Rongkard Patpong, Hantrakun Viriya, Dittrich Sabine, Srilohasin Prapaporn, Amornchai Premjit, Langla Sayan, Lim Cherry, Day Nicholas P J, AuCoin David, Wuthiekanun Vanaporn, Limmathurotsakul Direk
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao PDR.
PLoS Negl Trop Dis. 2016 Dec 14;10(12):e0005204. doi: 10.1371/journal.pntd.0005204. eCollection 2016 Dec.
Culture is the gold standard for the detection of environmental B. pseudomallei. In general, soil specimens are cultured in enrichment broth for 2 days, and then the culture broth is streaked on an agar plate and incubated further for 7 days. However, identifying B. pseudomallei on the agar plates among other soil microbes requires expertise and experience. Here, we evaluate a lateral flow immunoassay (LFI) developed to detect B. pseudomallei capsular polysaccharide (CPS) in clinical samples as a tool to detect B. pseudomallei in environmental samples.
METHODOLOGY/PRINCIPAL FINDINGS: First, we determined the limit of detection (LOD) of LFI for enrichment broth of the soil specimens. Soil specimens (10 grams/specimen) culture negative for B. pseudomallei were spiked with B. pseudomallei ranging from 10 to 105 CFU, and incubated in 10 ml of enrichment broth in air at 40°C. Then, on day 2, 4 and 7 of incubation, 50 μL of the upper layer of the broth were tested on the LFI, and colony counts to determine quantity of B. pseudomallei in the broth were performed. We found that all five soil specimens inoculated at 10 CFU were negative by LFI on day 2, but four of those five specimens were LFI positive on day 7. The LOD of the LFI was estimated to be roughly 3.8x106 CFU/ml, and culture broth on day 7 was selected as the optimal sample for LFI testing. Second, we evaluated the utility of the LFI by testing 105 soil samples from Northeast Thailand. All samples were also tested by standard culture and quantitative PCR (qPCR) targeting orf2. Of 105 soil samples, 35 (33%) were LFI positive, 25 (24%) were culture positive for B. pseudomallei, and 79 (75%) were qPCR positive. Of 11 LFI positive but standard culture negative specimens, six were confirmed by having the enrichment broth on day 7 culture positive for B. pseudomallei, and an additional three by qPCR. The LFI had 97% (30/31) sensitivity to detect soil specimens culture positive for B. pseudomallei.
CONCLUSIONS/SIGNIFICANCE: The LFI can be used to detect B. pseudomallei in soil samples, and to select which samples should be sent to reference laboratories or proceed further for bacterial isolation and confirmation. This could considerably decrease laboratory workload and assist the development of a risk map for melioidosis in resource-limited settings.
培养是检测环境中类鼻疽伯克霍尔德菌的金标准。一般来说,土壤标本在增菌肉汤中培养2天,然后将培养液划线接种在琼脂平板上,再进一步培养7天。然而,在琼脂平板上从其他土壤微生物中鉴定出类鼻疽伯克霍尔德菌需要专业知识和经验。在此,我们评估一种侧向流动免疫分析法(LFI),该方法用于检测临床样本中的类鼻疽伯克霍尔德菌荚膜多糖(CPS),作为检测环境样本中类鼻疽伯克霍尔德菌的工具。
方法/主要发现:首先,我们确定了LFI对土壤标本增菌肉汤的检测限(LOD)。将未检测出类鼻疽伯克霍尔德菌的土壤标本(10克/标本)接种10至105CFU的类鼻疽伯克霍尔德菌,在40°C空气中于10ml增菌肉汤中培养。然后,在培养的第2天、第4天和第7天,取50μL肉汤上层在LFI上进行检测,并进行菌落计数以确定肉汤中类鼻疽伯克霍尔德菌的数量。我们发现,接种10CFU的所有5个土壤标本在第2天LFI检测均为阴性,但其中4个标本在第7天LFI检测为阳性。LFI的检测限估计约为3.8×106CFU/ml,选择第7天的培养液作为LFI检测的最佳样本。其次,我们通过检测来自泰国东北部的105份土壤样本评估了LFI的实用性。所有样本还通过标准培养和针对orf2的定量PCR(qPCR)进行检测。在105份土壤样本中,35份(33%)LFI检测为阳性,25份(24%)类鼻疽伯克霍尔德菌培养阳性,79份(75%)qPCR检测阳性。在11份LFI检测为阳性但标准培养为阴性的标本中,6份通过第7天增菌肉汤类鼻疽伯克霍尔德菌培养阳性得到证实,另外3份通过qPCR得到证实。LFI检测类鼻疽伯克霍尔德菌培养阳性土壤标本的灵敏度为97%(30/31)。
结论/意义:LFI可用于检测土壤样本中的类鼻疽伯克霍尔德菌,并选择哪些样本应送往参考实验室或进一步进行细菌分离和鉴定。这可大幅减少实验室工作量,并有助于在资源有限的环境中绘制类鼻疽病风险地图。