We are making a review on it and according to a review of Cheng in 2005 (CLINICAL MICROBIOLOGY REVIEWS, Apr. 2005, 18(2):383–416), melioidosis is only endemic in some areas of South East Asia and Australia. However "sporadic" have been reported in Brazil, Colombia, Venezuela and Ecuador. Are there cases in other countries in the region?
I tried to look cases of mellioidosis according to MLST.net, only found two genotypes reported in Ecuador and Venezuela
http://bpseudomallei.mlst.net/earth/maps/
Thanks AbdeRahman, interesting. However Ecuador and Venezuela were reported in the past.
Dear Alfonso, I think this paper will help: http://www.ajtmh.org/content/75/5/947.long
Regards,
Dear Alfonso, I havent came across any case in Peru. The only reference about an isolated case is linked to this publication: Dance, D. A. B. 1991. Melioidosis: the tip of the iceberg? Clin. Microbiol.
Rev. 4:52–60. Regards.
I am not aware of any wide serological studies in the region, which I believe would act as surrogate for endemicity. It would be interesting to see if anyone conducts a pilot study in several South American countries, although one needs to be aware of potential limitations.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110358/
Thanks Mohamad-Ali. Good considerations on that article!
As luck would have it I was reviewing the question of the distribution of melioidosis and B. pseudomallei in S and C America and the Caribbean just last week. These are the countries for which I have found some evidence (albeit quite weak in some cases such as Peru, where French workers claim to have isolated the organism from soil, but this was before the existence of closely related avirulent Burkholderia spp. such as B. thailandensis were recognised):
Brazil, British Virgin Islands, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guadeloupe, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Peru, Puerto Rico, Trinidad, and Venezuela
Sources are listed at the end of this post, although some are reviews and not the primary source.
Within each of these, the distribution may be quite focal (for example in Brazil it has only been reported in Ceara to the best of my knowledge), but there is significant potential for underdiagnosis. You need a lab and staff who know what they are looking for to make the diagnosis. Serosurveys would be interesting but difficult to interpret. If blood cultures are being done then these are the best place to look for evidence as 50-60% of cases will have bacteraemia. If you are seeing oxidase positive Gram negative bacilli that are resistant to aminoglycosides and colistin/polymyxin but susceptible to co-amoxiclav than these could be B. pseudomallei and should not be dismissed as 'Pseudomonas sp.' or as contaminants.
As far as I know, no-one has done any really extensive surveys within S. America and I would be very interested to collaborate with anyone who is thinking of doing so
David Dance
1. Dance DAB. Melioidosis: the tip of the iceberg? Clin Microbiol Rev 1991; 4(1): 52-60.
2. Dorman SE, Gill VJ, Gallin JI, Holland SM. Burkholderia pseudomallei infection in a Puerto Rican patient with chronic granulomatous disease: case report and review of occurrences in the Americas. Clin Infect Dis 1998; 26(4): 889-94.
3. Gee JE, Allender CJ, Tuanyok A, Elrod MG, Hoffmaster AR. Burkholderia pseudomallei Type G in Western Hemisphere. Emerg Infect Dis 2014; 20(4): 661-3.
4. Inglis TJJ, Rolim DB, De Queiroz Sousa ANAS. Melioidosis in the Americas. Am J Trop Med Hyg 2006; 75(5): 947-54.
5. Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 2005; 18(2): 383-416.
6. Currie BJ, Dance DAB, Cheng AC. The global distribution of Burkholderia pseudomallei and melioidosis: an update. Trans R Soc Trop Med Hyg 2008; 102(Suppl. 1): S1-S4.
7. Corral DM, Coates AL, Yau YC, et al. Burkholderia pseudomallei infection in a cystic fibrosis patient from the Caribbean: a case report. Can Respir J 2008; 15(5): 237-9.
8. Dance DA. Melioidosis as an emerging global problem. . Acta Tropica 2000;74(2-3):115-9.
9. Centers for Diseazse Control and Prevention. Imported melioidosis--South Florida, 2005. Morb Mortal Wkly Rep 2006; 55(32): 873-6.
10. Guzmán-Gómez L, Agudo Bilbao M, Peiro-Callizo E, Salas C. Melioidosis imported from Colombia to Spain. Enfermedades Infecciosas y Microbiologia Clinica 2014.
11. Almuzara M, Barberis C, Bravo M, et al. [A case of melioidosis in Argentina]. Medicina (B Aires) 2011; 71(1): 39-41.
Dear Dr. Dance
Thank you very much for you excellent answer. We are concern about this and probably we will plan to do an study in the region. Could I have your email? I am interested to be in toch for this. My email is: [email protected]
Few countries like Brazil, British Virgin Islands, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guadeloupe, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Peru, Puerto Rico, Trinidad, and Venezuela
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