Burkholderia pseudomallei Antibodies in Children, Cambodia

Antibodies to Burkholderia pseudomallei were detected in 16% of children in Siem Reap, Cambodia. This organism was isolated from 30% of rice paddies in the surrounding vicinity. Despite the lack of reported indigenous cases, melioidosis is likely to occur in Cambodia

Prevalence of extended-spectrum β-lactamase-producing Enterobacterales in edible ice in Thailand

Background: The presence of antimicrobial-resistant (AMR) bacteria in edible ice in tropical countries is largely unknown. Methods: We evaluate the presence of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales in 100 edible ice samples from drink carts in 20 markets in four provinces (five markets/province) in Thailand. Ten samples of commercially sold edible ice in sealed packages were tested as controls. Results: Of 100 samples, 29 (29%) were culture positive for ESBL-producing Enterobacterales, with a median quantitative count of 2 colony-forming units (CFU)/100 mL (range, 1 to 40 CFU/100 mL). All control samples were culture negative for ESBL-producing Enterobacterales. Conclusions: AMR bacteria is commonly found in edible ice from drink carts

Capacity and Utilization of Blood Culture in Two Referral Hospitals in Indonesia and Thailand.

It is generally recommended that sepsis patients should have at least two blood cultures obtained before antimicrobial therapy. From 1995 to 2015, the number of blood cultures taken each year in a 1,100-bed public referral hospital in Ubon Ratchathani northeast Thailand rose from 5,235 to 56,719, whereas the number received in an 840-bed referral public hospital in South Sulawesi, Indonesia, in 2015 was 2,779. The proportion of patients sampled for blood cultures out of all inpatients in South Sulawesi in 2015 (9%; 2,779/30,593) was lower than that in Ubon Ratchathani in 2003 (13%; 8,707/66,515), at a time when health expenditure per capita in the two countries was comparable. Under-use of bacterial cultures may lead to an underestimate and underreporting of the incidence of antimicrobial-resistant infections. Raising capacity and utilization of clinical microbiology laboratories in developing countries, at least at sentinel hospitals, to monitor the antimicrobial resistance situation should be prioritized

Misidentification of Burkholderia pseudomallei as Acinetobacter species in northern Thailand.

Background: Burkholderia pseudomallei is the causative agent of melioidosis, a disease endemic throughout the tropics. Methods: A study of reported Acinetobacter spp. bacteraemia was performed at Chiang Rai provincial hospital from 2014 to 2015. Isolates were collected and tested for confirmation. Results: A total of 419 putative Acinetobacter spp. isolates from 412 patients were re-identified and 5/419 (1.2%) were identified as B. pseudomallei. Four of the five patients with melioidosis died. An estimated 88/419 (21%) isolates were correctly identified as Acinetobacter spp. Conclusions: Misidentification of Acinetobacter spp. as B. pseudomallei or other bacteria is not uncommon and programmes to address these shortfalls are urgently required

Effectiveness of Umonium38 against Burkholderia pseudomallei, Escherichia coli, Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus (MRSA)

Aims We investigated the antibacterial efficacy of Umonium38 and Virkon® against Burkholderia pseudomallei, Escherichia coli, Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus (MRSA) up to 14 days following treatment. Methods and results Umonium38 was diluted to 0.5%, 1.0%, 1.5%, 2.0%, 2.5% and 3%, tested against the bacterial strains at various contact times (15 min to 24 h), and incubated for up to 14 days. A minimum concentration of 0.5% Umonium38 with a contact time of 15 min effectively killed approximately 108 CFU/ml of all four bacterial species. No growth was observed on agar plates from day 0 until day 14 for all six concentrations. The bacteria were also inactivated by a 30-minute treatment time using Virkon® 1% solution. Conclusions Umonium38 effectively inactivates B. pseudomallei, E. coli, P. aeruginosa and MRSA at a concentration of ≥ 0.5% with a contact time of at least 15 min. The antimicrobial effect of Umonium38 remained for 14 days

Emergence of Pediatric Melioidosis in Siem Reap, Cambodia

We describe the first cases of pediatric melioidosis in Cambodia. Thirty-nine cases were diagnosed at the Angkor Hospital for Children, Siem Reap, between October 2005 and December 2008 after the introduction of microbiology capabilities. Median age was 7.8 years (range = 1.6–16.2 years), 15 cases were male (38%), and 4 cases had pre-existing conditions that may have pre-disposed the patient to melioidosis. Infection was localized in 27 cases (69%) and disseminated in 12 cases (31%). Eleven cases (28%) were treated as outpatients, and 28 (72%) cases were admitted. Eight children (21%) died a median of 2 days after admission; seven deaths were attributable to melioidosis, all of which occurred in children receiving suboptimal antimicrobial therapy and before bacteriological culture results were available. Our findings indicate the need for heightened awareness of melioidosis in Cambodia, and they have led us to review microbiology procedures and antimicrobial prescribing of suspected and confirmed cases

Competition between Burkholderia pseudomallei and B. thailandensis.

BACKGROUND: Burkholderia pseudomallei is a Gram-negative bacterium that causes melioidosis, an often fatal disease in tropical countries. Burkholderia thailandensis is a non-virulent but closely related species. Both species are soil saprophytes but are almost never isolated together. RESULTS: We identified two mechanisms by which B. pseudomallei affects the growth of B. thailandensis. First, we found that six different isolates of B. pseudomallei inhibited the growth of B. thailandensis on LB agar plates. Second, our results indicated that 55% of isolated strains of B. pseudomallei produced a secreted compound that inhibited the motility but not the viability of B. thailandensis. Analysis showed that the active compound was a pH-sensitive and heat-labile compound, likely a protein, which may affect flagella processing or facilitate their degradation. Analysis of bacterial sequence types (STs) demonstrated an association between this and motility inhibition. The active compound was produced from B. pseudomallei during the stationary growth phase. CONCLUSION: Taken together, our results indicate that B. pseudomallei inhibits both the growth and motility of its close relative B. thailandensis. The latter phenomenon appears to occur via a previously unreported mechanism involving flagellar processing or degradation

Competition between and

Syftet med denna litteraturstudie var att beskriva behov av information och stöd hos kvinnor med bröstcancer. Metoden som användes var en litteraturstudie och inkluderade både kvalitativa och kvantitativa artiklar. Tio studier inkluderades och resultatet presenterades i tre huvudkategorier: Information, stöd och sjuksköterskans uppfattning om behov av information och stöd, detta behov måste identifieras individuellt efter varje kvinna med bröstcancer. Dessa kvinnor uppskattade information om möjligheten att bli botad, behandlingsalternativ samt recidiv. Yngre kvinnor hade större behov av information om sexualitet än äldre. Detta informationsbehov beräknades ändå som mindre viktigt av alla kvinnor med bröstcancer oberoende av ålder. Det var många studier som visade samma resultat att kvinnor med bröstcancer har stort behov av information och stöd. Resultatet av litteraturstudien kan ge sjuksköterskorna ökad förståelse om vilka behov av information och stöd kvinnor med bröstcancer har. Ökad medvetenhet om dessa behov kan ligga till grund för en god omvårdnad.The aim of this study was to describe the need for information and support in women with breast cancer. The method used is a literature study with both of qualitative and quantitative articles. Ten studies were included and the results were presented in three main categories: information, support, and the nurse's perception of the need for information and support, this need must be identified individually by each woman with breast cancer. These women appreciated the information about chances of cure, treatment and recurrence. Young women had a greater need for information about sexuality than older. This information was calculated, however, as less important for all women with breast cancer regardless of age. There were many studies that showed the same results that women with breast cancer have great need for information and support. The results of the literature study can give nurses greater understanding of the needs for information and support women with breast cancer have. Increased awareness of these needs can be the basis for good care

Accuracy of a Commercial IgM ELISA for the Diagnosis of Human Leptospirosis in Thailand

The Leptospira immunoglobulin M enzyme-linked immunosorbent assay (IgM ELISA) has been recommended for the rapid diagnosis of leptospirosis in endemic areas. We conducted a retrospective case-control study of 218 patients (109 leptospirosis cases confirmed by Leptospira culture and/or microscopic agglutination test and 109 control patients with acute febrile illness) to evaluate the diagnostic accuracy of a commercial IgM ELISA (Panbio) in northeast Thailand. Paired serum samples taken on admission and at least 10 days after the onset of symptoms were tested. Using the cutoff value recommended by the manufacturer (11 Panbio units), sensitivity and specificity of IgM ELISA on paired sera were 90.8% and 55.1%. A receiver operating characteristic curve was used to determine the optimal cutoff value. This was 20 Panbio units, which gave a sensitivity and specificity of 76.1% and 82.6%, respectively, on paired sera. We conclude that using either cutoff value, the accuracy of IgM ELISA is limited in our setting