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Volume 23, Number 5—May 2017

CME ACTIVITY - Research

Increased Neurotropic Threat from Burkholderia pseudomallei Strains with a B. mallei–like Variation in the bimA Motility Gene, Australia

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Article Title:
Increased Neurotropic Threat from Burkholderia pseudomallei Strains with a B. mallei–like Variation in the bimA Motility Gene, Australia

CME Questions

1. Based on the mouse model of neurologic melioidosis studied by Morris and colleagues, which of the following statements about differences in virulence among Burkholderia pseudomallei bimBm sequence variants is most accurate?

A. Virulence of bimBm variants was similar to that of isolates with typical bimA alleles when delivered intranasally

B. Virulence of bimBm variants was similar to that of isolates with typical bimA alleles when delivered subcutaneously

C. Central nervous system (CNS) infection occurred with increased frequency and at lower inoculating doses after infection of mice with bimBm than with bimBp strains of B. pseudomallei

D. Virulence defined by 50% infectious dose (ID50) values was significantly greater for bimBp strains than for bimBm strains when delivered intranasally to BALB/c mice

2. Based on the mouse model of neurologic melioidosis studied by Morris and colleagues, which of the following statements about differences in progression among B. pseudomallei bimBm sequence variants is correct?

A. Compared with isolates with typical bimA alleles, those with the B. mallei–like variation had more rapid systemic dissemination and replication within brain, spinal cord, and other tissues

B. bimBm vs bimBp strains had greater bacterial colonization of the brain, but without meningeal involvement

C. Sites of abscessation within the CNS were consistent among infected animals

D. Phagocytic cells are not involved in rapid systemic dissemination of B. pseudomallei to the CNS and other distant sites

3. Based on the mouse model studied by Morris and colleagues, which of the following statements about implications for clinical disease of these differences among B. pseudomallei bimBm sequence variants in the progression and severity of experimental melioidosis is correct?

A. Route of infection, infecting dose, and host risk factors for melioidosis are the only predictors of melioidosis occurrence, manifestations, and severity

B. bimBm variation is a predictor for severe forms of melioidosis, including neurologic involvement

C. The study proves that bimA is the only gene that has a strong association with neurologic melioidosis

D. The study proves that B. pseudomallei uses only 1 mechanism to enter the CNS

Activity Evaluation

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2. The material was organized clearly for learning to occur.

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3. The content learned from this activity will impact my practice.

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4. The activity was presented objectively and free of commercial bias.

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