{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:53:23Z","timestamp":1770980003396,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.5935.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2015,5,15]],"date-time":"2015-05-15T00:00:00Z","timestamp":1431648000000}}],"reference-count":24,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2015,5,15]],"date-time":"2015-05-15T00:00:00Z","timestamp":1431648000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Melioidosis, infection caused by <ns4:italic>Burkholderia pseudomallei<\/ns4:italic>, is increasingly reported in Cambodia. We hypothesized that implementation of an enhanced sputum testing protocol in a provincial hospital diagnostic microbiology laboratory would increase detection of <ns4:italic>B. pseudomallei<\/ns4:italic>. We tested 241 sputum specimens that were deemed acceptable for culture, comparing culture in selective enrichment broth followed by sub-culture on Ashdown\u2019s medium to standard culture methods. Two specimens (0.8%) were positive for <ns4:italic>B. pseudomallei<\/ns4:italic> using the enhanced protocol whereas one specimen (0.4%) was positive using standard methods. Given the low numbers of positive specimens, we could not conclusively determine the utility of the enhanced sputum testing protocol. However, the ramifications of identification of\u00a0<ns4:italic>B. pseudomallei<\/ns4:italic>\u00a0are substantial, and the benefit of the enhanced testing protocol may be more apparent in patients selected based on risk factors and clinical presentation.\u00a0Promoting clinician awareness of the infection and encouraging utilization of diagnostic microbiology services are also likely to be important factors in facilitating identification of melioidosis.<\/ns4:p>","DOI":"10.12688\/f1000research.5935.2","type":"journal-article","created":{"date-parts":[[2015,5,15]],"date-time":"2015-05-15T15:50:12Z","timestamp":1431705012000},"page":"302","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Detection of Burkholderia pseudomallei in Sputum using Selective Enrichment Broth and Ashdown\u2019s Medium at Kampong Cham Provincial Hospital, Cambodia"],"prefix":"10.12688","volume":"3","author":[{"given":"Somary","family":"Nhem","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Letchford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chea","family":"Meas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sovanndeth","family":"Thann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"McLaughlin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen Jo","family":"Baron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. Eoin","family":"West","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2015,5,15]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"S21-5","DOI":"10.1016\/S0035-9203(08)70007-5","article-title":"A first report of pulmonary melioidosis in Cambodia.","volume":"102","author":"R Overtoom","year":"2008","journal-title":"Trans R Soc Trop Med Hyg."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"1289-92","DOI":"10.3201\/eid1707.101069","article-title":"Melioidosis, Phnom Penh, Cambodia.","volume":"17","author":"E Vlieghe","year":"2011","journal-title":"Emerg Infect Dis."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/1471-2334-11-126","article-title":"Pulmonary melioidosis in Cambodia: a prospective study.","volume":"11","author":"B Rammaert","year":"2011","journal-title":"BMC Infect Dis."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"e60634","DOI":"10.1371\/journal.pone.0060634","article-title":"A prospective study of the causes of febrile illness requiring hospitalization in children in Cambodia.","volume":"8","author":"K Chheng","year":"2013","journal-title":"PLoS One."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"1106-12","DOI":"10.4269\/ajtmh.2010.10-0030","article-title":"Emergence of pediatric melioidosis in Siem Reap, Cambodia.","volume":"82","author":"Y Pagnarith","year":"2010","journal-title":"Am J Trop Med Hyg."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"865-8","DOI":"10.1097\/INF.0b013e318258873b","article-title":"Pediatric suppurative parotitis in Cambodia between 2007 and 2011.","volume":"31","author":"N Stoesser","year":"2012","journal-title":"Pediatr Infect Dis J."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"1035-44","DOI":"10.1056\/NEJMra1204699","article-title":"Melioidosis.","volume":"367","author":"W Wiersinga","year":"2012","journal-title":"N Engl J Med."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"983-5","DOI":"10.4269\/ajtmh.13-0286","article-title":"Prevalence of melioidosis in patients with suspected pulmonary tuberculosis and sputum smear negative for acid-fast bacilli in northeast Thailand.","volume":"89","author":"P Suntornsut","year":"2013","journal-title":"Am J Trop Med Hyg."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1086\/517787","article-title":"Empirical cephalosporin treatment of melioidosis.","volume":"28","author":"W Chaowagul","year":"1999","journal-title":"Clin Infect Dis."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"599-601","DOI":"10.1016\/S0035-9203(97)90044-4","article-title":"Oral fluoroquinolones for maintenance treatment of melioidosis.","volume":"91","author":"W Chaowagul","year":"1997","journal-title":"Trans R Soc Trop Med Hyg."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"383-416","DOI":"10.1128\/CMR.18.2.383-416.2005","article-title":"Melioidosis: epidemiology, pathophysiology, and management.","volume":"18","author":"A Cheng","year":"2005","journal-title":"Clin Microbiol Rev."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"121-6","DOI":"10.1099\/00222615-33-2-121","article-title":"The use of selective media for the isolation of Pseudomonas pseudomallei in clinical practice.","volume":"33","author":"V Wuthiekanun","year":"1990","journal-title":"J Med Microbiol."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/0035-9203(95)90685-1","article-title":"Selective broths for the isolation of Pseudomonas pseudomallei from clinical samples.","volume":"89","author":"A Walsh","year":"1995","journal-title":"Trans R Soc Trop Med Hyg."},{"key":"ref-14","doi-asserted-by":"crossref","first-page":"812-3","DOI":"10.4269\/ajtmh.2007.77.812","article-title":"Quantitation of B. 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B. Dance, Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, UK, 20 Jan 2015, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/3-302\/v1#referee-response-7216","order":0,"name":"referee-response-7216","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>T Eoin West<\/b>; \n<i>Posted: 07 May 2015<\/i>; Thank you for the helpful comments.We opted not to perform cost-benefit analyses in light of our small numbers of positive samples and wide confidence intervals around point estimates. We agree that these calculations are important to perform in the future in larger studies.We chose to use selective broth based on Wuthiekanun V et al, Am J Trop Med Hyg 77(5), 2007, 812-13. This study reported that \u201ca total of 94 of 120 (78%) respiratory secretions were positive for B. pseudomallei, of which 33 (35%) were positive from enrichment broth alone.\u201dUnfortunately we do not have any data on patient characteristics. Our future studies aim to investigate patient characteristics and indications for sampling.","URL":"https:\/\/f1000research.com\/articles\/3-302\/v2#referee-comment-1339","order":1,"name":"referee-comment-1339","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.6343.r7217, Jan Jacobs, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, 06 Feb 2015, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/3-302\/v1#referee-response-7217","order":2,"name":"referee-response-7217","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>T Eoin West<\/b>; \n<i>Posted: 07 May 2015<\/i>; Thank you for this constructive review.&nbsp;We agree and have modified the introduction to clarify these points as suggested.This is indeed a shortcoming of this study; unfortunately we do not have any data on the patients who provided the sputum samples tested for these patients. Sputum samples are submitted to the laboratory from both clinic and hospitalized patients. Our future studies aim to investigate patient characteristics and indications for sampling.We agree with these very helpful comments, and have modified the abstract and discussion as suggested.We have now added this information as suggested.","URL":"https:\/\/f1000research.com\/articles\/3-302\/v2#referee-comment-1338","order":3,"name":"referee-comment-1338","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This study was funded by support from the University of Washington to TEW. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Data associated with the article are available under the terms of the Creative Commons Zero \"No rights reserved\" data waiver (CC0 1.0 Public domain dedication).","order":0,"name":"copyright-info","label":"Copyright"}]}}