 40 species that inhabit a variety of ecological niches. The majority of species within this genus are non-pathogenic soil-dwelling bacteria, but a few species are highly pathogenic to humans and can result in severe disease [1]. This includes B. mallei, an obligate mammalian pathogen and the causative agent of glanders, which primarily affects horses and other solipeds and is highly virulent in humans. A clinically important species of Burkholderia is B. cenocepacia, which is a major cause of opportunistic infections in patients with cystic fibrosis [2, 3]. The genus also includes the Bp-like strain B. thailandensis,
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It is believed that these habitats are the primary reservoirs from which susceptible hosts acquire infections [14]. Infection results from percutaneous inoculation (e.g. by means of a penetrating injury or open wound), inhalation (e.g. during severe weather or as a result of a deliberate release), or ingestion (e.g. through contaminated food or water) [3]. Manifestations of disease are dependent on host pathogen interaction and extremely broad ranging from rapidly life-threatening sepsis to chronic low-grade infection. A common clinical picture associated with melioidosis is that of sepsis associated with bacterial dissemination to distant sites [9, 15, 16], frequently causing simultaneous pneumonia and liver and splenic abscesses [17]. Infection may also occur in bone, joints, skin, soft tissue, or the prostate [18-20] and can also cause blood disease, kidney disease, heart disease, and more [17]. This broad spectrum of clinical symptoms has earned Bp the nickname “The Great Mimicker”, since the clinical symptoms of melioidosis imitate those of many other diseases. Thus, differentiating between melioidosis and other acute and chronic bacterial infections, including tuberculosis, is often impossible which often leads to misdiagnosis and improper treatment [21] which is often fatal [3]. Confirmation of the …show more content…
The initial intensive phase includes at least 10 to 14 days of ceftazidime, meropenem, or imipenem administered intravenously. This is followed by oral eradication therapy usually with trimethoprim-sulfamethoxazole or doxycycline for 3 to 6 months [3]. Despite this long antibiotic course, the rate of relapse is about 10%, which rises to nearly 30% if antibiotic treatment lasts for 8 weeks or less. The risk of relapse is related to adherence to treatment and the initial extent of disease, but not to any underlying conditions. The prognosis of melioidosis is much better in children than in adults, and relapse is rare [32]. Adult patients require follow-up throughout their lives. Unfortunately, melioidosis has high mortality rates (up to 50%) despite the use of aggressive antimicrobial therapy

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