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Burkholderia pseudomallei and melioidosis

Nature Reviews Microbiology volume 22, pages 155–169 (2024)Cite this article

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Abstract

Burkholderia pseudomallei, the causative agent of melioidosis, is found in soil and water of tropical and subtropical regions globally. Modelled estimates of the global burden predict that melioidosis remains vastly under-reported, and a call has been made for it to be recognized as a neglected tropical disease by the World Health Organization. Severe weather events and environmental disturbance are associated with increased case numbers, and it is anticipated that, in some regions, cases will increase in association with climate change. Genomic epidemiological investigations have confirmed B. pseudomallei endemicity in newly recognized regions, including the southern United States. Melioidosis follows environmental exposure to B. pseudomallei and is associated with comorbidities that affect the immune response, such as diabetes, and with socioeconomic disadvantage. Several vaccine candidates are ready for phase I clinical trials. In this Review, we explore the global burden, epidemiology and pathophysiology of B. pseudomallei as well as current diagnostics, treatment recommendations and preventive measures, highlighting research needs and priorities.

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Fig. 1: Global distribution of Burkholderia pseudomallei.
Fig. 2: Virulence factors of Burkholderia pseudomallei and the host immune response.
Fig. 3: Antimicrobial resistance mechanisms of Burkholderia pseudomallei.
Fig. 4: Vaccines against Burkholderia pseudomallei currently under development.

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Acknowledgements

The authors would like to acknowledge the excellent work being done by global colleagues within the International Melioidosis Network. S.J.D. is funded by an NIHR Global Research Professorship (NIHR300791).

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Authors and Affiliations

  1. Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia

    Ella M. Meumann & Bart J. Currie

  2. Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia

    Ella M. Meumann & Bart J. Currie

  3. Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand

    Direk Limmathurotsakul & Susanna J. Dunachie

  4. Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

    Direk Limmathurotsakul

  5. NDM Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK

    Direk Limmathurotsakul & Susanna J. Dunachie

  6. Division of Infectious Diseases, Center for Experimental Molecular Medicine, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

    Willem J. Wiersinga

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Meumann, E.M., Limmathurotsakul, D., Dunachie, S.J. et al. Burkholderia pseudomallei and melioidosis. Nat Rev Microbiol 22, 155–169 (2024). https://doi.org/10.1038/s41579-023-00972-5

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