Melioidosis Queensland: An analysis of clinical outcomes and genomic factors.


Journal

PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 10 07 2023
accepted: 03 10 2023
revised: 27 10 2023
medline: 30 10 2023
pubmed: 12 10 2023
entrez: 12 10 2023
Statut: epublish

Résumé

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.

Sections du résumé

BACKGROUND BACKGROUND
The clinical and genomic epidemiology of melioidosis varies across regions.
AIM OBJECTIVE
To describe the clinical and genetic diversity of B. pseudomallei across Queensland, Australia.
METHODS METHODS
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.
RESULTS RESULTS
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%.
CONCLUSION CONCLUSIONS
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.

Identifiants

pubmed: 37824595
doi: 10.1371/journal.pntd.0011697
pii: PNTD-D-23-00850
pmc: PMC10610085
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0011697

Informations de copyright

Copyright: © 2023 Gassiep et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Ian Gassiep (I)

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.
Pathology Queensland, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia.

Delaney Burnard (D)

Queensland Cyber Infrastructure Foundation, Brisbane, Queensland, Australia.

Budi Permana (B)

The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.
Herston Infectious Diseases Institute, Metro North Health, Queensland, Australia.

Michelle J Bauer (MJ)

The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.

Thom Cuddihy (T)

The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.

Brian M Forde (BM)

The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.

Mark D Chatfield (MD)

The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.

Weiping Ling (W)

The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.

Robert Norton (R)

Pathology Queensland, Townsville University Hospital, Townsville, Queensland, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Patrick N A Harris (PNA)

The University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Herston, Queensland, Australia.
Pathology Queensland, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia.

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Classifications MeSH