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Published on: February 24, 2023
Emergence of Melioidosis in Indonesia
Abstract:
Melioidosis is known to be highly endemic in parts of southeast Asia and northern Australia; however, cases are rarely reported in Indonesia. Here we report three cases of melioidosis in Makassar, South Sulawesi, Indonesia occurring between 2013 and 2014. Two patients died and the other was lost to follow-up. Burkholderia pseudomallei isolates from all three cases were identified by the VITEK2 Compact installed in the hospital in 2012. None of the three patients reported received antimicrobials recommended for melioidosis because of the delayed recognition of the organism. We reviewed the literature and found only seven reports of melioidosis in Indonesia. Five were reported before 1960. We suggest that melioidosis is endemic throughout Indonesia but currently under-recognized. Training on how to identify B. pseudomallei accurately and safely in all available microbiological facilities should be provided, and consideration should be given to making melioidosis a notifiable disease in Indonesia.
Insights
Melioidosis, a serious bacterial infection caused by Burkholderia pseudomallei, is under-recognized in Indonesia. This study highlights three cases in Makassar, emphasizing the need for improved diagnostics and disease awareness.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Melioidosis is endemic in Southeast Asia and Northern Australia.
- Cases are infrequently reported in Indonesia, suggesting underdiagnosis.
Observation:
- Three cases of melioidosis occurred in Makassar, South Sulawesi, Indonesia, between 2013 and 2014.
- Two patients died, and one was lost to follow-up.
- Burkholderia pseudomallei was identified using VITEK2 Compact, but delayed recognition hindered appropriate antimicrobial treatment.
Findings:
- A literature review revealed only seven previous reports of melioidosis in Indonesia, with most from before 1960.
- The study suggests melioidosis is likely endemic throughout Indonesia but remains significantly under-recognized.
Implications:
- Enhanced training for accurate and safe identification of Burkholderia pseudomallei is crucial for all microbiological facilities.
- Consideration should be given to making melioidosis a notifiable disease in Indonesia to improve surveillance and management.
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