Detection of antibodies to Detection of antibodies to Burkholderia pseudomalleiBurkholderia pseudomallei in children in Siem Reap, Kingdom of Cambodia in children in Siem Reap, Kingdom of Cambodia and presence of the organism in their environmentand presence of the organism in their environment

Vanaporn WuthiekanunVanaporn Wuthiekanun11, Dr. Ngoun Pheaktra, Dr. Ngoun Pheaktra22, Hor Putchhat, Hor Putchhat22, Sayan Lankla, Sayan Lankla11, Sin Lina, Sin Lina22, Bun Sen, Bun Sen22, Sharon , Sharon PeacockPeacock11, Nicholas Day, Nicholas Day11

1. Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, Thailand; 1. Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, Thailand; 2. Angkor Hospital for Children (AHC), Siem Reap, Kingdom of Cambodia2. Angkor Hospital for Children (AHC), Siem Reap, Kingdom of Cambodia

METHODS

Study design: prospective, cross-sectional study

Study site: Angkor Hospital for Children (AHC) in Siem Reap, Cambodia

Study sample: Serum from 968 unselected consecutive patients 0-16 years old who had blood drawn at AHC for routine work-up

Measure: Indirect hemagglutination assay (IHA) to detect presence and titer of antibodies to B. pseudomallei

Environmental sampling: 4 soil samples were collected from each of 10 different paddy fields around Siem Reap. Culture & sensitivities for B. pseudomallei were done on the soil samples.

RESULTS

Antibodies to B. pseudomallei were detected in 16.4% of 968 children

Detectable IHA titer values ranged from 1:10 to 1:10240 (IQR 1:20 to 1:640)

6.5% had an IHA titer ≥ 1:160

The proportion of children with any detectable IHA titer rose with age (see chart below)

B. pseudomallei was isolated from 12 (30%) sites in 6 (60%) rice fields

The colony forming unit (cfu) of B. pseudomallei per gram of soil ranged from 1 to 5000 cfu/g (median 90 cfu/g, IQR 20 to 250 cfu/g).

All 12 B. pseudomallei isolates were susceptible to ceftazidime, imipenem, amoxicillin-clavulanate, chloramphenicol, doxycycline and co-trimoxazole.

CONCLUSION

The presence of antibodies to B. pseudomallei in the serum of children and isolation of B. pseudomallei from the environmental soil as shown by this study provide evidence that,despite the lack of reported indigenous cases, melioidosis is likely to occur in Cambodia. These results also show a need for diagnostic microbiology development and associated detection of melioidosis cases across rural southeast Asia.

INTRODUCTION

Burkholderia pseudomallei is a soil saprophyte and the cause of melioidosis

The majority of reported cases occur in northeast Thailand and northern Australia

True burden of disease is likely more extensive since microbial culture for melioidosis is not available across much of rural Asia

ABSTRACT

Antibodies to B. pseudomallei were detected in 16% of children living in Siem Reap, Cambodia, and this organism was isolated from 30% of rice paddies in the surrounding vicinity. Despite the lack of reported indigenous cases, melioidosis is likely to occur in Cambodia.

Poster ID: EPP005 Poster ID: EPP005

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Age (years)

Any detectable titerTiter 1:160 or more

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