A systematic review and meta-analysis of the global prevalence and relationships among Burkholderia pseudomallei sequence types isolated from humans, animals, and the environment

Research (Published online: 04-01-2024)

4. A systematic review and meta-analysis of the global prevalence and relationships among Burkholderia pseudomallei sequence types isolated from humans, animals, and the environment

Sa-ngob Laklaeng, Doan Hoang Phu, Jirarat Songsri, Sueptrakool Wisessombat, Wanida Mala, Wilaiwan Senghoi, Preeda Phothaworn, Manit Nuinoon, Tuempong Wongtawan, and Wiyada Kwanhian Klangbud

Veterinary World, 17(1): 26-36

Sa-ngob Laklaeng: College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Doan Hoang Phu: College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand; Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City 70000, Vietnam.

Jirarat Songsri: Center of Excellence in Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat 80160, Thailand; Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Sueptrakool Wisessombat: Center of Excellence in Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat 80160, Thailand; Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Wanida Mala: Center of Excellence in Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat 80160, Thailand; Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Wilaiwan Senghoi: Center of Excellence in Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat 80160, Thailand; Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Preeda Phothaworn: Center of Excellence in Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat 80160, Thailand; Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Manit Nuinoon: Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Tuempong Wongtawan: Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Wiyada Kwanhian Klangbud: Center of Excellence in Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat 80160, Thailand; Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.

Background and Aim: Burkholderia pseudomallei, a highly pathogenic bacterium responsible for melioidosis, exhibits ecological ubiquity and thrives within soil and water reservoirs, posing significant infection risks to humans and animals through direct contact. The aim of this study was to elucidate the genetic diversity and prevalence patterns of B. pseudomallei sequence types (STs) across a global spectrum and to understand the relationships between strains isolated from different sources.

Materials and Methods: We performed a systematic review and meta-analysis in this study. Extensive research was carried out across three comprehensive databases, including PubMed, Scopus, and ScienceDirect with data collected from 1924 to 2023.

Results: A total of 40 carefully selected articles contributed 2737 B. pseudomallei isolates attributed to 729 distinct STs and were incorporated into the systematic review. Among these, ST46 emerged as the most prominent, featuring in 35% of the articles and demonstrating a dominant prevalence, particularly within Southeast Asia. Moreover, ST51 consistently appeared across human, animal, and environmental studies. Subsequently, we performed a meta-analysis, focusing on nine specific STs: ST46, ST51, ST54, ST70, ST84, ST109, ST289, ST325, and ST376. Surprisingly, no statistically significant differences in their pooled prevalence proportions were observed across these compartments for ST46, ST70, ST289, ST325, and ST376 (all p > 0.69). Conversely, the remaining STs, including ST51, ST54, ST84, and ST109, displayed notable variations in their prevalence among the three domains (all p < 0.04). Notably, the pooled prevalence of ST51 in animals and environmental samples surpassed that found in human isolates (p < 0.01).

Conclusion: To the best of our knowledge, this study is the first systematic review and meta-analysis to investigate the intricate relationships between STs and their sources and contributes significantly to our understanding of B. pseudomallei diversity within the One Health framework.

Keywords: Burkholderia pseudomallei, melioidosis, meta-analysis, One Health, sequence type, systematic review.