TY - JOUR
T1 - Melioidosis in Timor-Leste
T2 - First Case Description and Phylogenetic Analysis
AU - Guterres, Helio
AU - Gusmao, Celia
AU - Pinheiro, Mateus
AU - Martins, Joana
AU - Odio, Gustavo
AU - Maia, Carolina
AU - Da Conceicao, Virginia
AU - Soares, Messias
AU - Osorio, Celita
AU - Da Silva, Endang Soares
AU - Tilman, Arijayanti
AU - Givney, Rodney
AU - Oakley, Tessa
AU - Yan, Jennifer
AU - Toto, Lucia
AU - Amaral, Elfiana
AU - James, Rodney
AU - Buising, Kirsty
AU - Mayo, Mark
AU - Kaestli, Mirjam
AU - Webb, Jessica R.
AU - Baird, Robert W.
AU - Currie, Bart J.
AU - Francis, Joshua R.
AU - Muhi, Stephen
N1 - 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.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - 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.
AB - 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.
KW - Timor-Leste
KW - Burkholderia pseudomallei
KW - melioidosis
KW - phylogeny
UR - http://www.scopus.com/inward/record.url?scp=85168788574&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofad405
DO - 10.1093/ofid/ofad405
M3 - Article
SN - 2328-8957
VL - 10
SP - 1
EP - 7
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 8
M1 - ofad405
ER -