Abstract
BackgroundMelioidosis is gaining recognition as an emerging infectious disease with diverse clinical manifestations and high-case fatality rates worldwide. However, the molecular epidemiology of the disease outside the endemic regions such as northeast part of Thailand and northern Australia remains unclear.Methodology/Principal findingsClinical data and B. pseudomallei isolates obtained from 199 culture-confirmed cases of melioidosis diagnosed during 2006–2016 in South India were used to elucidate the host and pathogen specific variable virulence determinants associated with clinical presentations and disease outcome. Further, we determined the temporal variations and the influence of ecological factors on B.pseudomallei Lipopolysaccharide (LPS) genotypes causing infections. Severe forms of the disease were observed amongst 169 (85%) patients. Renal dysfunction and infection due to B.pseudomallei harboring BimABm variant had significant associations with severe forms of the disease. Diabetes mellitus, septicemic melioidosis and infection due to LPSB genotype were independent risk factors for mortality. LPSB (74%) and LPSA (20.6%) were the prevalent genotypes causing infections. Both genotypes demonstrated temporal variations and had significant correlations with rainfall and humidity.Conclusion/SignificanceOur study findings suggest that the pathogen specific virulence traits under the influence of ecological factors are the key drivers for geographical variations in the molecular epidemiology of melioidosis.
Highlights
Variable virulence genes contributing to varied clinical presentation and the association of LPS genotypes provides key insights regarding the disease dynamics, host and pathogen specific determinants for disease presentations and outcomes among melioidosis patients in India
The study shows the divergence of Indian B.pseudomallei strains in context to LPS genotypes compared to isolates reported worldwide
Melioidosis is a fatal infectious disease caused by soil saprophytic bacterium, Burkholderia pseudomallei
Summary
Melioidosis is a fatal infectious disease caused by soil saprophytic bacterium, Burkholderia pseudomallei. Lipopolysaccharide (LPS) of B. pseudomallei is a well-known virulence factor that confers serum resistance and helps in evading host immune defenses during the early stages of infection. In this context, LPS is gaining recognition as a potential candidate for vaccine and diagnostic assay development [1,2]. Burkholderia intracellular motility (BimA) and filamentous hemagglutinin gene (fhaB3) were reported previously as the significant variable virulence factors based on their geographic distribution and associations with clinical presentations [4]. Melioidosis is gaining recognition as an emerging infectious disease with diverse clinical manifestations and high-case fatality rates worldwide. The molecular epidemiology of the disease outside the endemic regions such as northeast part of Thailand and northern Australia remains unclear
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call