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      Dose‐dependant acute or subacute disease caused by Burkholderia pseudomallei strain NCTC 13392 in a BALB/c aerosol model of infection

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          Abstract

          Aims

          The goal of this study was to examine, for the first time, the virulence and pathogenicity of aerosolized Burkholderia pseudomallei, strain NCTC 13392, in BALB/c mice in order to develop an animal model for testing novel medical countermeasures (MCMs) for the treatment of human acute and subacute (a disease state between acute and chronic) melioidosis.

          Methods and Results

          BALB/c mice were exposed to varying doses of aerosolized bacteria. Acute disease was seen in animals exposed to a very‐high dose (≥10 3 CFU per animal) and death occurred 3–4 days postchallenge (pc). Bacteria were detected in the lungs, liver, kidney and spleen. In contrast, animals exposed to a low dose (<10 CFU per animal) survived to the end of the study (day 30 pc) but developed weight loss, a bacterial tissue burden and increasing clinical signs of infection from day 20 pc onwards, mimicking a subacute form of the disease. Pathological changes in the tissues mirrored these findings.

          Conclusions

          This proof of concept study has shown that B. pseudomallei strain NCTC 13392 is virulent and pathogenic in BALB/c mice, when delivered by aerosol. By varying the doses of aerosolized bacteria it was possible to mimic characteristics of both human acute and subacute melioidosis, at the same time, within the same study.

          Significance and Impact of the Study

          Burkholderia pseudomallei, the aetiological agent of melioidosis, causes a serious and often fatal disease in humans and animals. Novel MCMs are urgently needed for both public health and biodefense purposes. The present model provides a useful tool for the assessment and evaluation of new MCMs (e.g. therapeutics and vaccines) and offers the potential for testing new treatments for both subacute to chronic and acute melioidosis prior to human clinical trials.

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          Most cited references44

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          Melioidosis: insights into the pathogenicity of Burkholderia pseudomallei.

          Burkholderia pseudomallei is a potential bioterror agent and the causative agent of melioidosis, a severe disease that is endemic in areas of Southeast Asia and Northern Australia. Infection is often associated with bacterial dissemination to distant sites, and there are many possible disease manifestations, with melioidosis septic shock being the most severe. Eradication of the organism following infection is difficult, with a slow fever-clearance time, the need for prolonged antibiotic therapy and a high rate of relapse if therapy is not completed. Mortality from melioidosis septic shock remains high despite appropriate antimicrobial therapy. Prevention of disease and a reduction in mortality and the rate of relapse are priority areas for future research efforts. Studying how the disease is acquired and the host-pathogen interactions involved will underpin these efforts; this review presents an overview of current knowledge in these areas, highlighting key topics for evaluation.
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            Melioidosis

            NJ White (2003)
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              Cutaneous melioidosis in a man who was taken as a prisoner of war by the Japanese during World War II.

              Melioidosis, an infection caused by the gram-negative bacillus Burkholderia pseudomallei, is endemic to Southeast Asia and Northern Australia. Human infection is acquired through contact with contaminated water via percutaneous inoculation. Clinical manifestations range from skin and soft tissue infection to pneumonia with sepsis. We report a case of a man who was taken as a prisoner of war by the Japanese during World War II who presented with a nonhealing ulcer on his right hand 62 years after the initial exposure.
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                Author and article information

                Contributors
                simon.funnell@phe.gov.uk
                Journal
                J Appl Microbiol
                J. Appl. Microbiol
                10.1111/(ISSN)1365-2672
                JAM
                Journal of Applied Microbiology
                John Wiley and Sons Inc. (Hoboken )
                1364-5072
                1365-2672
                09 August 2019
                October 2019
                : 127
                : 4 ( doiID: 10.1111/jam.v127.4 )
                : 1224-1235
                Affiliations
                [ 1 ] National Infection Service Public Health England (PHE) Salisbury Wiltshire UK
                Author notes
                [*] [* ] Correspondence

                Simon G.P. Funnell, National Infection Service, Public Health England, Porton Down, Salisbury, Wiltshire, SP4 0GJ, UK.

                E‐mail: simon.funnell@ 123456phe.gov.uk

                Author information
                https://orcid.org/0000-0002-4254-2751
                https://orcid.org/0000-0002-1720-6764
                Article
                JAM14396 0625
                10.1111/jam.14396
                6747009
                31330088
                abdab456-868d-4b4a-8b29-0e8c7814dcc0
                © 2019 Crown copyright. Journal of Applied Microbiology published by John Wiley & Sons Ltd on behalf of The Society for Applied Microbiology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 April 2019
                : 21 June 2019
                : 25 June 2019
                Page count
                Figures: 5, Tables: 1, Pages: 12, Words: 7926
                Funding
                Funded by: National Institute of Allergy and Infectious Diseases
                Award ID: N01-A1-30062
                Categories
                Original Article
                Original Articles
                Public Health Microbiology/Clinical Microbiology
                Custom metadata
                2.0
                jam14396
                October 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.9 mode:remove_FC converted:01.10.2019

                Microbiology & Virology
                aerosol,balb/c,burkholderia,dose,melioidosis,pseudomallei,subacute
                Microbiology & Virology
                aerosol, balb/c, burkholderia, dose, melioidosis, pseudomallei, subacute

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