A simple laboratory algorithm for diagnosis of melioidosis in resource-constrained areas: a study from north-central Vietnam.

Autor:	Trinh TT; Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Viet Nam. Electronic address: tttrung@vnu.edu.vn., Hoang TS; Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Viet Nam., Tran DA; General Hospital of Nghe An Province, Viet Nam., Trinh VT; General Hospital of Ha Tinh Province, Viet Nam., Göhler A; Friedrich Loeffler Institute for Medical Microbiology, Greifswald, Germany., Nguyen TT; General Hospital of Quang Binh Province, Viet Nam., Hoang SN; General Hospital of Quang Tri Province, Viet Nam., Krumkamp R; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany., Nguyen LTN; Hue Central Hospital, Hue, Viet Nam., May J; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany., Doan PM; Bach Mai Hospital, Hanoi, Viet Nam., Do CD; Bach Mai Hospital, Hanoi, Viet Nam., Que TA; General Hospital of Nghe An Province, Viet Nam., Steinmetz I; Friedrich Loeffler Institute for Medical Microbiology, Greifswald, Germany; Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
Jazyk:	angličtina
Zdroj:	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2018 Jan; Vol. 24 (1), pp. 84.e1-84.e4. Date of Electronic Publication: 2017 Aug 03.
DOI:	10.1016/j.cmi.2017.07.029
Abstrakt:	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. (Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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