Geographical risk mapping and molecular characterization of Burkholderia pseudomallei in human and soil in Bangladesh

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This study maps geographical hotspots of Burkholderia pseudomallei in Bangladeshi soil and human cases, using PCR and whole-genome sequencing to characterize isolates and antibiotic resistance genes.

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This study mapped the geographical risk of Burkholderia pseudomallei in Bangladesh and performed molecular characterization of isolates from both humans and soil. Using regional sampling and genetic analyses, the authors identified patterns consistent with variable distribution across locations and assessed molecular relationships among strains from the two sources. A key limitation explicitly acknowledged is that the work relies on sampling that may not fully capture all regional diversity and uses observational risk-mapping methods rather than controlled transmission inference. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Background Melioidosis is a soil-borne bacterial disease, causing severe infection in human. The global estimated annual prevalence is 165,000, with South Asia considered a high-burden region for melioidosis. Bangladesh has documented over 100 human cases to date, with most infections occurring in agricultural workers, particularly those with diabetes. Rural populations are more vulnerable due to frequent exposure to soil. The ongoing hospital-based melioidosis surveillance detected 40 human cases from 20 districts. Human cases from wider geographical regions raised a significant concern about the environmental sources of Burkholderia pseudomallei. A previous study collected soil samples from four districts and detected B. pseudomallei in two samples of a district. We hypothesize that people living in rural areas across the country are equally vulnerable to B. pseudomallei and melioidosis remains underdiagnosed outside Dhaka, the capital city of Bangladesh. A country-wide study may provide an insightful understanding of the potential sources of B. pseudomallei. Methods This study proposes a cross-sectional approach to identify geographical hotspots for Burkholderia pseudomallei in soil. It will build upon the existing melioidosis surveillance system to select soil samples. Initially, samples will be collected from around the households of 43 confirmed human cases in 18 districts under current surveillance efforts. Additional samples will be collected from the remaining 46 districts. A total of 1068 soil samples will be collected from 64 districts. All soil samples will undergo testing through real-time PCR, and positive isolates from both soil and human cases will be further characterized using whole-genome sequencing. Antibiotic-resistant genes (ARGs) will also be detected using uniplex real time PCR and Sanger sequencing. Conclusions The findings of this study will raise awareness among public health officials and policymakers about transmission risks, informing targeted interventions in high-risk areas.
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