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METHODS Study design : prospective, cross-sectional study

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Poster ID: EPP005.

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Poster ID: EPP005

Detection of antibodies to Burkholderia pseudomallei in children in Siem Reap, Kingdom of Cambodia and presence of the organism in their environmentVanaporn Wuthiekanun1, Dr. Ngoun Pheaktra2, Hor Putchhat2, Sayan Lankla1, Sin Lina2, Bun Sen2, Sharon Peacock1, Nicholas Day11. Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, Thailand; 2. Angkor Hospital for Children (AHC), Siem Reap, Kingdom of Cambodia

  • Antibodies to B. pseudomallei were detected in 16.4% of 968 children
    • Detectable IHA titer values ranged from 1:10 to 1:10240 (IQR 1:20 to 1:640)
    • 6.5% had an IHA titer ≥ 1:160
    • The proportion of children with any detectable IHA titer rose with age (see chart below)
  • B. pseudomallei was isolated from 12 (30%) sites in 6 (60%) rice fields
    • The colony forming unit (cfu) of B. pseudomallei per gram of soil ranged from 1 to 5000 cfu/g (median 90 cfu/g, IQR 20 to 250 cfu/g).
    • All 12 B. pseudomallei isolates were susceptible to ceftazidime, imipenem, amoxicillin-clavulanate, chloramphenicol, doxycycline and co-trimoxazole.
  • Antibodies to B. pseudomallei were detected in 16% of children living in Siem Reap, Cambodia, and 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.
  • Burkholderia pseudomallei is a soil saprophyte and the cause of melioidosis
  • The majority of reported cases occur in northeast Thailand and northern Australia
  • True burden of disease is likely more extensive since microbial culture for melioidosis is not available across much of rural Asia


Study design: prospective, cross-sectional study

Study site: Angkor Hospital for Children (AHC) in Siem Reap, Cambodia

Study sample: Serum from 968 unselected consecutive patients 0-16 years old who had blood drawn at AHC for routine work-up

Measure: Indirect hemagglutination assay (IHA) to detect presence and titer of antibodies to B. pseudomallei

Environmental sampling: 4 soil samples were collected from each of 10 different paddy fields around Siem Reap. Culture & sensitivities for B. pseudomallei were done on the soil samples.


The presence of antibodies to B. pseudomallei in the serum of children and isolation of B. pseudomallei from the environmental soil as shown by this study provide evidence that,despite the lack of reported indigenous cases, melioidosis is likely to occur in Cambodia. These results also show a need for diagnostic microbiology development and associated detection of melioidosis cases across rural southeast Asia.