Summary:

The Darwin Prospective Melioidosis Study aims to understand the clinical and microbiological aspects of melioidosis in the Top End and collaborate with colleagues globally through the International Melioidosis Network. This information is then used to lessen the burden of the disease, through earlier diagnosis, improved treatment and public health prevention messages. Over the 31 years the study has been running there has been a large decrease in the mortality rate from melioidosis, from over 30 per cent initially to now under 5 per cent.

Following very heavy wet seasons in 2009-2012, there was a dramatic rise in melioidosis cases in tropical Northern Australia. Between 1 October 2009 and 30 September 2010, a then record number of 91 confirmed melioidosis cases were recorded. Of these, 11 proved fatal. This compares with a median of 27 cases per 12-month period over the previous 20 years. Subsequently, there were 64 cases in 2010/2011 and 97 cases in 2011/2012. In the dryer years since 2013, yearly case numbers have varied between 42 and 70.

The rise in the proportion of cases from the Darwin urban region has been particularly striking and the reasons for this are considered to be a combination of weather patterns, urban construction activity (with disturbance of soil) and increased numbers of people with risk factors for melioidosis living in Darwin and surrounds.

In addition, the genetic diversity of the Burkholderia pseudomallei (B. pseudomallei) strains from the various locations over recent years is being determined, with a particular focus on those strains that originate from higher risk Darwin suburbs. Comparisons with bacterial genotypes from overseas supports the hypothesis that B. pseudomallei originated in Australia and subsequently spread to Southeast Asia and then to Africa and most recently to the Americas.

The Darwin Melioidosis Treatment Guidelines have been adopted internationally and the findings from 30+ years of Menzies studies have resulted in 258 peer-reviewed journal publications covering diverse aspects of the disease (melioidosis) and its pathogen (B. pseudomallei). Menzies will be hosting the 10th World Melioidosis Congress in Darwin in 2023.

Chief investigator:
Project manager:
Contact information:
Project dates:

The study commenced in 1989 and is ongoing.

Funder:
  • National Health and Medical Research Council (NHMRC)

 

Centre for Disease Control resources:

 

Publications in the last two years

  1. Currie, B.J., Mayo, M., Ward, L.M., Kaestli, M., Meumann, E.M., Webb, J.R., Woerle, C., Baird, R.W., Price, R.N., Marshall, C.S., Ralph, A.P., Spencer, E., Davies, J., Huffam, S.E., Janson, S., Lynar, S., Markey, P., Krause, V.L. & Anstey, N.M. (2021). Melioidosis is an opportunistic infectious disease: the 30-year Darwin Prospective Melioidosis Study. Lancet Infectious Diseases: in print.
  2. Janesomboon, S., Muangsombut, V., Srinon, V., Meethai, C., Tharinjaroen, C.S., Amornchai, P., Chantratita, N., Mayo, M., Wuthiekanun, V., Currie, B.J., Stevens, J.M. & Korbsrisate, S. (2021). PCR detection of Burkholderia species with pathogenic potential in environmental soil samples. PLoS ONE, 16(1): e0245175. doi: 10.1371/journal.pone.0245175.
  3. Rachlin, A., Luangrai, M., Kaestli, M., Rattanavong, S., Phoumin, P., Webb, J.R., Mayo, M., Currie, B.J. & Dance, D.A.B. (2020). Using land runoff to survey the distribution and genetic diversity of Burkholderia pseudomallei in Vientiane, Laos. Applied and Environmental Microbiology: in press. doi: 10.1128/AEM.02112-20.
  4. Somprasong, N., Hall, C.M., Webb, J.R., Sahl, J.W., Wagner, D.M., Keim, P., Currie, B.J. & Schweizer, H.P. (2020). Burkholderia ubonensis high-level tetracycline resistance is due to efflux pump synergy involving a novel TetA(64) resistance determinant. Antimicrobial Agents and Chemotherapy: in press. doi: 10.1128/AAC.01767-20.
  5. Aziz, A., Currie, B.J., Mayo, M., Sarovich, D.S. & Price, E.P. (2020). Comparative genomics confirms a rare melioidosis human-to-human transmission event and reveals incorrect phylogenomic reconstruction due to polyclonality. Microbial Genomics, 6(2). doi:10.1099/mgen.0.000326.
  6. Chang, C.Y., Lau, N.L.J., Podin, Y. & Currie, B.J. (2020). Disseminated melioidosis in early pregnancy - an unproven cause of foetal loss. BMC Infectious Diseases, 20:201. doi:10.1186/s12879-020-4937-8.
  7. Rachlin, A., Mayo, M., Webb, J.R., Kleinecke, M., Rigas, V., Harrington, G., Currie, B.J. & Kaestli, M. (2020). Whole-genome sequencing of Burkholderia pseudomallei from an urban melioidosis hot-spot reveals a fine-scale population structure and localised spatial clustering in the environment. Nature Scientific Reports, 10, 5443. doi: 10.1038/s41598-020-62300-8. 
  8. Somprasong, N., Hall, C.M., Webb, J.R., Sahl, J.W., Wagner, D.M., Keim, P., Currie, B.J. & Schweizer, H.P. (2020). Burkholderia ubonensis meropenem resistance: Insights into distinct properties of class A b-lactamases in Burkholderia cepacia complex and Burkholderia pseudomallei complex bacteria. mBio, 11, e00592-20. doi:10.1128/mBio.00592-20.
  9. Pearson, T., Sahl, J.W., Hepp, C.M., Handady, K., Hornstra, H., Vazquez, A.J., Settles, E.W., Mayo, M., Kaestli, M., Williamson, C.H.D., Price, E.P., Sarovich, D.S., Cook, J.M., Wolken, S.R., Bowen, R.A., Tuanyok, A., Foster, J.T., Drees, K.P., Kidd, T.J., Bell, S.C., Currie, B.J. & Keim, P. (2020). Pathogen to commensal? Longitudinal within-host population dynamics, evolution, and adaptation during a chronic >16-year Burkholderia pseudomallei infection. PLoS Pathogens, 16(3), e1008298. doi:10.1371/journal. ppat.1008298.
  10. Sullivan, R.P., Marshall, C.S., Anstey, N.M., Ward, L.& Currie, B.J. (2020). 2020 Review and revision of the 2015 Darwin melioidosis treatment guideline; paradigm drift not shift. PloS Neglected Tropical Diseases, 14(9): e0008659. doi:10.1371/journal.pntd.0008659.
  11. Webb, J.R., Win, M.M., Zin, K.N., Win, K.K.N., Wah, T.T., Ashley, E.A., Smithuis, F., Swe, M.M.M., Mayo, M., Currie, B.J. & Dance, D.A.B. (2020). Myanmar Burkholderia pseudomallei strains are genetically diverse and originate from Asia with phylogenetic evidence of reintroductions from neighbouring countries. Scientific Reports, 10, 16260. doi:10.1038/s41598-020-73545-8.
  12. Arnold, L., Borecky, N., Geddes, D.A., Lydiard, L., Field, A. & Currie, B.J. (2020). Melioidosis breast abscess diagnosed by screening mammography. The Breast Journal, 26, 2070-2071. doi:10.1111/tbj.14040.
  13. Webb, J.R., Buller, N., Rachlin, A., Golledge, C., Sarovich, D.S., Price, E.P., Mayo, M. & Currie, B.J. (2020). A persisting non-tropical focus of Burkholderia pseudomallei with limited genome evolution over five decades. mSystems, 5, e00726-20. doi: 10.1128/mSystems.00726-20.
  14. Amiss, A.S., Webb, J.R., Mayo, M., Currie, B.J., Craik, D.J., Troeira Henriques, S. & Lawrence, N. (2020). Safer in vitro drug screening models for melioidosis therapy development. American Journal of Tropical Medicine and Hygiene, 103, 1846-185. doi:10.4269/ajtmh.20-0248.
  15. Madden, D.E., Webb, J.R., Steinig, E.J., Currie, B.J., Price, E.P., Sarovich, D.S. (2020). Taking the next-gen step: comprehensive antimicrobial resistance detection from Burkholderia pseudomallei. EBioMedicine, 63, 103152: doi:10.1016/j.ebiom.2020.103152.
  16. Sullivan, R.P., Ward, L. & Currie, B.J. (2019). Oral eradication therapy for melioidosis: important but not without risks. International Journal of Infectious Diseases, 80, 111-114. doi: 10.1016/j.ijid.2019.01.019
  17. Jinhee, Y. J., Simpanya, M.F., Settles, E.W., Shannon, A.B., Hernandez, K., Pristo, L., Keener, M.E., Hornstra, H., Busch, J.D., Soffler, C., Brett, P., Currie, B.J., Bowen, R.A., Tuanyok, A. & Keim, P. (2019). Caprine humoral response to Burkholderia pseudomallei antigens during acute melioidosis from aerosol exposure. PloS Neglected Tropical Diseases, 13(2): e0006851. doi: 10.1371/journal.pntd.0006851.
  18. Limmathurotsakul, D., Daily, F., Bory, S., Khim, G., Wiersinga, W.J., Torres, A.G., Dance, D.A.B. & Currie, B.J. (2019). Melioidosis: the hazards of incomplete peer-review. PloS Neglected Tropical Diseases, 13(3):e0007123. doi: 10.1371/journal.pntd.0007123.
  19. Dance, D.A.B., Wuthiekanun, V., Sarovich, D., Price, E.P., Limmathurotsakul, D., Currie, B.J. & Trung, T.T. (2019). Letter: Pan-drug-resistant and biofilm-producing strain of Burkholderia pseudomallei: first report of melioidosis from a diabetic patient in Yogyakarta, Indonesia. International Medical Case Reports Journal, 12, 117-118. doi: 10.2147/IMCRJ.S205245.
  20. Kirby, P., Smith, S., Ward, L., Hanson, J. & Currie, B.J. (2019). Clinical utility of platelet count as a prognostic marker in melioidosis. American Journal of Tropical Medicine and Hygiene, 100, 1085-1087. doi: 10.4269/ajtmh.18-0698
  21. Schully, K.L., Young, C.C., Mayo, M., Connolly, A.L., Rigas, V., Spall, A., Chan, A.A., Salvador, M.G., Lawler, J.V., Opdyke, J.A., Clark, D.V. & Currie, B.J. (2019). Next generation diagnostics for melioidosis: evaluation of a prototype i-STAT cartridge to detect Burkholderia pseudomallei biomarkers. Clinical Infectious Diseases, 69, 421-427. doi: 10.1093/cid/ciy929.
  22. Webb, J.R., Sarovich, D.S., Price, E.P., Ward, L.M., Mayo, M. & Currie, B.J. (2019). Burkholderia pseudomallei lipopolysaccharide genotype does not correlate with severity or outcome in melioidosis: host risk factors remain the critical determinant. Open Forum Infectious Diseases, 6(4), 1-5. doi:10.1093/ofid/ofz091.
  23. Luangasanatip, N., Flasche, S., Dance, D.A.B., Limmathurotsakul, D., Currie, B.J., Mukhopadhyay, C., Atkins, T., Titball, R. & Jit, M. (2019). The global impact and cost-effectiveness of a melioidosis vaccine. BMC Medicine, 17,129. doi:10.1186/s12916-019-1358-x.
  24. Webb, J.R., Rachlin, A., Rigas, V., Sarovich, D.S., Price, E.P., Kaestli, M., Ward, L.M., Mayo, M. & Currie, B.J. (2019). Tracing the environmental footprint of the Burkholderia pseudomallei lipopolysaccharide genotypes in the tropical “Top End” of the Northern Territory, Australia. PloS Neglected Tropical Diseases, 13(7), e0007369. doi: 10.1371/journal.pntd.0007369.
  25. Schully, K.L., Burtnick, M.N., Bell, M.G., Spall, A., Mayo, M., Rigas, V., Chan, A.A., Yu, K., Clark, D.V., Maves, R.C., Currie, B.J., Brett, P.J. & Lawler, J.V. (2019). Serological evidence of Burkholderia pseudomallei infection in U.S. Marines who trained in Australia from 2012-2014: a retrospective analysis of archived samples. MSMR, 26, 8-17. PMID: 31347371. 
  26. Rachlin, A., Kleinecke, M., Kaestli, M., Mayo, M., Webb, J.R., Rigas, V., Shilton, C., Benedict, S., Dyrting, K. & Currie, B.J. (2019). A cluster of melioidosis infections in hatchling saltwater crocodiles (Crocodylus porosus) resolved using genome-wide comparison of a common north Australian strain of Burkholderia pseudomallei. Microbial genomics, 5 (8), 1-11. doi: 10.1099/mgen.0.000288.
  27. Kaestli, M., O’Donnell, M., Rose, A., Webb, J., Mayo, M., Currie, B.J. & Gibb, K. (2019). Opportunistic pathogens and large microbial diversity detected in source-to-distribution drinking water of three remote communities in Northern Australia. PloS Neglected Tropical Diseases, 13(9), e0007672. doi: 10.1371/journal.pntd.0007672.
  28. Rachlin, A., Shilton, C., Webb, J.R., Mayo, M., Kaestli, M., Kleinecke, M., Rigas, V., Benedict, S., Gurry, I. & Currie, B.J. (2019). Melioidosis fatalities in captive slender-tailed meerkats (Suricata suricatta): Combining epidemiology, pathology and whole-genome sequencing supports variable mechanisms of transmission with One Health implications. BMC Veterinary Research,15, 458. doi:10.1186/s12917-019-2198-9.
  29. Jiminez, V.M., Settles, E.W., Currie, B.J., Keim, P. & Monroy, F.P. (2019). Persistence of Burkholderia thailandensis E264 in lung tissue after a single binge alcohol episode. PLoS ONE, 14, e0218147. doi: 10.1371/journal.pone.0218147.
  30. Mahomed, Y.F., Scott, N.E., Molinaro, A., Creuzenet, C., Ortega, X., Lertmemongkolchai, G., Tunney, M.M., Green, H., Jones, A.M., DeShazer, D., Currie, B.J., Foster, L.J., Ingram, R., De Castro, C. & Valvano, M.A. (2019). A general protein O-glycosylation machinery conserved in Burkholderia species improves bacterial fitness and elicits glycan immunogenicity in humans. Journal of Biological Chemistry, 294, 13248-13268. doi:10.1074/jbc.RA119.009671.
  31. Zaw, K.K., Wasgewatta, S.L., Kwong, K.K., Fielding, D., Heraganahally, S.S. & Currie, B.J. (2019). Chronic pulmonary melioidosis masquerading as lung malignancy diagnosed by EBUS guided sheath technique. Respiratory Medicine Case Reports, 28,100894. doi:10.1016/j.rmcr.2019.100894.