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Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis
Published on: February 24, 2023
Melioidosis: Reinfection going incognito as relapse
Isra Halim1, Tushar Shaw1, Chaitanya Tellapragada1
1Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Abstract:
Melioidosis has recently gained importance as an emerging disease in India. Recurrent melioidosis has been reported from different parts of the world and can be due to relapse or reinfection. Distinction between relapse and reinfection is important for epidemiology, investigation and management. Here, we present the data regarding rate of recurrence and utility of multilocus sequence typing (MLST) in differentiating relapse form reinfection amongst melioidosis patients from a tertiary care hospital in South India. Amongst the 31 patients who survived and underwent follow-up, 4 (13%) presented with recurrence. Three cases (75%) were identified as reinfection and one (25%) as relapse based on MLST. Re-exposure to environmental Burkholderia pseudomallei amongst patients with melioidosis in endemic areas is likely. In such a scenario, more often than not, recurrence of melioidosis can be attributed to reinfection.
Insights
Recurrent melioidosis, an emerging disease in India, was studied. Multilocus sequence typing (MLST) revealed most recurrences were due to reinfection, not relapse, highlighting environmental exposure risks.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Melioidosis is an emerging infectious disease in India.
- Recurrent melioidosis can result from relapse or reinfection.
- Differentiating relapse from reinfection is crucial for public health management.
Purpose of the Study:
- To determine the recurrence rate of melioidosis.
- To evaluate the utility of multilocus sequence typing (MLST) in distinguishing relapse from reinfection.
- To understand the causes of melioidosis recurrence in South India.
Main Methods:
- Retrospective analysis of melioidosis patients from a tertiary care hospital.
- Follow-up of surviving patients to identify recurrence.
- Multilocus sequence typing (MLST) for genotypic differentiation of recurrent isolates.
Main Results:
- Four out of 31 (13%) surviving patients experienced melioidosis recurrence.
- MLST identified three cases (75%) as reinfection and one case (25%) as relapse.
- The findings suggest frequent re-exposure to environmental Burkholderia pseudomallei.
Conclusions:
- Recurrence of melioidosis in endemic areas is often due to reinfection.
- MLST is a valuable tool for differentiating relapse from reinfection in melioidosis.
- Environmental re-exposure is a significant factor in melioidosis recurrence.
