Detection of Burkholderia pseudomallei in Sputum using Selective Enrichment Broth and Ashdown’s Medium at Kampong Cham Provincial Hospital, Cambodia

Abstract

Melioidosis infection, caused by Burkholderia pseudomallei, is increasingly reported in Cambodia. We hypothesized that implementation of an enhanced sputum testing protocol in a provincial hospital diagnostic microbiology laboratory would increase detection of B. pseudomallei. We tested 241 sputum specimens that were deemed acceptable for culture, comparing culture in selective enrichment broth followed by sub-culture on Ashdown’s medium to standard culture methods. Two specimens (0.8%) were positive for B. pseudomallei using the enhanced protocol whereas one specimen (0.4%) was positive using standard methods. These findings demonstrate that B. pseudomallei is rarely detected in sputum at this hospital. The low frequency of B. pseudomallei in sputum specimens precludes drawing any conclusions about the relative benefits of an enhanced sputum testing protocol at this site. Promoting clinician awareness of the infection and encouraging utilization of diagnostic microbiology services are likely to be important factors in facilitating identification of melioidosis.

Melioidosis in lower provincial Cambodia: A case series from a prospective study of sepsis in Takeo Province

“…pseudomallei by the age of four [ 30 ]. While in Cambodia, a single serosurvey in the Siem Reap Province detected antibodies in 16% of children [ 31 ] and recent reports have described only several hundred cases of melioidosis in 14 Cambodian provinces since 2007 [ 28 , 32 – 37 ]. Although the true burden of B .…”

Melioidosis in Timor-Leste: First Case Description and Phylogenetic Analysis

“…We have recently incorporated additional biochemical spectra to perform in-country confirmatory MALDI-ToF identity testing. Additionally, the recognition of these cases prompted the implementation of Ashdown's agar, a selective media that improves the detection of B. pseudomallei from nonsterile specimens, such as sputum [ 27 ].…”