Burkholderia: Gram ___? Shape?
Gram Negative, Rods
Burkholderia: Catalase result?
Used to be in genus Pseudomonas. Oxidizes carbohydrates -24+ species
Burkholderia: Pathogenic strains:
Animals: B. mallei, B. pseudomallei Compromised humans: B. cepacia, B gladioli
Burkholderia: General Disease Pattern
Pyogranulomatous Diseases -Few organisms needed to cause disease
Burkholderia: Pathogen classification (by CDC & USDA/APHIS)
Category B! REPORTABLE!! Biosafety level 3 Aerosol infection possible
Burkholderia mallei -Dangerous uses
REPORTABLE!! Bioweaponized! WWII Germans spread to debilitate enemy horses
Burkholderia mallei -Disease Pattern
Burkholderia mallei -Species affected
Glanders in: *Equids*, *Felines, dogs, goats, camels, sheep, *humans* -Dead-end hosts
Burkholderia mallei What species is particularly susceptible?
Cats (Guinea pigs & hamsters in labs too)
Burkholderia mallei Main geographic location?
Asia & South America
Burkholderia mallei Characteristic signs?
Nodules & ulcers in respiratory tract or on skin -Systemic pyogranulomatous diseases vary in acuteness & severity
Burkholderia mallei Cellular products of medical interest?
Capsule (anti-complement/ anti-phagocytosis) Cell Wall (LPS) Miscellaneous products
Burkholderia mallei Miscellaneous products
-Quorum sensing -Type 3 & 4 secretion systems (T3SS, T4SS) -Proteases, lipases, phospholipase C
Burkholderia mallei Reservoir
-*Equidae*- True parasite (die outside w/in 2 weeks) -Respiratory tract or skin lesions
Burkholderia mallei Common reservoir site in males
Glanderous orchitis common in males (Inflammation of one or both testicles)
Burkholderia mallei Transmission
*Ingestion* (feed/water) -Fomites -Inhalation -Wounds
Burkholderia mallei Pathogenesis
Primary lesion @ point of entry (pharynx, skin) --> Spreads by blood & lymphatics --> Nodular lesions in: Lymph nodes, lungs, spleen, liver, nasal septum, skin (cutaneous glanders = "farcy")
Burkholderia mallei General Glanders description
Usually chronic, disseminated, debilitating disease
Burkholderia mallei Cutaneous glanders = ____?
Burkholderia mallei Pathology
Suppurative & Granulomatous lesions
Burkholderia mallei Pathology Suppurative lesion description
Basic nodular lesion, made up initially of neutrophils, fibrin, red cells
Burkholderia mallei Pathology Granulomatous lesion description
Central necrotic area becomes surrounded by epithelioid, giant cells & lymphocytes embedded in granulation tissue
Burkholderia mallei: Glanders Acute Infection
Fever - Nasal Discharge - Lymphadenitis Of head & neck with swelling along upper respiratory tract --Usually ends fatally in 2 weeks--
Burkholderia mallei: Glanders Chronic Infection
Common in horses IF signs are present they include: Fever - Persistant respiratory problems - Skin abscesses (Farcy) - nodular induration (sclerosis/hardening) of cranial lymph nodes
Burkholderia mallei: Glanders Humans!
ZOONOTIC! -Traced to an ill horse usually -Acute / Chronic -50% mortality before antimicrobials
What are these pictures of?
Burkholderia pseudomallei Diseases
REPORTABLE!!! Melioidosis and pseudoglanders
Burkholderia pseudomallei "The Great Imitator" Disease Description
Pyogranulomatous diseases, usually disseminate REPORTABLE
Burkholderia pseudomallei Intracellular/Extracellular?
Facultative intracellular rod
Burkholderia pseudomallei Saprophyte/ Parasite? -Reservoir-
Saprophyte! *Unlike B. mallei!* Wet environments: endosymbiot of amoeba living in environment. Swampy terrain or rice paddies
Burkholderia pseudomallei Motile/Non-Motile?
Motile by Flagella! **Different than B. Mallei*
Name Differences between B. mallei and B. pseudomallei
B. Mallei: Non-Motile - obligate parasite - grows slower - does not oxidize lactose - No growth at 42C B. pseudomallei: Motile - saprophyte - grows faster - oxidizes lactose - Grows at 42C -
Burkholderia pseudomallei Melioidosis General
Similar to Glanders with wider host range
Burkholderia pseudomallei Melioidosis Species Affected
-Mainly Sheep & goats -Severe in rodents (tropical) -Avian -Fish -Reptiles
Burkholderia pseudomallei Melioidosis in Humans
Range from subclinical to rapidly FATAL
Burkholderia pseudomallei Cellular products of interest
Adhesins - Adherence Capsule - Protection Cell Wall - LPS Miscellaneous products
Burkholderia pseudomallei Adhesins What do they bind to?
-Adheres to amoebic throphozoites & phagocytes -Flagellin aids
Burkholderia pseudomallei Miscellaneous Products
T3SS, T4SS Pathogenicity Island (unknown effector functions) Proteases, Lipases, Phospholipase C
Burkholderia pseudomallei Reservoir
-Soil & water (amoeba) -Mainly tropics, also Europe, Asia, North America -Increased disease incidence with heavy rainfall
Burkholderia pseudomallei Transmission
Ingestion Wound infection Airborne Arthropod bites (+/-)
Burkholderia pseudomallei Melioidosis Systemic disease description
Chronic nodular or purulent inflammatory diseases -Any tissue -Pyogranulomatous
Burkholderia pseudomallei Melioidosis Systemic disease in humans
Whitmore's Disease -asymptomatic to overwhelming sepsis -Pneumonia, benign, acute-chronic, "Vietnamese Time Bomb"
Burkholderia pseudomallei Melioidosis Human disease nickname
Vietnamese Time Bomb -Still present in veterans
Burkholderia pseudomallei Melioidosis Dog presentation
Febrile disease with localized suppurative foci
Burkholderia pseudomallei Melioidosis Equine
Mimics "Glanders" Pseudoglanders
Burkholderia pseudomallei Melioidosis Cattle
Acute or chronic Localize in lungs, joints, uterus
Burkholderia pseudomallei Melioidosis Sheep
Arthritis and lymphadenitis
Burkholderia pseudomallei Melioidosis Goats
Loss of condition, respiratory, CNS disturbances, arthritis, mastitis
Burkholderia pseudomallei Melioidosis Swine
Loss of condition, respiratory & CNS disturbances, arthritis, mastitis, abortion, diarrhea
Burkholderia pseudomallei Lab Dx Classification? Submitted to what labs?
BSL-3 Submit isolates to reference laboratories
Lab Dx What stains can you use with Burkholderia pseudomallei?
Giemsa Methylene Blue Wright's Gram
What samples should be used for lab diagnostics for Burkholderia pseudomallei?
Nodular contents (swab, aspirates)
What type of agar should Burkholderia pseudomallei be grown on?
Blood Glycerol Glycerol-potato Chocolate MacConkey (some)
What grows faster, B. pseudomallei or B. mallei?
B. pseudomallei faster! <48hr
What percentage NaCl should Burkholderia pseudomallei be grown on?
Burkholderia pseudomallei grows on 2% NaCl
Does Burkholderia pseudomallei oxidize lactose?
Yes! Oxidizes lactose UNLIKE B. mallei and P. aeuruginosa
What temperature can Burkholderia pseudomallei grow at but B. mallei cannot?
42C B. pseudomallai and P aeruginosa can grow at 42C but B. mallei cannot
What medium helps detect Burkholderia pseudomallei in mixed infections?
Ashdown's selective medium
What species are used for in vivo laboratory infections?
Guinea pigs & hamsters -Highly susceptible
What type of agar is demonstrated below? How long and what temp should Burkholderia pseudomallei be grown at?
Pseudomonas cepacia "PC agar" -72 hours at 30C
What type of agar is demonstrated below?
MacConkey Agar Note- B. pseudomallei oxidizes the lactose
What serological tests are useful in diagnosing Burkholderia pseudomallei?
IFA, complement fixation, ELISA Indirect hemagglutination most common, lacks specificity (and always PCR for molecular Dx)
What tests are done on horses coming into the USA?
Complement fixation = official test Intradermal palpebral mallein test (detects Cell mediated hypersensitivity, indicated infection)
What are the immunological aspects of Burkholderia pseudomallei?
Humoral & CMI Recovered are not protected No commercial vaccines (though successful in horses & zoo animals)
How is Glanders (B. mallei) controlled in endemic areas?
Testing suspect clinical cases Screening apparently normal animals Destroying reactors Communal feeding & watering discouraged
How is Glanders (B. mallei) controlled/ treated in outbreaks?
All contaminated bedding & footstuffs should be burned or buried
Should you treat equids with Glanders? (B. mallei)
TREATING EQUIDS IS DISCOURAGED!!! -Same antibiotics as humans -Positives to Mallein-test are destroyed
How is Meilioidosis (B. pseudomallei) treated and controlled?
No effective prevention -Contact with water and soil too common Surgically drain abscesses & antimicrobial therapy Treatment must be in early course of disease -Highly resistant, Fluoroquinolones & tetracyclines are choice -No commercial vaccines for Glanders of Melioidosis