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. 2001 May-Jun;7(3):428–433. doi: 10.3201/eid0703.010310

Melioidosis: an emerging infection in Taiwan?

P R Hsueh 1, L J Teng 1, L N Lee 1, C J Yu 1, P C Yang 1, S W Ho 1, K T Luh 1
PMCID: PMC2631793  PMID: 11384520

Abstract

From January 1982 to May 2000, 17 infections caused by Burkholderia pseudomallei were diagnosed in 15 patients in Taiwan; almost all the infections were diagnosed from 1994 to May 2000. Of the 15 patients, 9 (60%) had underlying diseases, and 10 (67%) had bacteremic pneumonia. Thirteen (76%) episodes of infection were considered indigenous. Four patients died of melioidosis. Seventeen B. pseudomallei isolates, recovered from eight patients from November 1996 to May 2000, were analyzed to determine their in vitro susceptibilities to 14 antimicrobial agents, cellular fatty acid and biochemical reaction profiles, and randomly amplified polymorphic DNA patterns. Eight strains (highly related isolates) were identified. All isolates were arabinose non-assimilators and were susceptible to amoxicillin-clavulanate, piperacillin-tazobactam, imipenem, and meropenem. No spread of the strain was documented.

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Selected References

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  1. Chaowagul W., Simpson A. J., Suputtamongkol Y., Smith M. D., Angus B. J., White N. J. A comparison of chloramphenicol, trimethoprim-sulfamethoxazole, and doxycycline with doxycycline alone as maintenance therapy for melioidosis. Clin Infect Dis. 1999 Aug;29(2):375–380. doi: 10.1086/520218. [DOI] [PubMed] [Google Scholar]
  2. Chaowagul W., Simpson A. J., Suputtamongkol Y., White N. J. Empirical cephalosporin treatment of melioidosis. Clin Infect Dis. 1999 Jun;28(6):1328–1328. doi: 10.1086/517787. [DOI] [PubMed] [Google Scholar]
  3. Chaowagul W., Suputtamongkol Y., Dance D. A., Rajchanuvong A., Pattara-arechachai J., White N. J. Relapse in melioidosis: incidence and risk factors. J Infect Dis. 1993 Nov;168(5):1181–1185. [PubMed] [Google Scholar]
  4. Chaowagul W., White N. J., Dance D. A., Wattanagoon Y., Naigowit P., Davis T. M., Looareesuwan S., Pitakwatchara N. Melioidosis: a major cause of community-acquired septicemia in northeastern Thailand. J Infect Dis. 1989 May;159(5):890–899. doi: 10.1093/infdis/159.5.890. [DOI] [PubMed] [Google Scholar]
  5. Chen Y. H., Peng C. F., Hwang K. P., Tsai J. J., Lu P. L., Chen T. P. An indigenous melioidosis: a case report. Kaohsiung J Med Sci. 1999 May;15(5):292–296. [PubMed] [Google Scholar]
  6. Dance D. A. Melioidosis: the tip of the iceberg? Clin Microbiol Rev. 1991 Jan;4(1):52–60. doi: 10.1128/cmr.4.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dance D. A., Wuthiekanun V., Naigowit P., White N. J. Identification of Pseudomonas pseudomallei in clinical practice: use of simple screening tests and API 20NE. J Clin Pathol. 1989 Jun;42(6):645–648. doi: 10.1136/jcp.42.6.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Desmarchelier P. M., Dance D. A., Chaowagul W., Suputtamongkol Y., White N. J., Pitt T. L. Relationships among Pseudomonas pseudomallei isolates from patients with recurrent melioidosis. J Clin Microbiol. 1993 Jun;31(6):1592–1596. doi: 10.1128/jcm.31.6.1592-1596.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Everett E. D., Nelson R. A. Pulmonary melioidosis. Observations in thirty-nine cases. Am Rev Respir Dis. 1975 Sep;112(3):331–340. doi: 10.1164/arrd.1975.112.3.331. [DOI] [PubMed] [Google Scholar]
  10. Haase A., Melder A., Smith-Vaughan H., Kemp D., Currie B. RAPD analysis of isolates of Burkholderia pseudomallei from patients with recurrent melioidosis. Epidemiol Infect. 1995 Aug;115(1):115–121. doi: 10.1017/s0950268800058179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hsueh P. R., Teng L. J., Hung C. C., Hsu J. H., Yang P. C., Ho S. W., Luh K. T. Molecular evidence for strain dissemination of Penicillium marneffei: an emerging pathogen in Taiwan. J Infect Dis. 2000 May 15;181(5):1706–1712. doi: 10.1086/315432. [DOI] [PubMed] [Google Scholar]
  12. Hsueh P. R., Teng L. J., Pan H. J., Chen Y. C., Sun C. C., Ho S. W., Luh K. T. Outbreak of Pseudomonas fluorescens bacteremia among oncology patients. J Clin Microbiol. 1998 Oct;36(10):2914–2917. doi: 10.1128/jcm.36.10.2914-2917.1998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kanaphun P., Thirawattanasuk N., Suputtamongkol Y., Naigowit P., Dance D. A., Smith M. D., White N. J. Serology and carriage of Pseudomonas pseudomallei: a prospective study in 1000 hospitalized children in northeast Thailand. J Infect Dis. 1993 Jan;167(1):230–233. doi: 10.1093/infdis/167.1.230. [DOI] [PubMed] [Google Scholar]
  14. Lee N., Wu J. L., Lee C. H., Tsai W. C. Pseudomonas pseudomallei infection from drowning: the first reported case in Taiwan. J Clin Microbiol. 1985 Sep;22(3):352–354. doi: 10.1128/jcm.22.3.352-354.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lee S. C., Ling T. S., Chen J. C., Huang B. Y., Sheih W. B. Melioidosis with adrenal gland abscess. Am J Trop Med Hyg. 1999 Jul;61(1):34–36. doi: 10.4269/ajtmh.1999.61.34. [DOI] [PubMed] [Google Scholar]
  16. Lee S. S., Liu Y. C., Chen Y. S., Wann S. R., Wang J. H., Yen M. Y., Wang J. H., Lin H. H., Huang W. K., Cheng D. L. Melioidosis: two indigenous cases in Taiwan. J Formos Med Assoc. 1996 Jul;95(7):562–566. [PubMed] [Google Scholar]
  17. Lee S. S., Liu Y. C., Wang J. H., Wann S. R. Mycotic aneurysm due to Burkholderia pseudomallei. Clin Infect Dis. 1998 Apr;26(4):1013–1014. doi: 10.1086/517640. [DOI] [PubMed] [Google Scholar]
  18. Lertpatanasuwan N., Sermsri K., Petkaseam A., Trakulsomboon S., Thamlikitkul V., Suputtamongkol Y. Arabinose-positive Burkholderia pseudomallei infection in humans: case report. Clin Infect Dis. 1999 Apr;28(4):927–928. doi: 10.1086/517253. [DOI] [PubMed] [Google Scholar]
  19. Mays E. E., Ricketts E. A. Melioidosis: recrudescence associated with bronchogenic carcinoma twenty-six years following initial geographic exposure. Chest. 1975 Aug;68(2):261–263. doi: 10.1378/chest.68.2.261. [DOI] [PubMed] [Google Scholar]
  20. McEniry D. W., Gillespie S. H., Felmingham D. Susceptibility of Pseudomonas pseudomallei to new beta-lactam and aminoglycoside antibiotics. J Antimicrob Chemother. 1988 Feb;21(2):171–175. doi: 10.1093/jac/21.2.171. [DOI] [PubMed] [Google Scholar]
  21. Parry C. M., Wuthiekanun V., Hoa N. T., Diep T. S., Thao L. T., Loc P. V., Wills B. A., Wain J., Hien T. T., White N. J. Melioidosis in Southern Vietnam: clinical surveillance and environmental sampling. Clin Infect Dis. 1999 Nov;29(5):1323–1326. doi: 10.1086/313479. [DOI] [PubMed] [Google Scholar]
  22. Phung L. V., Tran T. B., Hotta H., Yabuuchi E., Yano I. Cellular lipid and fatty acid compositions of Burkholderia pseudomallei strains isolated from human and environment in Viet Nam. Microbiol Immunol. 1995;39(2):105–116. doi: 10.1111/j.1348-0421.1995.tb02176.x. [DOI] [PubMed] [Google Scholar]
  23. Silbermann M. H., Gyssens I. C., Endtz H. P., Kuijper E. J., van der Meer J. T. Two patients with recurrent melioidosis after prolonged antibiotic therapy. Scand J Infect Dis. 1997;29(2):199–201. doi: 10.3109/00365549709035886. [DOI] [PubMed] [Google Scholar]
  24. Simpson A. J., Suputtamongkol Y., Smith M. D., Angus B. J., Rajanuwong A., Wuthiekanun V., Howe P. A., Walsh A. L., Chaowagul W., White N. J. Comparison of imipenem and ceftazidime as therapy for severe melioidosis. Clin Infect Dis. 1999 Aug;29(2):381–387. doi: 10.1086/520219. [DOI] [PubMed] [Google Scholar]
  25. Smith M. D., Angus B. J., Wuthiekanun V., White N. J. Arabinose assimilation defines a nonvirulent biotype of Burkholderia pseudomallei. Infect Immun. 1997 Oct;65(10):4319–4321. doi: 10.1128/iai.65.10.4319-4321.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Smith M. D., Wuthiekanun V., Walsh A. L., White N. J. In-vitro activity of carbapenem antibiotics against beta-lactam susceptible and resistant strains of Burkholderia pseudomallei. J Antimicrob Chemother. 1996 Mar;37(3):611–615. doi: 10.1093/jac/37.3.611. [DOI] [PubMed] [Google Scholar]
  27. Smith M. D., Wuthiekanun V., Walsh A. L., White N. J. Quantitative recovery of Burkholderia pseudomallei from soil in Thailand. Trans R Soc Trop Med Hyg. 1995 Sep-Oct;89(5):488–490. doi: 10.1016/0035-9203(95)90078-0. [DOI] [PubMed] [Google Scholar]
  28. Suputtamongkol Y., Chaowagul W., Chetchotisakd P., Lertpatanasuwun N., Intaranongpai S., Ruchutrakool T., Budhsarawong D., Mootsikapun P., Wuthiekanun V., Teerawatasook N. Risk factors for melioidosis and bacteremic melioidosis. Clin Infect Dis. 1999 Aug;29(2):408–413. doi: 10.1086/520223. [DOI] [PubMed] [Google Scholar]
  29. Trakulsomboon S., Dance D. A., Smith M. D., White N. J., Pitt T. L. Ribotype differences between clinical and environmental isolates of Burkholderia pseudomallei. J Med Microbiol. 1997 Jul;46(7):565–570. doi: 10.1099/00222615-46-7-565. [DOI] [PubMed] [Google Scholar]
  30. Tsai W. C., Liu Y. C., Yen M. Y., Wang J. H., Chen Y. S., Wang J. H., Wann S. R., Lin H. H. [Septicemic melioidosis in Southern Taiwan: a case report]. J Microbiol Immunol Infect. 1998 Jun;31(2):137–140. [PubMed] [Google Scholar]
  31. Vadivelu J., Puthucheary S. D., Drasar B. S., Dance D. A., Pitt T. L. Stability of strain genotypes of Burkholderia pseudomallei from patients with single and recurrent episodes of melioidosis. Trop Med Int Health. 1998 Jul;3(7):518–521. doi: 10.1046/j.1365-3156.1998.00262.x. [DOI] [PubMed] [Google Scholar]
  32. White N. J., Dance D. A., Chaowagul W., Wattanagoon Y., Wuthiekanun V., Pitakwatchara N. Halving of mortality of severe melioidosis by ceftazidime. Lancet. 1989 Sep 23;2(8665):697–701. doi: 10.1016/s0140-6736(89)90768-x. [DOI] [PubMed] [Google Scholar]
  33. Wilks D., Jacobson S. K., Lever A. M., Farrington M. Fatal melioidosis in a tourist returning from Thailand. J Infect. 1994 Jul;29(1):87–90. doi: 10.1016/s0163-4453(94)95222-1. [DOI] [PubMed] [Google Scholar]
  34. Yee K. C., Lee M. K., Chua C. T., Puthucheary S. D. Melioidosis, the great mimicker: a report of 10 cases from Malaysia. J Trop Med Hyg. 1988 Oct;91(5):249–254. [PubMed] [Google Scholar]

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