Abstract
Neurologic melioidosis is a serious, potentially fatal form of Burkholderia pseudomallei infection. Recently, we reported that a subset of clinical isolates of B. pseudomallei from Australia have heightened virulence and potential for dissemination to the central nervous system. In this study, we demonstrate that this subset has a B. mallei-like sequence variation of the actin-based motility gene, bimA. Compared with B. pseudomallei isolates having typical bimA alleles, isolates that contain the B. mallei-like variation demonstrate increased persistence in phagocytic cells and increased virulence with rapid systemic dissemination and replication within multiple tissues, including the brain and spinal cord, in an experimental model. These findings highlight the implications of bimA variation on disease progression of B. pseudomallei infection and have considerable clinical and public health implications with respect to the degree of neurotropic threat posed to human health.
Highlights
This activity has been planned and implemented through the joint providership of Medscape, LLC and Emerging Infectious Diseases
We reported that B. pseudomallei isolates from patients with neurologic melioidosis do not demonstrate selective neurotropism in an experimental model, a distinct subset of B. pseudomallei isolates appeared equipped for rapid dissemination to multiple tissues, including the central nervous system (CNS), after infection [11]
Similar to other intracellular bacteria, B. pseudomallei and B. mallei are able to spread to adjacent host cells and evade immune surveillance through the formation of actin tails in a process that involves polymerization of host actin monomers [5,10,23,24]
Summary
This activity has been planned and implemented through the joint providership of Medscape, LLC and Emerging Infectious Diseases. LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: [1] review the learning objectives and author disclosures; [2] study the education content; [3] take the posttest with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; and [4] view/print certificate. Distinguish differences in progression among B. pseudomallei bimBm sequence variants Determine the implications for clinical disease of these differences among B. pseudomallei bimBm sequence variants in progression and severity of experimental melioidosis
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