Updates on Human Melioidosis

Dear Colleagues,

The impact of melioidosis is escalating globally. This infectious disease, which predominantly affects low- and middle-income countries, remains underdiagnosed and underreported. The effect of a delayed or incorrect diagnosis ultimately results in poor patient outcomes. While awareness of this disease has improved over time, the case-fatality rate is estimated to be above 50% in some regions. Rapid and cost-effective diagnostic tests remain an essential requirement for improving patient outcomes.

The geographical burden of disease continues to expand worldwide. In recent years, the United States and multiple countries in Africa and South America have been recognized as melioidosis-endemic regions. A critical risk factor associated with melioidosis is diabetes mellitus. Current estimates suggest that this risk factor will impact approximately 700 million people in 2045, with 80% of these individuals living in low- and middle-income countries. Of additional concern is immunosuppression and the added risk of the increasing use of biologics for an ever-growing list of conditions.

In most regions, the risk of infection is also associated with severe weather events. Heavy rainfall, floods, and cyclones/typhoons have all been linked to a significant rise in melioidosis case incidence. Climate change has resulted in an increased intensity of these weather events and will likely play a significant role in the near future.

As B. pseudomallei is intrinsically resistant to a range of antimicrobial agents, first-line therapy is limited to ceftazidime or meropenem, and access to these medications may be challenging. Furthermore, there have been limited additions to the therapeutic arsenal over time. However, recent studies into novel compounds and phage therapy are promising.

Finally, the organism in question is highly recombinant and genetically diverse. This information may be relevant to both the fields of genomic epidemiology and disease prevention in the form of vaccine development.

This Special Issue seeks to provide an update on the epidemiology, diagnosis, management, and prevention of melioidosis. We welcome the submission of both review articles and original research.

Dr. Ian Gassiep
Dr. Robert Norton
Guest Editors

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• melioidosis
• Burkholderia pseudomallei
• epidemiology
• climate change
• diagnosis
• management
• prevention
• whole genome sequencing