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In Vietnam, melioidosis is not nationally reportable and little is known regarding its epidemiology and distribution in the northernmost mountainous provinces. To address this gap, a hospital\u2010based cross\u2010sectional study was conducted across six northernmost provinces of Vietnam: Son La, Dien Bien, Lai Chau, Lao Cai, Ha Giang, and Cao Bang. Objectives were to (a) elucidate the distribution and environmental correlates of\n                    <jats:italic>B. pseudomallei<\/jats:italic>\n                    seroreactivity, and (b) identify bacteria isolated from subset of admitted patients.\n                    <jats:italic>Burkholderia pseudomallei<\/jats:italic>\n                    \u2010specific IgG ELISAs were used to identify elevated serological responses in febrile (\u226538\u00b0C, unknown cause) hospital patients (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a02,440; 2020\u20132023). Exploratory blood culturing and whole genome sequencing (WGS) from a small subset of patients was performed. A commune\u2010scale presence\u2010absence analysis examined environmental associations to seropositivity via a generalized linear model with Moran's eigenvector spatial filtering. Spatial distributions of the proportion of patients IgG seropositive (+2 SD above mean) to Hcp1\/OPS were smoothed using spatial Bayes and clusters were detected with local Moran's I. WGS revealed\n                    <jats:italic>B. pseudomallei<\/jats:italic>\n                    near\u2010neighbor species in some blood cultures; organisms that persist in similar environments, infect opportunistically, and are difficult to diagnose. A seasonal pattern was identified with more seropositivity among febrile hospital patients admitted in the wet season. At commune\u2010scale, seropositivity correlated to higher rainfall averages, proximity to major waterways, and low soil nutrients. Seropositivity was spatially heterogeneous and several spatial clusters (seropositivity hotspots) were detected, indicating a need for local or regional surveillance.\n                  <\/jats:p>","DOI":"10.1029\/2025gh001606","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T10:56:36Z","timestamp":1780138596000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hospital\u2010Based Cross\u2010Sectional Study of\n                    <i>Burkholderia pseudomallei<\/i>\n                    Seroreactivity Among Febrile Patients in Northernmost Vietnam: Near\u2010Neighbor Bloodstream Isolates, Environmental Correlates, and Spatial Clustering"],"prefix":"10.1029","volume":"10","author":[{"given":"Morgan C.","family":"Metrailer","sequence":"first","affiliation":[{"name":"Spatial Epidemiology &amp; Ecology Research Laboratory Department of Geography University of Florida  Gainesville FL USA"},{"name":"Emerging Pathogens Institute University of Florida  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Thi","family":"Le Quyen","sequence":"additional","affiliation":[{"name":"VNU \u2010 Institute for Microbiology and Biotechnology Vietnam National University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khang","family":"Van Pham","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2188-6643","authenticated-orcid":false,"given":"Tan Minh","family":"Luong","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Treenate","family":"Jiranantasak","sequence":"additional","affiliation":[{"name":"Spatial Epidemiology &amp; Ecology Research Laboratory Department of Geography University of Florida  Gainesville FL USA"},{"name":"Emerging Pathogens Institute University of Florida  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Bluhm","sequence":"additional","affiliation":[{"name":"Spatial Epidemiology &amp; Ecology Research Laboratory Department of Geography University of Florida  Gainesville FL USA"},{"name":"Emerging Pathogens Institute University of Florida  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Frank J.","family":"Tuozzo","sequence":"additional","affiliation":[{"name":"Spatial Epidemiology &amp; Ecology Research Laboratory Department of Geography University of Florida  Gainesville FL USA"},{"name":"Emerging Pathogens Institute University of Florida  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thi Thu","family":"Ha Hoang","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh Hoa","family":"Luong","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bich Ngoc","family":"Do","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh Hai","family":"Pham","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1560-6024","authenticated-orcid":false,"given":"Madison E. 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