Systematic Review and Consensus Guidelines for Environmental Sampling of Burkholderia pseudomallei

Direk Limmathurotsakul, David A.B. Dance, Vanaporn Wuthiekanun, Mirjam Kaestli, Mark Mayo, Jeffrey Warner, David M. Wagner, Apichai Tuanyok, Heiman Wertheim, Tan Yoke Cheng, Chiranjay Mukhopadhyay, Savithiri Puthucheary, Nicholas P.J. Day, Ivo Steinmetz, Bart J. Currie, Sharon J. Peacock

Research output: Contribution to journalArticlepeer-review

110 Scopus citations


Background: Burkholderia pseudomallei, a Tier 1 Select Agent and the cause of melioidosis, is a Gram-negative bacillus present in the environment in many tropical countries. Defining the global pattern of B. pseudomallei distribution underpins efforts to prevent infection, and is dependent upon robust environmental sampling methodology. Our objective was to review the literature on the detection of environmental B. pseudomallei, update the risk map for melioidosis, and propose international consensus guidelines for soil sampling. Methods/Principal Findings: An international working party (Detection of Environmental Burkholderia pseudomallei Working Party (DEBWorP)) was formed during the VIth World Melioidosis Congress in 2010. PubMed (January 1912 to December 2011) was searched using the following MeSH terms: pseudomallei or melioidosis. Bibliographies were hand-searched for secondary references. The reported geographical distribution of B. pseudomallei in the environment was mapped and categorized as definite, probable, or possible. The methodology used for detecting environmental B. pseudomallei was extracted and collated. We found that global coverage was patchy, with a lack of studies in many areas where melioidosis is suspected to occur. The sampling strategies and bacterial identification methods used were highly variable, and not all were robust. We developed consensus guidelines with the goals of reducing the probability of false-negative results, and the provision of affordable and 'low-tech' methodology that is applicable in both developed and developing countries. Conclusions/Significance: The proposed consensus guidelines provide the basis for the development of an accurate and comprehensive global map of environmental B. pseudomallei.

Original languageEnglish (US)
Article numbere2105
JournalPLoS neglected tropical diseases
Issue number3
StatePublished - 2013

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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