The causative agent of melioidosis, Burkholderia pseudomallei, a tier 1 select agent, is endemic in Southeast Asia and northern Australia, with increased incidence associated with high levels of rainfall. Increasing reports of this condition have occurred worldwide, with estimates of up to 165,000 cases and 89,000 deaths per year. The ecological niche of the organism has yet to be clearly defined, although the organism is associated with soil and water. The culture of appropriate clinical material remains the mainstay of laboratory diagnosis. Identification is best done by phenotypic methods, although mass spectrometric methods have been described. Serology has a limited diagnostic role. Direct molecular and antigen detection methods have limited availability and sensitivity. Clinical presentations of melioidosis range from acute bacteremic pneumonia to disseminated visceral abscesses and localized infections. Transmission is by direct inoculation, inhalation, or ingestion. Risk factors for melioidosis include male sex, diabetes mellitus, alcohol abuse, and immunosuppression. The organism is well adapted to intracellular survival, with numerous virulence mechanisms. Immunity likely requires innate and adaptive responses. The principles of management of this condition are drainage and debridement of infected material and appropriate antimicrobial therapy. Global mortality rates vary between 9% and 70%. Research into vaccine development is ongoing.

中文翻译：

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 人类类鼻疽。


类鼻疽的病原体类鼻疽伯克霍尔德杆菌是一种一级选择病原体，在东南亚和澳大利亚北部流行，发病率随高降雨量而增加。世界范围内有关这种情况的报道越来越多，估计每年有多达 165,000 例病例和 89,000 人死亡。尽管该生物体与土壤和水有关，但该生物体的生态位尚未明确定义。培养适当的临床材料仍然是实验室诊断的支柱。尽管已经描述了质谱方法，但最好通过表型方法进行鉴定。血清学的诊断作用有限。直接分子和抗原检测方法的可用性和灵敏度有限。类鼻疽的临床表现包括急性菌血症性肺炎、播散性内脏脓肿和局部感染。传播途径是直接接种、吸入或摄入。类鼻疽的危险因素包括男性、糖尿病、酗酒和免疫抑制。该生物体很好地适应细胞内生存，具有多种毒力机制。免疫可能需要先天和适应性反应。这种情况的处理原则是感染物质的引流和清创以及适当的抗菌治疗。全球死亡率在 9% 到 70% 之间。疫苗开发研究正在进行中。