Defining the True Sensitivity of Culture for the Diagnosis of Melioidosis Using Bayesian Latent Class Models

Background

Culture remains the diagnostic gold standard for many bacterial infections, and the method against which other tests are often evaluated. Specificity of culture is 100% if the pathogenic organism is not found in healthy subjects, but the sensitivity of culture is more difficult to determine and may be low. Here, we apply Bayesian latent class models (LCMs) to data from patients with a single Gram-negative bacterial infection and define the true sensitivity of culture together with the impact of misclassification by culture on the reported accuracy of alternative diagnostic tests.

Methods/Principal Findings

Data from published studies describing the application of five diagnostic tests (culture and four serological tests) to a patient cohort with suspected melioidosis were re-analysed using several Bayesian LCMs. Sensitivities, specificities, and positive and negative predictive values (PPVs and NPVs) were calculated. Of 320 patients with suspected melioidosis, 119 (37%) had culture confirmed melioidosis. Using the final model (Bayesian LCM with conditional dependence between serological tests), the sensitivity of culture was estimated to be 60.2%. Prediction accuracy of the final model was assessed using a classification tool to grade patients according to the likelihood of melioidosis, which indicated that an estimated disease prevalence of 61.6% was credible. Estimates of sensitivities, specificities, PPVs and NPVs of four serological tests were significantly different from previously published values in which culture was used as the gold standard.

Conclusions/Significance

Culture has low sensitivity and low NPV for the diagnosis of melioidosis and is an imperfect gold standard against which to evaluate alternative tests. Models should be used to support the evaluation of diagnostic tests with an imperfect gold standard. It is likely that the poor sensitivity/specificity of culture is not specific for melioidosis, but rather a generic problem for many bacterial and fungal infections.     

An ELISA-disc procedure for antibodies toPseudomonas pseudomallei: application for a serological study of melioidosis in an endemic area

The optimization and development of an ELISA-disc procedure for the detection of antibodies to whole cell surface antigens and purified exotoxin ofPseudomonas pseudomallei is described. Comparison of the serum agglutination test (SAT), the serum based enzyme-linked immunosorbent assay (ELISA) and the ELISA-disc procedures used on goat and human sera demonstrated a high correlation in their ability to detect antibodies specific forP. pseudomallei antigens. A serological survey using the ELISA-disc method was carried out on a normal human population in Sabah, Malaysia, an area known to be endemic for melioidosis. The prevalances of antibodies towards cell surface antigens and exotoxin ofP. pseudomallei were 28% and 8%, respectively. As a procedure, the ELISA-disc technique reported here is technically simple and provides savings in costs and is thus deemed suitable for seroepidemiological surveillance of melioidosis in remote areas of South-East Asia.     

A Serological Survey of Ruminant Livestock in Kazakhstan During Post-Soviet Transitions in Farming and Disease Control

The results of a serological survey of livestock in Kazakhstan, carried out in 1997–1998, are reported. Serum samples from 958 animals (cattle, sheep and goats) were tested for antibodies to foot and mouth disease (FMD), bluetongue (BT), epizootic haemorrhagic disease (EHD), rinderpest (RP) and peste des petits ruminants (PPR) viruses, and to Brucella spp. We also investigated the vaccination status of livestock and related this to changes in veterinary provision since independence in 1991. For the 2 diseases under official surveillance (FMD and brucellosis) our results were similar to official data, although we found significantly higher brucellosis levels in 2 districts and widespread ignorance about FMD vaccination status. The seroprevalence for BT virus was 23%, and seropositive animals were widespread suggesting endemicity, despite the disease not having being previously reported. We found a few seropositives for EHDV and PPRV, which may suggest that these diseases are also present in Kazakhstan. An hierarchical model showed that seroprevalence to FMD and BT viruses were clustered at the farm/village level, rather than at a larger spatial scale. This was unexpected for FMD, which is subject to vaccination policies which vary at the raion (county) level.     

Temporal and spatial variability of pelagic wild fish assemblages around Atlantic bluefin tuna Thunnus thynnus farms in the eastern Adriatic Sea

The abundance and size structure of wild fishes aggregated around the sea‐cages of two commercial Thunnus thynnus farms, including control locations, were assessed and compared over a 1 year period. The T. thynnus farms were located in the eastern Adriatic Sea, offshore of the islands of Ugljan and Bra?. Fish assemblages were evaluated through visual census using scuba at 2 month intervals at two sites within each farm. The data suggest that wild fish assemblages at the study sites differed greatly; 20 species occurred at the Ugljan farm and 17 at the Bra? farm, while only seven species were observed at the control locations. The abundance and diversity of wild fish assemblages were greater at the farms in comparison to control locations. The most abundant families were Sparidae and Belonidae (>80% of aggregated fishes). At both farms, the abundance and diversity of wild fishes were highest during summer, while diversity was lowest in winter and was mainly characterized by schools of bogue Boops boops and garfish Belone belone. Variability was also detected in spatial assemblages between farms; B. boops and B. belone were the most abundant species for the overall study at the Bra? farm, while B. belone and saddled bream Oblada melanura were the most abundant at the Ugljan farm. The settlement also played a significant role in farm‐associated fish assemblages, as both juveniles and advanced juveniles were common residents at farms. The majority of species which settled at the farms belonged to the sparids. Results indicate that aggregations of wild fishes at T. thynnus farms are persistent year‐round, though the assemblage compositions and size structures of dominant species vary in respect to location and season.     

First epidemiological study on exposure to Neospora caninum in different canine populations in the Algiers District (Algeria)

Neospora caninum is an important cause of abortion in cattle worldwide. Dogs act as final hosts shedding oocysts in the environment. They can also harbour the extraintestinal stage of the parasite and this may be associated with a fairly rare neuromuscular condition. The sera of 781 dogs from the Algiers District were screened by IFAT for the presence of anti-N. caninum antibodies. These dogs were distributed into four populations: local stray dogs, police dogs, dogs from breeding kennels and farm dogs. The overall seroprevalence was 21.90%. Significant differences were observed between the different populations, the highest prevalence being observed in farm (44.44%) and stray dogs (22.55%). Additionally, the highest titres were observed in farm dogs. Among studied epidemiological parameters, breed, dog origin, season and vaccination status were significantly associated with IFAT results. Additionally, a recently described real time PCR was used on the blood of 100 pound dogs and the results were compared with the serological data. A higher proportion of dogs was found to be positive by PCR when compared to the IFAT results. There was only a fairly low agreement between PCR and IFAT results which suggests that these techniques measured different aspects of the host–parasite relationship. This study indicates that the level of exposure of the canine population of Algiers area to N. caninum is very high. This would indicate a potentially high risk for N. caninum induced abortion in cattle in this region and in Algeria.     

Examination of the independent contribution of rheumatic heart disease and congestive cardiac failure to the development and outcome of melioidosis in Far North Queensland,tropical Australia

BackgroundPatients with rheumatic heart disease (RHD) and congestive cardiac failure (CCF) are believed to have an increased risk of melioidosis and are thought to be more likely to die from the infection. This study was performed to confirm these findings in a region with a high incidence of all three conditions.Principal findingsBetween January 1998 and December 2021 there were 392 cases of melioidosis in Far North Queensland, tropical Australia; 200/392 (51.0%) identified as an Indigenous Australian, and 337/392 (86.0%) had a confirmed predisposing comorbidity that increased risk for the infection. Overall, 46/392 (11.7%) died before hospital discharge; the case fatality rate declining during the study period (p for trend = 0.001).There were only 3/392 (0.8%) with confirmed RHD, all of whom had at least one other risk factor for melioidosis; all 3 survived to hospital discharge. Among the 200 Indigenous Australians in the cohort, 2 had confirmed RHD; not statistically greater than the prevalence of RHD in the local general Indigenous population (1.0% versus 1.2%, p = 1.0). RHD was present in only 1/193 (0.5%) cases of melioidosis diagnosed after October 2016, a period which coincided with prospective data collection. There were 26/392 (6.6%) with confirmed CCF, but all 26 had another traditional risk factor for melioidosis. Patients with CCF were more likely to also have chronic lung disease (OR (95% CI: 4.46 (1.93–10.31), p<0.001) and chronic kidney disease (odds ratio (OR) (95% confidence interval (CI): 2.98 (1.22–7.29), p = 0.01) than those who did not have CCF. Two patients with melioidosis and CCF died before hospital discharge; both were elderly (aged 81 and 91 years) and had significant comorbidity.ConclusionsIn this region of tropical Australia RHD and CCF do not appear to be independent risk factors for melioidosis and have limited prognostic utility.     

A seroprevalence survey of Toxoplasma gondii in common wombats (Vombatus ursinus)

Serum was collected from 23 wild common wombats (Vombatus ursinus) on a pastoral property in the Southern Tablelands of New South Wales, Australia (231N 616E) between 3rd August 2001 and 25th March 2002. The serum was tested using three serological methods for antibodies to Toxoplasma gondii. Six animals (26.1%) were shown to have antibodies to T. gondii. The latex agglutination test proved to be less sensitive than the direct agglutination test or the modified agglutination test. This is the first serological survey of T. gondii in wombats. This is the first recorded use of the latex agglutination test on wombat serum. This study demonstrated the highest percentage of seropositive animals in any serological survey for T. gondii in marsupials.     

Overexpression of the Endothelial Protein C Receptor Is Detrimental during Pneumonia-Derived Gram-negative Sepsis (Melioidosis)

Background

The endothelial protein C receptor (EPCR) enhances anticoagulation by accelerating activation of protein C to activated protein C (APC) and mediates anti-inflammatory effects by facilitating APC-mediated signaling via protease activated receptor-1. We studied the role of EPCR in the host response during pneumonia-derived sepsis instigated by Burkholderia (B.) pseudomallei, the causative agent of melioidosis, a common form of community-acquired Gram-negative (pneumo)sepsis in South-East Asia.

Methodology/Principal Findings

Soluble EPCR was measured in plasma of patients with septic culture-proven melioidosis and healthy controls. Experimental melioidosis was induced by intranasal inoculation of B. pseudomallei in wild-type (WT) mice and mice with either EPCR-overexpression (Tie2-EPCR) or EPCR-deficiency (EPCR^−/−). Mice were sacrificed after 24, 48 or 72 hours. Organs and plasma were harvested to measure colony forming units, cellular influxes, cytokine levels and coagulation parameters. Plasma EPCR-levels were higher in melioidosis patients than in healthy controls and associated with an increased mortality. Tie2-EPCR mice demonstrated enhanced bacterial growth and dissemination to distant organs during experimental melioidosis, accompanied by increased lung damage, neutrophil influx and cytokine production, and attenuated coagulation activation. EPCR^−/− mice had an unremarkable response to B. pseudomallei infection as compared to WT mice, except for a difference in coagulation activation in plasma.

Conclusion/Significance

Increased EPCR-levels correlate with accelerated mortality in patients with melioidosis. In mice, transgenic overexpression of EPCR aggravates outcome during Gram-negative pneumonia-derived sepsis caused by B. pseudomallei, while endogenous EPCR does not impact on the host response. These results add to a better understanding of the regulation of coagulation during severe (pneumo)sepsis.     

Selection of Burkholderia pseudomallei protease-binding peptides by phage display

Burkholderia pseudomallei is a causative agent of melioidosis, a fatal community acquired septicemia in Southeast Asia and Northern Australia. A protease has been proposed to be one of the major pathogenic factors to play a significant role in melioidosis. We have used phage display technology to identify peptides binding to B. pseudomallei protease. By screening a constrained cyclic heptapeptide library, five independent clones with affinity to this protease were isolated and the amino acid sequences were determined. The cyclic heptapeptides from two of the phage clones (Cys-Phe-Phe-Met-Pro-His-Thr-Phe-Cys) were identical and showed the strongest phage-protease interaction as detected by ELISA. Four of the five selected phages at the amount of 10¹³ phages could inhibit B. pseudomallei protease activity by approximately 50%.     

Application of variable number of tandem repeat analysis to track Salmonella enterica ssp. enterica serovar Typhimurium infection of pigs reared on three British farms through the production cycle to the abattoir

Aims: This study investigated the diversity and persistence of Salmonella strains through the pork finishing cycle, from the farm into the abattoir. Methods and Results: Isolates from four batches of finishers, from farm to abattoir, were used. Salmonella Typhimurium isolates were subjected to molecular typing using pulsed‐field gel electrophoresis and variable number of tandem repeat analysis. The results demonstrated that infection was transferred from the farm to the abattoir. Within the abattoir, infection from individual pigs contaminated the exterior of the carcass and pigs exposed to Salmonella in the lairage were infected. Conclusions: Salmonella can be introduced at various points in the pig production and slaughter process. Carcass contamination may arise from infection on farm and exposure in the lairage and abattoir environment. Pigs could be contaminated by previous batches of pigs while in lairage or during the dressing process. Salmonella infection on farms is dynamic with multiple serovars present from different sources. Significance and Impact of the Study: Molecular typing methods facilitated the tracing of Salm. Typhimurium through the production cycle and differentiated some farm‐acquired from abattoir‐acquired strains. The findings emphasize the importance of integrated control strategies along the pork food chain.     

A preliminary survey for human immunodeficient virus (HIV) infections in tuberculosis and melioidosis patients in Ubon Ratchathani, Thailand.

A preliminary survey was conducted for the prevalence of HIV infections in pulmonary tuberculosis and melioidosis patients in Ubon Ratchathani province, in Thailand, the second largest province in population which supplies labors to Bangkok metropolis. In this province, tuberculosis is prevalent in a higher rate than in most other provinces and melioidosis is endemic. Four HIV-seropositives were found in a total of 551 suspected and culture-positive cases of pulmonary tuberculosis, while no HIV-seropositive was found in 121 melioidosis patients. In view of the rapidly expanding HIV-infections in Thailand, a strict watch will be needed on the future epidemiological status of HIV-infection in tuberculous patient.     

Occurrence of latent virus infection in visually-rated cowpea (Vigna unguiculata L. Walp) seedlings

Abstract

The presence of latent infections was studied in five cowpeas varieties. Seeds of the varieties were planted and the seedlings inoculated with antigens from Cucumber mosaic virus (CMV) genus Cucumovirus, Bean common mosaic virus (BCMV) genus Potyvirus (Blackeye cowpea mosaic virus strain), Southern bean mosaic virus (SBMV) genus Sobemovirus and Cowpea mottle virus (CPMoV) genus Carmovirus seven days after planting. Seedlings expressing symptoms were rouged at two weeks after inoculation, while asymptomatic ones were subjected to serological indexing to detect the presence/absence of latent infection. Protein A-sandwich enzyme-linked immunosorbent assay (PAS ELISA) was employed for the serological detection of CMV, SBMV and CPMoV, while antigen-coated plate (ACP) ELISA was used to detect BCMV in the asymptomatic plants. Cowpea seedlings without virus symptoms but with positive serological reactions were considered as being latently infected. All of the inoculated TVu 1272 and SuVita-2 plants showed symptoms consistent with CMV and CPMoV infections, respectively. The rate of CMV latent infection was high in TVu 1179 (14.5%), low in SuVita-2 (1.3%) but not recorded in TVu 1272.     

Spatial distribution of soil seed banks of three African savanna woody species at two contrasting sites

In southern African savannas, bush encroachment is a major problem for range managers. However, little is understood of the actual regeneration processes leading to it, and in particular the role of soil seed banks. The horizontal (between microsites) and vertical (with depth in litter and soil) distribution of soil seed banks of the microphyllous woody species, Acacia tortilis, A. nilotica and Dichrostachys cinerea (all legumes of the Mimosoideae), were quantified in an area with low intensity grazing (reserve), and a bordering cattle farm with high intensity grazing (farm). Species differed in seed bank densities between microsites and sites. Seed densities for all species were highest below parent tree canopies and decreased with distance beyond the canopy, and with soil depth. D. cinerea had the smallest seed bank associated with parent trees, particularly on the farm (8 vs. 1643 seeds/tree on the reserve), A. tortilis had the largest (6357, 31910), with A. nilotica intermediate (1789, 1906). The proportion of current (recently fallen) versus old (1 year old) seeds differed between species and sites. These species form at least short-term persistent seed banks with the old seeds largely representing the persistent seed bank. Seed densities in the open (inter-canopy) and those dispersed under either of the other two (non-parental) study species were much lower than those associated with parent trees. The latter were mostly found under the acacias (single-stemmed) rather than D. cinerea (multistemmed). Total seed store per parent plant increased with plant size (best fits were mostly power curves of canopy area). A large proportion of intact seeds were viable, namely 81–84% for A. tortilis, 68–77% for A. nilotica and 63–78% for D. cinerea, with no differences between sites. Viability tended to increase with depth of burial, except for A. nilotica seeds at the 3–5 cm depths on the farm. At the landscape scale there were 1.5 million and 140000 A. tortilis seeds/ha on the reserve and farm respectively, with corresponding values of 2000 and 31000 for D. cinerea, and 23000 and 86000 for A. nilotica.     

Biochemical and Immunochemical Studies of Fungi

Crude mannans extracted from Candida albicans and Saccharomyces cerevisiae by autoclaving yeast cells in citrate buffer (pH 7.0) according to Peat's method, were fractionated repeatedly by column chromatography on DEAE-Sephadex, acetate form, yielding neutral and acidic mannans. The former fraction showed a single peak by boundary electrophoresis and ultracentrifugal analysis, while the latter contained small amounts of phosphorus and protein. Using purified mannans as controls, various serological experiments were carried out with mannan antigens extracted from C. albicans with 45% phenol water and with 3% NaOH. No remarkable differences were observed in the antigenic activity of 4 mannan antigens from C. albicans, and the purified mannan exhibited very high antigenic activity. It was found that the mannan of S. cerevisiae was antigenically less specific than that of C. albicans mannan. The difference in serological specificity between mannans of both species may reflect not only differences in mannopyranose linkages but differences in the structure of the macromolecules.     

Airborne Transmission of Melioidosis to Humans from Environmental Aerosols Contaminated with B. pseudomallei

Melioidosis results from an infection with the soil-borne pathogen Burkholderia pseudomallei, and cases of melioidosis usually cluster after rains or a typhoon. In an endemic area of Taiwan, B. pseudomallei is primarily geographically distributed in cropped fields in the northwest of this area, whereas melioidosis cases are distributed in a densely populated district in the southeast. We hypothesized that contaminated cropped fields generated aerosols contaminated with B. pseudomallei, which were carried by a northwesterly wind to the densely populated southeastern district. We collected soil and aerosol samples from a 72 km² area of land, including the melioidosis-clustered area and its surroundings. Aerosols that contained B. pseudomallei-specific TTSS (type III secretion system) ORF2 DNA were well distributed in the endemic area but were rare in the surrounding areas during the rainy season. The concentration of this specific DNA in aerosols was positively correlated with the incidence of melioidosis and the appearance of a northwesterly wind. Moreover, the isolation rate in the superficial layers of the contaminated cropped field in the northwest was correlated with PCR positivity for aerosols collected from the southeast over a 2-year period. According to pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) analyses, PFGE Type Ia (ST58) was the predominant pattern linking the molecular association among soil, aerosol and human isolates. Thus, the airborne transmission of melioidosis moves from the contaminated soil to aerosols and/or to humans in this endemic area.     

Ticks and Tick-Borne Diseases of Livestock Belonging to Resource-poor Farmers in the Eastern Free State of South Africa

The paper provides a summary of three studies conducted in the eastern Free State of South Africa between 1998 and 2000. In a questionnaire-based study approximately 21% of interviewed resource-poor farmers (n = 150) indicated that they experienced problems with ticks and tick-borne diseases. About 56% of farmers indicated that tick-related problems were most severe in summer, while 32% indicated that the most problems were encountered in winter. About 12% indicated that the tick problems were experienced throughout the year. Farmers also indicated that the highest tick burdens were experienced between spring and early winter. The principal ticks infesting cattle (n = 30) were found to be Boophilus decoloratus (53.1%), Rhipicephalus evertsi evertsi (44.7%), Rhipicephalus follis (1.0%), Rhipicephalus gertrudae (0.7%) and Rhipicephalus warburtoni (0.4%). On small stock (n = 188), R. evertsi evertsi (68%) and B. decoloratus (32%) were recorded as the main ticks in the study area. A sero-epidemiological survey of cattle (n = 386) showed that 94% of cattle were sero-positive for Babesia bigemina by IFAT, while 87% were sero-positive for Anaplasma by indirect ELISA. All the animals were sero-negative for Babesia bovis and this is probably because the tick vector, Boophilus microplus, is not present in the study area. All sheep and goats were sero-positive for Theileria species by IFAT while 85% of sheep and 100% of goats tested positive for Anaplasma species by competition inhibition ELISA. The high incidence of positive serological results for B. bigemina and Anaplasma in cattle, and Theileria and Anaplasma in sheep and goats and the absence of clinical cases would indicate that this area is endemically stable for these diseases. This revised version was published online in July 2006 with corrections to the Cover Date.     

The occurrence and importance of okra mosaic virus in Nigerian weeds

The Nigerian National Horticultural Research Institute experimental and commercial farm has a long history of okra mosaic virus (OMV) disease. In an attempt to determine possible sources of inoculum, weeds growing within or around the vicinity of the farm were investigated. Several weeds showed virus or virus-like disease symptoms and mechanical inoculation of crude sap from three malvaceous weeds (Abutilon hirtum, Sida acuta, and Malvastrum coromandelianum) and one solanaceous weed (Physalis angulata) induced symptoms of OMV on okra test seedlings; serological tests confirmed the presence of OMV. Beetle vectors caught both from weeds and from okra were infective when confined on healthy okra seedlings for 48 h. Increase in the abundance of beetle vectors was accompanied by an increase in the incidence of OMV disease. The implications of these findings in the epidemiology and control of OMV are discussed.     

The Parthenogenetic Rock Lizard Lacerta unisexualis: An Example of Limited Genetic Polymorphism

Protein electrophoresis of Lacerta unisexualis from three populations found that 21 of 36 allozyme loci were homozygous, while 14 expressed fixed heterozygotes and one locus was variable. Three clones were detected at the locus Cat-A. Two individuals represent two rare clones while all others form a common clone. Our favored explanation is the mutation of a preexisting common clone rather than multiple origins. Received: 27 January 1997 / Accepted: 29 April 1997     

Capture Rates of Male Euglossine Bees across a Human Intervention Gradient, Chocó Region, Colombia1

Euglossine bees are important pollinators of lowland Neotropical forests. Compared to disturbed habitats, undisturbed ones have been previously characterized by higher abundance and diversity of euglossine bees. Most past studies have relied on chemically baiting male bees at single sites within habitats. Over a two‐year period, we employed a repeated‐measures design in which we sampled bees at multiple sites within three different habitat types, reflecting a mosaic of human disturbance (farm, secondary forest, and old logged forest). After 22 monthly samples, a total of 2008 male bees were captured, representing 31 species in five genera: 1156 at the farm (57.6%, 21 spp.), 505 in the secondary forest (25.1%, 27 spp.), and 347 in the old logged forest (17.2%, 21 spp.). Eighty‐one percent of the bees captured belonged to the five most abundant species: Eulaema cingulata, El. chocoana, Euglossa hansoni, Eg. ignita, and Eg. imperialis. These species differed significantly in capture frequencies among habitats. Eulaema cingulata, El. chocoana, and Eg. ignita were captured most frequently at the farm, while Eg. imperialis was most abundant in the secondary forest. In contrast, Eg. hansoni, the sole short‐tongued species among the five, was equally abundant in the two forest habitats but occurred rarely on the farm. Additionally, habitats differed in bee composition. The high capture rates for long‐proboscis species at the farm may have been due to their ability to extract nectar from flowers with long floral tubes, which probably occurred at a greater density on the farmed land than in the adjacent forests.     

Burkholderia pseudomallei: Its Detection in Soil and Seroprevalence in Bangladesh

Background

Melioidosis, caused by Burkholderia pseudomallei, is an endemic disease in Bangladesh. No systematic study has yet been done to detect the environmental source of the organism and its true extent in Bangladesh. The present study attempted to isolate B. pseudomallei in soil samples and to determine its seroprevalence in several districts in Bangladesh.

Methodology and Results

Soil samples were collected from rural areas of four districts of Bangladesh from where culture confirmed melioidosis cases were detected earlier. Multiple soil samples, collected from 5–7 sampling points of 3–5 sites of each district, were cultured in Ashdown selective media. Suspected colonies of B. pseudomallei were identified by biochemical and serological test, and by polymerase chain reaction (PCR) using 16s rRNA specific primers. Blood samples were collected from 940 healthy individuals of four districts to determine anti- B. pseudomallei IgG antibody levels by indirect enzyme linked immunosorbent assay (ELISA) using sonicated crude antigen. Out of 179 soil samples, B. pseudomallei was isolated from two samples of Gazipur district which is located 58 km north of capital Dhaka city. Both the isolates were phenotypically identical, arabinose negative and showed specific 550bp band in PCR. Out of 940 blood samples, anti- B. pseudomallei IgG antibody, higher than the cut-off value (>0.8), was detected in 21.5% individuals. Seropositivity rate was 22.6%-30.8% in three districts from where melioidosis cases were detected earlier, compared to 9.8% in a district where no melioidosis case was either detected or reported (p<0.01). Seropositivity increased with the advancement of age from 5.3% to 30.4% among individuals aged 1–10 years and > 50 years respectively. The seropositivity rates were 26.0% and 20.6% in male and female respectively, while it was 20–27% among different occupational groups. No significant association was observed with gender (χ2 = 3.441, p = 0.064) or any occupational group (χ² = 3.835, p = 0.280).

Conclusion

This is the first study demonstrating the presence of B. pseudomallei in the environmental (soil) samples of Bangladesh. It also suggested that a large proportion of people, residing in these districts, were exposed to the organism.