T T Trinh1, T S Hoang2, D A Tran3, V T Trinh4, A Göhler5, T T Nguyen6, S N Hoang7, R Krumkamp8, L T N Nguyen9, J May8, P M Doan10, C D Do10, T A Que3, I Steinmetz11. 1. Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Viet Nam. Electronic address: tttrung@vnu.edu.vn. 2. Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Viet Nam. 3. General Hospital of Nghe An Province, Viet Nam. 4. General Hospital of Ha Tinh Province, Viet Nam. 5. Friedrich Loeffler Institute for Medical Microbiology, Greifswald, Germany. 6. General Hospital of Quang Binh Province, Viet Nam. 7. General Hospital of Quang Tri Province, Viet Nam. 8. Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany. 9. Hue Central Hospital, Hue, Viet Nam. 10. Bach Mai Hospital, Hanoi, Viet Nam. 11. Friedrich Loeffler Institute for Medical Microbiology, Greifswald, Germany; Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
Abstract
OBJECTIVES: Melioidosis may be endemic in many tropical developing countries, but diagnosis of the disease is currently unreliable in resource-limited areas. We aimed to validate a simple and cheap laboratory algorithm for the identification of Burkholderia pseudomallei from clinical specimens in parts of Vietnam where the disease has not previously been reported. METHODS: In June 2015, we conducted training courses at five general hospitals in north-central provinces in order to raise awareness of the disease and to introduce a simple and cheap laboratory identification algorithm for B. pseudomallei including the three-antibiotic disc test. RESULTS: Until the end of the year (7 months later), 94 suspected B. pseudomallei strains resistant to gentamicin and colistin but sensitive to amoxicillin/clavulanic acid were detected in clinical specimens from 70 patients. All strains were further confirmed as B. pseudomallei by using a specific TTSS1 real-time PCR assay and recA sequencing analysis. Among positive blood cultures, positive rates with B. pseudomallei ranged from 3.4% (5/147) to 10.2% (32/312) in the various clinics. A total of 82.8% (58/70) patients were bacteraemic, with a mortality of 50% (18/36) among patients with known outcome. No death occurred in nonbacteraemic patients. CONCLUSIONS: Our results demonstrate that the introduction of a simple and easy-to-perform laboratory algorithm for the identification of B. pseudomallei from clinical samples, together with clinical awareness raising, can lead to the diagnosis of a significant number of melioidosis cases in resource-limited clinical laboratories which previously did not identify the pathogen.
OBJECTIVES:Melioidosis may be endemic in many tropical developing countries, but diagnosis of the disease is currently unreliable in resource-limited areas. We aimed to validate a simple and cheap laboratory algorithm for the identification of Burkholderia pseudomallei from clinical specimens in parts of Vietnam where the disease has not previously been reported. METHODS: In June 2015, we conducted training courses at five general hospitals in north-central provinces in order to raise awareness of the disease and to introduce a simple and cheap laboratory identification algorithm for B. pseudomallei including the three-antibiotic disc test. RESULTS: Until the end of the year (7 months later), 94 suspected B. pseudomallei strains resistant to gentamicin and colistin but sensitive to amoxicillin/clavulanic acid were detected in clinical specimens from 70 patients. All strains were further confirmed as B. pseudomallei by using a specific TTSS1 real-time PCR assay and recA sequencing analysis. Among positive blood cultures, positive rates with B. pseudomallei ranged from 3.4% (5/147) to 10.2% (32/312) in the various clinics. A total of 82.8% (58/70) patients were bacteraemic, with a mortality of 50% (18/36) among patients with known outcome. No death occurred in nonbacteraemic patients. CONCLUSIONS: Our results demonstrate that the introduction of a simple and easy-to-perform laboratory algorithm for the identification of B. pseudomallei from clinical samples, together with clinical awareness raising, can lead to the diagnosis of a significant number of melioidosis cases in resource-limited clinical laboratories which previously did not identify the pathogen.
Authors: Emma Birnie; Ayorinde James; Folake Peters; Makinwa Olajumoke; Tieble Traore; Eric Bertherat; Trung T Trinh; Dhamari Naidoo; Ivo Steinmetz; W Joost Wiersinga; Rita Oladele; Alani S Akanmu Journal: Am J Trop Med Hyg Date: 2022-01-10 Impact factor: 2.345
Authors: Quyen T L Tran; Ha V Nguyen; Huyen T Pham; Tuan V Mai; Quyen H M Nguyen; Dzung V Le; Linh N H Bui; Lan T H Hoang; Trung Q Hoang; Trung T Trinh Journal: Am J Trop Med Hyg Date: 2022-07-25 Impact factor: 3.707
Authors: Emma Birnie; Senne van 't Hof; Anne Bijnsdorp; Yembeh Mansaray; Erdi Huizenga; Arie van der Ende; Floor Hugenholtz; Martin P Grobusch; W Joost Wiersinga Journal: PLoS Negl Trop Dis Date: 2019-06-14