#1211

Melioidosis in the Rain: Environmental Triggers and the Pathophysiology of Prostatic Abscesses

E. Alpay^1,2, K. Chah¹, M. Yuhico¹

¹Townsville University Hospital, Urology, Townsville, Australia
²University of Melbourne, Medicine, Dentistry and Health Sciences, Melbourne, Australia

Introduction:

Melioidosis, an infectious disease caused by Burkholderia pseudomallei has been closely linked to the development of prostatic abscesses, often requiring surgical drainage. It displays a distinct seasonal pattern, with a marked rise in cases during monsoonal and flood seasons in endemic regions such as Southeast Asia and Northern Australia. With recent flooding in Northern Queensland and increased incidence of cases, a review was conducted to explore the environmental and pathophysiological mechanisms underpinning the increased incidence of melioidosis during flooding, with a specific focus on genitourinary and prostatic involvement.

Material and methods:

A systematic review of peer-reviewed literature published from 2000 onwards was conducted using PubMed and Scopus. Inclusion criteria were English-language human studies examining the relationship between environmental exposure to B. pseudomallei, flood or rainfall patterns, and genitourinary melioidosis. Key themes analysed included transmission pathways, bacterial survival mechanisms, host susceptibility, and clinical outcomes.

Results:

Several studies identified a strong temporal association between heavy rainfall and spikes in melioidosis cases. Floodwaters facilitate widespread dispersion of B. pseudomallei from soil into surface water, increasing exposure via skin abrasions, inhalation, or ingestion. The pathogen’s ability to form biofilms and persist in waterlogged environments enhances environmental resilience. Clinically, dissemination of B. pseudomallei via the bloodstream frequently results in visceral abscess formation, particularly in the prostate. This is attributed to the bacterium’s facultative intracellular survival, immune evasion, and tropism for well-perfused, immunologically vulnerable tissues in susceptible hosts such as those with diabetes or alcohol use disorder.