Melioidosis in Timor-Leste: First Case Description and Phylogenetic Analysis

Helio Guterres, Celia Gusmao, Mateus Pinheiro, Joana Martins, Gustavo Odio, Carolina Maia, Virginia Da Conceicao, Messias Soares, Celita Osorio, Endang Soares Da Silva, Arijayanti Tilman, Rodney Givney, Tessa Oakley, Jennifer Yan, Lucia Toto, Elfiana Amaral, Rodney James, Kirsty Buising, Mark Mayo, Mirjam KaestliJessica R. Webb, Robert W. Baird, Bart J. Currie, Joshua R. Francis, Stephen Muhi

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Abstract

Burkholderia pseudomallei, the causative agent of melioidosis, has not yet been reported in Timor-Leste, a sovereign state northwest of Australia. In the context of improved access to diagnostic resources and expanding clinical networks in the Australasian region, we report the first 3 cases of culture-confirmed melioidosis in Timor-Leste. These cases describe a broad range of typical presentations, including sepsis, pneumonia, multifocal abscesses, and cutaneous infection. Phylogenetic analysis revealed that the Timor-Leste isolates belong to the Australasian clade of B. pseudomallei, rather than the Asian clade, consistent with the phylogeographic separation across the Wallace Line. This study underscores an urgent need to increase awareness of this pathogen in Timor-Leste and establish diagnostic laboratories with improved culture capacity in regional hospitals. Clinical suspicion should prompt appropriate sampling and communication with laboratory staff to target diagnostic testing. Local antimicrobial guidelines have recently been revised to include recommendations for empiric treatment of severe sepsis.
Original languageEnglish
Article numberofad405
Pages (from-to)1-7
Number of pages7
JournalOpen Forum Infectious Diseases
Volume10
Issue number8
DOIs
Publication statusPublished - 1 Aug 2023

Bibliographical note

Funding Information:
Financial support. This work was supported by the Fleming Fund (financial support of regional activities and resources).

Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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