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. 2013;7(3):e2105.
doi: 10.1371/journal.pntd.0002105. Epub 2013 Mar 21.

Systematic review and consensus guidelines for environmental sampling of Burkholderia pseudomallei

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Systematic review and consensus guidelines for environmental sampling of Burkholderia pseudomallei

Direk Limmathurotsakul et al. PLoS Negl Trop Dis. 2013.

Abstract

Background: Burkholderia pseudomallei, a Tier 1 Select Agent and the cause of melioidosis, is a Gram-negative bacillus present in the environment in many tropical countries. Defining the global pattern of B. pseudomallei distribution underpins efforts to prevent infection, and is dependent upon robust environmental sampling methodology. Our objective was to review the literature on the detection of environmental B. pseudomallei, update the risk map for melioidosis, and propose international consensus guidelines for soil sampling.

Methods/principal findings: An international working party (Detection of Environmental Burkholderia pseudomallei Working Party (DEBWorP)) was formed during the VIth World Melioidosis Congress in 2010. PubMed (January 1912 to December 2011) was searched using the following MeSH terms: pseudomallei or melioidosis. Bibliographies were hand-searched for secondary references. The reported geographical distribution of B. pseudomallei in the environment was mapped and categorized as definite, probable, or possible. The methodology used for detecting environmental B. pseudomallei was extracted and collated. We found that global coverage was patchy, with a lack of studies in many areas where melioidosis is suspected to occur. The sampling strategies and bacterial identification methods used were highly variable, and not all were robust. We developed consensus guidelines with the goals of reducing the probability of false-negative results, and the provision of affordable and 'low-tech' methodology that is applicable in both developed and developing countries.

Conclusions/significance: The proposed consensus guidelines provide the basis for the development of an accurate and comprehensive global map of environmental B. pseudomallei.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram showing study selection.
Figure 2
Figure 2. Global map showing the distribution of B. pseudomallei.
Definitions of definite, probable and possible presence of environmental B. pseudomallei are described in Table 1. 1 represents ‘Jardin des Plantes’ in Paris where soil cultures positive for B. pseudomallei were initially reported after an outbreak of melioidosis, which was thought to have originated from a panda imported from China . 2 represents Bologna, Italy, where B. pseudomallei in tap water (6 out of 85 specimens) was reported in 2000 . However, confirmation of B. pseudomallei by specific identification methods was not reported. 3 represents Chittering, southwest Western Australia, where B. pseudomallei was isolated and confirmed from a single soil specimen in 1980, following the outbreak of melioidosis in animals , . There has been no evidence of environmental B. pseudomallei in southwest Western Australia since then.

References

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