The Concentrations of Ambient Burkholderia Pseudomallei during Typhoon Season in Endemic Area of Melioidosis in Taiwan

Chen, Ya Lei; Yen, Yu Chuan; Yang, Ching-Ching; Lee, Min Sheng; Ho, Chi Kung; Mena, Kristina D.; Wang, Peng Yau; Chen, Pei–Shih

doi:10.1371/journal.pntd.0002877

Cited by 30 publications

(42 citation statements)

References 38 publications

(118 reference statements)

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“…Thus, the rainy season will increase the risk of occupational exposure to infections such as melioidosis. 18 Among cases with determined organisms of liver abscess, B. pseudomallei was the most frequently reported. This might be due to endemic melioidosis, which is the major cause of community-acquired septicemia in northeast Thailand, 19 and due to a high index of clinical suspicion among physicians in areas of endemic disease.…”

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confidence: 99%

Burden of Liver Abscess and Survival Risk Score in Thailand: A Population-Based Study

Poovorawan¹,

Pan-ngum²,

Soonthornworasiri³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. In Thailand, the burden of liver abscess, a life-threatening infectious disease, has not been thoroughly evaluated. We developed a predictive scoring system to estimate survival of patients with liver abscess using information from the 2008-2013 Nationwide Hospital Admission Data to evaluate the burden of liver abscess in Thailand. All patients with primary diagnosis of pyogenic liver abscess (PLA) and amoebic liver abscess (ALA) were included. Epidemiological data, baseline characteristics, hospital course, and survival were analyzed. Overall, 11,296 admissions comprising 8,423 patients from 844 hospitals across Thailand were eligible for analysis. The mean age was 52 ± 17 years and 66.1% of patients were male. ALA was significantly prevalent in southern and western border regions of Thailand, and PLA occurred nationwide. The highest incidence of liver abscess occurred in the rainy season (June-November, P < 0.01). The median length of hospital stay was 8 days (interquartile range = 4-13 days), and mean direct cost of hospitalization was 846 ± 1,574 USD. The overall inhospital mortality rate was 2.8%. Incidence of ALA decreased over the 5-year study period, whereas PLA incidence increased (P < 0.01). Using multivariable Cox regression methods with stepwise variable selection, we developed a final model with five highly significant baseline parameters associated with increased 60-day mortality: older age, PLA, underlying chronic kidney disease, cirrhosis, and human immunodeficiency virus infection. Range of estimated probability of 60-day survival was 95-16% at cumulative risk score 0-13. This simplified score is practical, and may help clinicians prioritize patients requiring more intensive care.

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confidence: 99%

Burden of Liver Abscess and Survival Risk Score in Thailand: A Population-Based Study

Poovorawan¹,

Pan-ngum²,

Soonthornworasiri³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…It is usual for laboratories in non-endemic locations to misidentify the bacterium as commensal. Although there has been expansion of the disease in tropical countries due to global warming and population movement, many cases are unmasked by improved clinical surveillance and better diagnostic methodology [9]. …”

Section: Discussionmentioning

confidence: 99%

Chronic melioidosis presenting with multiple abscesses

et al. 2016

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Melioidosis is common in Australia and Southeast Asia and is increasingly recognized in India. It presents in various forms which are difficult to identify and often mimics suppurative infections, tuberculosis, fungal infections, malignancy and systemic rheumatic diseases. Presentation may vary from local disease to disseminated abscesses, pneumonia and sepsis. Disease is common and severe in diabetics. We describe a case of diabetic man presenting with fever, septic shock, peri-articular nodules, lung opacities and multiple abscesses in muscles for the past 3 months remaining undiagnosed. Autoimmune conditions were ruled out and infection with Burkholderia pseudomallei was suspected. Burkholderia pseudomallei was isolated from blood cultures, confirming the diagnosis. Prolonged treatment with intravenous ceftazidime followed by oral cotrimoxazole led to complete recovery. Awareness of this infection is required by clinicians and microbiologists unfamiliar with the condition to diagnose the disease early to prevent mortality.

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“…This bacterium is a tier 1 select agent and a natural inhabitant of soil and surface waters in tropical and subtropical regions where it is endemic (1–5). Melioidosis is acquired through inoculation, aerosols, or ingestion (6, 7).…”

Section: Introductionmentioning

confidence: 99%

Multitarget Quantitative PCR Improves Detection and Predicts Cultivability of the Pathogen Burkholderia pseudomallei

Göhler

Trung

Hopf

et al. 2017

Appl Environ Microbiol

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Burkholderia pseudomallei is present in the environment in many parts of the world and causes the often-fatal disease melioidosis. The sensitive detection and quantification of B. pseudomallei in the environment are a prerequisite for assessing the risk of infection. We recently reported the direct detection of B. pseudomallei in soil samples using a quantitative PCR (qPCR) targeting a single type three secretion system 1 (TTSS1) gene. Here, we extend the qPCR-based analysis of B. pseudomallei in soil by validating novel qPCR gene targets selected from a comparative genomic analysis. Two hundred soil samples from two rice paddies in northeast Thailand were evaluated, of which 47% (94/200) were B. pseudomallei culture positive. The TTSS1 qPCR and two novel qPCR assays that targeted open reading frames (ORFs) BPSS0087 and BPSS0745 exhibited detection rates of 76.5% (153/200), 34.5% (69/200), and 74.5% (150/200), respectively. The combination of TTSS1 and BPSS0745 qPCR increased the detection rate to 90% (180/200). Combining the results of the three qPCR assays and the BPSS1187 nested PCR previously published, all 200 samples were positive by at least one PCR assay. Samples positive by either TTSS1 (n = 153) or BPSS0745 (n = 150) qPCR were more likely to be direct-culture positive, with odds ratios of 4.0 (95% confidence interval [CI], 1.7 to 9.5; P < 0.001) and 9.0 (95% CI, 3.1 to 26.4; P < 0.001), respectively. High B. pseudomallei genome equivalents correlated with high CFU counts by culture. In conclusion, multitarget qPCR improved the B. pseudomallei detection rate in soil samples and predicted culture positivity. This approach has the potential for use as a sensitive environmental screening method for B. pseudomallei.IMPORTANCE The worldwide environmental distribution of the soil bacterium Burkholderia pseudomallei remains to be determined. So far, most environmental studies have relied on culture-based approaches to detect this pathogen. Since current culture methods are laborious, are time consuming, and have limited sensitivity, culture-independent and more sensitive methods are needed. In this study, we show that a B. pseudomallei-specific qPCR approach can detect significantly higher numbers of B. pseudomallei-positive soil samples from areas where it is endemic compared with that from culture. The use of multiple independent B. pseudomallei-specific qPCR targets further increased the detection rate of B. pseudomallei compared with that from single targets. Samples with a high molecular B. pseudomallei load were more likely to be culture positive. We conclude that our quantitative multitarget approach might be useful in defining areas where there is a risk of B. pseudomallei infections in different parts of the world.

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The Concentrations of Ambient Burkholderia Pseudomallei during Typhoon Season in Endemic Area of Melioidosis in Taiwan

Cited by 30 publications

References 38 publications

Burden of Liver Abscess and Survival Risk Score in Thailand: A Population-Based Study

Burden of Liver Abscess and Survival Risk Score in Thailand: A Population-Based Study

Chronic melioidosis presenting with multiple abscesses

Multitarget Quantitative PCR Improves Detection and Predicts Cultivability of the Pathogen Burkholderia pseudomallei

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