Elsevier

Acta Tropica

Volume 77, Issue 2, 2 November 2000, Pages 157-165
Acta Tropica

Melioidosis research in China

https://doi.org/10.1016/S0001-706X(00)00139-XGet rights and content

Abstract

Research on melioidosis and its pathogen has been ongoing in China for more than two decades. It has been demonstrated that the natural foci are located predominantly in Hainan, Guangdong and Guangxi province, where there is a good correlation between soil isolation and the serum prevalence of antibodies to Burkholderia pseudomallei. The cases of melioidosis reported up to now are concentrated in the Hainan and Zhanjiang peninsula. Investigations on serotype, virulence, ecology, antibiotic susceptibility, whole cell analysis by gas chromatography, and genetics have led to a new understanding of the pathology of the disease. Immunological cross reactions between Burkholderia mallei and B. pseudomallei and the difference between melioidosis and glanders in horses is discussed.

Introduction

Melioidosis caused by Burkholderia pseudomallei is a tropical and subtropical disease that has been recognized for more than 80 years since it was first described in Rangoon (Whitmore and Krishnaswami, 1912). When melioidosis was identified as a threat to US army personnel in Vietnam and to returning service men in the US (Howe et al., 1971), a Chinese military scholar discussed, for the first time, the possibility of its existence in southern China in 1972 (Yutu, 1972). A few years later, military veterinary officers realized that horses stationed in southern China might be misdiagnosed as having glanders and be killed according to law. To differentiate glanders from melioidosis in military horses, a collaborating research group was organized to research on melioidosis in China. Over the past two decades, a number of investigations and laboratory studies have been undertaken on B. pseudomallei and melioidosis. However, due to the language barrier, little is known by the outside world. This review, covering almost all the research work in China, is an attempt to share our achievements in this field with our counterparts in other regions of the world.

Section snippets

Geographical distribution of B. pseudomallei

Since 1975, B. pseudomallei has routinely been isolated from environment (Li et al., 1981, Li et al., 1990, Li et al., 1994, Yang et al., 1995a), and a number of isolates identified (Table 1). Earlier studies demonstrated that the pathogen was distributed in the southern provinces of Hainan, Guangxi and Guangdong (Fig. 1). The natural foci were found to be localized to regions south of the Tropic of Cancer (Li et al., 1981). A recent survey isolated the pathogen from Putian in the Fujian

Serotype

It is well established that B. pseudomallei can be classified into two serological types based on the presence or absence of thermolabile and thermostable antigens. Serotype 1 possesses both antigens and is found predominantly in Asia while serotype 2 has only thermostable antigens and is found in Australia and Africa (Dodin, 1970). About 68 strains isolated in China were examined by bi-directional agar diffusion test with antibodies to thermolabile antigens purified by Sephadex 200 from a

Immunological cross reactions between B. pseudomallei and B. mallei

Military veterinary officers showed great concern for the cross reaction to the antigen of B. mallei in horses that had actually been exposed to B. pseudomallei. It was first confirmed that the two species share the same antigens by a bidirectional agar diffusion test (Li et al., 1981). Then, in experimentally infected horses, cross reactions to the antigens of B. mallei were observed through complement fixation test, electroimmunodiffusion and allergic reaction in eyes by eye-dropping of the

Discussion

During the last two decades, melioidosis has received attention as an important tropical disease worldwide (Yang and Zhenzi, 1994), yet it is still unfamiliar to almost all physicians in China. It was due to increased awareness among physicians in endemic areas that human cases were identified and reported in recent years. However, the reported cases have made it clear that human melioidosis, as a newly emerging tropical disease, does exist, but its exact prevalence and threat to farmers, who

Acknowledgements

I am grateful to Dr Donald E. Woods of Canadian Bacterial Diseases Network for his critical review of this manuscript. I also thank Yuhai M. for his careful preparation of the drawings.

References (45)

  • S.Y. So et al.

    Melioidosis:a serological survey in a tuberculosis sanatorium in Hong Kong

    Trans. R. Soc. Trop. Med. Hyg.

    (1987)
  • D. Ching et al.

    Preparation and application of the specific antigens of Pseudomonas pseudomallei: part 2

    Chin. J. Zoonoses

    (1986)
  • Ching, D., Zhongli, Z., Li, L., Zhenzi, L., 1988. Preparation of monoclonal antibodies to Pseudomonas pseudomallei....
  • D. Ching et al.

    Protective effects of specific antigen and cell wall membrane antigen of Pseudomonas pseudomallei to animals

    Chin. J. Zoonoses

    (1991)
  • T. Deshen et al.

    Occurrence of human melioidosis in China

    Chin. J. Zoonoses

    (1991)
  • A. Dodin

    Antigens precipitants et antigens agglutinants de Pseudomonas pseudomallei

    Ann. De. Limistitat. Pasteur.

    (1970)
  • Z. Fang et al.

    Gas chromatographic analysis of the whole cells of Pseudomonas pseudomallei and mallei

    Acta Vet. Zootech. Sinica

    (1988)
  • C. Guangyuan et al.

    Review of thirteen cases of melioidosis

    Chin. J. Zoonoses

    (1995)
  • C. Guangyuan et al.

    Clinical diagnosis of melioidosis by enzyme-linked immunosorbant assay

    Chin. J. Zoonoses

    (1998)
  • C. Guangyuan et al.

    Study on the 29 Pneumonia melioidosis

    Chin. J. Zoonoses

    (1999)
  • C. Howe et al.

    The pseudomallei group: a review

    J. Infect. Dis.

    (1971)
  • Huang, C.T., 1976. What is Pseudomonas pseudomallei. Elixir,...
  • G. Ismail et al.

    Resistance of Pseudomonas pseudomallei to normal human serum bactericidal action

    Microbiol. Immunol.

    (1988)
  • J. Jigen et al.

    Study on the plasmids in Pseudomonas pseudomallei

    Chin. J. Epid.

    (1992)
  • L. Li et al.

    Restricting property of Pseudomonas pseudomallei to the growth of other kind of bacterium species

    Chin. J. Zoonoses

    (1988)
  • L. Li et al.

    Investigation of endemic areas of melioidosis

    Chin. J. Prev. Med.

    (1981)
  • N. Lee et al.

    Pseudomonas pseudomallei infection from drowning: the first reported case in Taiwan

    J. Clin. Microbiol.

    (1985)
  • L. Li et al.

    Preparation and application of the specific antigens of Pseudomonas pseudomallei: part 1.

    Chin. J. Zoonoses

    (1986)
  • L. Li et al.

    First report of human melioidosis and its serological prevalence in Hainan Island

    Chin. J. Zoonoses

    (1990)
  • L. Li et al.

    Epidemiological investigation of melioidosis in China

    Chin. J. Epidemiol.

    (1994)
  • S.C. Lee et al.

    Melioidosis with adrenal gland abscess

    Am. J. Trop. Med. Hyg.

    (1999)
  • H. Ouer et al.

    Classify species of Pseudomonas pseudomallei into serotypes

    Acta Microbiol. Sinica

    (1990)
  • Cited by (42)

    • Characterization of Burkholderia pseudomallei O antigens in different clinical strains

      2023, International Journal of Biological Macromolecules
      Citation Excerpt :

      It is the etiological agent of melioidosis, and is considered a potential bioweapon, classified as a Tier 1 select agent with no available vaccine [1]. Recent studies have reported that melioidosis is considerably more widespread than previously thought, with the disease being endemic in China, particularly in Hainan province [2,3]. Melioidosis progresses acutely, resulting in a high mortality rate (approximately 40 % in Thailand, and approximately 15 % in Australia), with approximately 89,000 global deaths per year [2,4,5].

    • Structural characterization of a novel pentasaccharide repeating unit from Burkholderia pseudomallei strain BPC006 and its role in diagnosis and immunogenicity

      2021, Journal of Pharmaceutical and Biomedical Analysis
      Citation Excerpt :

      Burkholderia pseudomallei, a facultative intracellular Gram-negative bacterium and the etiological agent of melioidosis, has been considered a potential bioweapon and classified as a Tier 1 select agent [1]. B. pseudomallei infections occur primarily in Southeast Asia and Northern Australia, and China is also an endemic focus of melioidosis particularly in Hainan province [2,3]. Humans acquire the B. pseudomallei infection through broken skin, inhalation, or ingestion, and the disease manifestation can range from subclinical to acute sepsis or chronic tuberculosis-like illness [4].

    • The prevalence and distribution of Burkholderia pseudomallei in rice paddy within Hainan, China

      2018, Acta Tropica
      Citation Excerpt :

      Given the prevalence of melioidosis in the province, the molecular epidemiology of 102 B. pseudomallei clinical isolates showed 6 predominated STs (ST46, ST50, ST55, ST58, ST70 and ST1095) and no geographical-specific phylogenetic lineages (Fang et al., 2016). From 1975 to 1983, a total of 33 strains of B. pseudomallei was isolated from the soil samples in four counties located different latitude from Hainan Island, most are the typical serotype in Asia (Yang, 2000). In 2016, we obtained two positive B. pseudomallei isolates from soil samples near the household of a patient with melioidosis (Lin et al., 2016).

    View all citing articles on Scopus
    View full text