Biosafety and biosecurity for Burkholderia pseudomallei and Burkholderia mallei: evidence, gaps, and sustainable practice in endemic, low-resource settings.

SUMMARYBurkholderia pseudomallei and Burkholderia mallei present significant biosafety challenges due to their high pathogenicity, environmental resilience, intrinsic antimicrobial resistance, and potential use as bioterrorism agents. This review examines key aspects of laboratory management and infection control for these organisms, focusing on inconsistencies in biosafety protocols and risk classifications across regions. We synthesize current evidence on biocontainment requirements, disinfection strategies, and personal protective equipment (PPE), with particular emphasis on sustainable practices for laboratories in low-resource settings. Although laboratory-acquired infections are rare, their potential severity underscores the importance of stringent safety measures. Critical gaps remain in our understanding of infectious dose, the effectiveness of post-exposure prophylaxis (PEP), and the development of risk assessment frameworks. We advocate for harmonized global biosafety standards and targeted research on transmission dynamics and inactivation protocols. These priorities are essential to enhance laboratory safety, especially in endemic areas, and to inform coherent international policy on B. pseudomallei and B. mallei containment and management.