Komfo Anokye Teaching Hospitalgrid.415450.1, Kumasi (KATH), Kumasi, Ghana.
Austere environments Consortium for Enhanced Sepsis Outcomes (ACESO), The Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.
Appl Environ Microbiol. 2022 Jun 28;88(12):e0060022. doi: 10.1128/aem.00600-22. Epub 2022 Jun 2.
Burkholderia pseudomallei is a Gram-negative soil saprophyte with the potential to cause melioidosis, an opportunistic disease with a high mortality potential. Periodic case reports of melioidosis in or imported from Africa occur in the literature dating back decades. Furthermore, statistical models suggest Western sub-Saharan Africa as a high-risk zone for the presence of B. pseudomallei. A recent case report from the United Kingdom of a returning traveler from Ghana highlights the need for environmental studies in Ghana. We examined 100 soil samples from a rice farm in south-central Ghana. Soil was subjected to selective enrichment culture for B. pseudomallei using threonine-basal salt solution with colistin (TBSS-C50) and erythritol medium, as described in the literature. Bacterial cultures were identified with standard biochemical tests, a rapid antigen detection assay, and real-time PCR specific for B. pseudomallei. Of the 100 soil samples, 55% yielded cultures consistent with B. pseudomallei on Ashdown's agar as well as by capsular polysaccharide antigen production. This is the first confirmatory report of culture-confirmed B. pseudomallei in the environment of Ghana. Our study emphasizes the need for further exploration of the burden of human melioidosis in Ghana. We recommend that local clinicians familiarize themselves with the diagnosis and clinical management of melioidosis, while laboratories develop capacity for the safe isolation and identification of B. pseudomallei. We present the first confirmation of the presence of B. pseudomallei in the environment of Ghana. This study will bring attention to a disease with the potential to cause significant morbidity and mortality in Ghana, but which has gone completely unrecognized until this point. Furthermore, this work would encourage local clinicians to familiarize themselves with the diagnosis and clinical management of melioidosis and laboratories to develop capacity for the safe isolation and identification of B. pseudomallei.
类鼻疽伯克霍尔德菌是一种革兰氏阴性土壤腐生菌，具有引起类鼻疽的潜力，类鼻疽是一种具有高致死潜力的机会性疾病。几十年来，文献中定期有类鼻疽在非洲或从非洲输入的病例报告。此外，统计模型表明，撒哈拉以南的西非是类鼻疽伯克霍尔德菌存在的高风险区域。最近，英国的一份报告显示，一名从加纳返回的旅行者患有类鼻疽，这突显了加纳进行环境研究的必要性。我们检查了加纳中南部一个水稻农场的 100 个土壤样本。按照文献中的描述，使用苏氨酸基础盐溶液和多粘菌素（TBSS-C50）以及赤藓糖醇培养基对土壤进行选择性富集培养类鼻疽伯克霍尔德菌。采用标准生化试验、快速抗原检测和针对类鼻疽伯克霍尔德菌的实时 PCR 对细菌培养物进行鉴定。在 100 个土壤样本中，55%的样本在 Ashdown 琼脂上以及通过荚膜多糖抗原产生培养物与类鼻疽伯克霍尔德菌一致。这是加纳环境中首次确认培养出的类鼻疽伯克霍尔德菌。我们的研究强调了进一步探索加纳人类类鼻疽负担的必要性。我们建议当地临床医生熟悉类鼻疽的诊断和临床管理，同时实验室开发出安全分离和鉴定类鼻疽伯克霍尔德菌的能力。我们首次确认了类鼻疽伯克霍尔德菌在加纳环境中的存在。这项研究将引起人们对这种疾病的关注，该疾病有可能在加纳造成严重的发病率和死亡率，但直到现在还完全没有被认识到。此外，这项工作将鼓励当地临床医生熟悉类鼻疽的诊断和临床管理，以及实验室开发出安全分离和鉴定类鼻疽伯克霍尔德菌的能力。
