title: Systematic review and consensus guidelines for environmental sampling of Burkholderia pseudomallei.
abstract: BACKGROUND
  Burkholderia pseudomallei, a Tier 1 Select Agent and the cause of melioidosis, is a Gram-negative bacillus present in the environment in many tropical countries. Defining the global pattern of B. pseudomallei distribution underpins efforts to prevent infection, and is dependent upon robust environmental sampling methodology. Our objective was to review the literature on the detection of environmental B. pseudomallei, update the risk map for melioidosis, and propose international consensus guidelines for soil sampling.
  
  
  RESULTS
  An international working party (Detection of Environmental Burkholderia pseudomallei Working Party (DEBWorP)) was formed during the VIth World Melioidosis Congress in 2010. PubMed (January 1912 to December 2011) was searched using the following MeSH terms: pseudomallei or melioidosis. Bibliographies were hand-searched for secondary references. The reported geographical distribution of B. pseudomallei in the environment was mapped and categorized as definite, probable, or possible. The methodology used for detecting environmental B. pseudomallei was extracted and collated. We found that global coverage was patchy, with a lack of studies in many areas where melioidosis is suspected to occur. The sampling strategies and bacterial identification methods used were highly variable, and not all were robust. We developed consensus guidelines with the goals of reducing the probability of false-negative results, and the provision of affordable and 'low-tech' methodology that is applicable in both developed and developing countries.
  
  
  CONCLUSIONS
  The proposed consensus guidelines provide the basis for the development of an accurate and comprehensive global map of environmental B. pseudomallei.
authors.affiliation: Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. direk@tropmedres.ac
authors.forename: Direk
authors.initials: D
authors.lastname: Limmathurotsakul
authors.forename: David A B
authors.initials: DA
authors.lastname: Dance
authors.forename: Vanaporn
authors.initials: V
authors.lastname: Wuthiekanun
authors.forename: Mirjam
authors.initials: M
authors.lastname: Kaestli
authors.forename: Mark
authors.initials: M
authors.lastname: Mayo
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Warner
authors.forename: David M
authors.initials: DM
authors.lastname: Wagner
authors.forename: Apichai
authors.initials: A
authors.lastname: Tuanyok
authors.forename: Heiman
authors.initials: H
authors.lastname: Wertheim
authors.forename: Tan
authors.initials: T
authors.lastname: Yoke Cheng
authors.forename: Chiranjay
authors.initials: C
authors.lastname: Mukhopadhyay
authors.forename: Savithiri
authors.initials: S
authors.lastname: Puthucheary
authors.forename: Nicholas P J
authors.initials: NP
authors.lastname: Day
authors.forename: Ivo
authors.initials: I
authors.lastname: Steinmetz
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Peacock
mesh_terms: D001431:Bacteriological Techniques / Q000379:methods*; D016957:Burkholderia pseudomallei / Q000302:isolation & purification*; D004783:Environmental Microbiology; D017408:Guidelines as Topic; D006801:Humans; D018570:Risk Assessment; D019371:Topography, Medical
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