Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 20, Number 2—February 2014
Dispatch

Melioidosis Caused by Burkholderia pseudomallei in Drinking Water, Thailand, 2012

Direk LimmathurotsakulComments to Author , Gumphol Wongsuvan, David Aanensen, Sujittra Ngamwilai, Natnaree Saiprom, Patpong Rongkard, Janjira Thaipadungpanit, Manas Kanoksil, Narisara Chantratita, Nicholas P.J. Day, and Sharon J. Peacock
Author affiliations: Mahidol University, Bangkok, Thailand (D. Limmathurotsakul, G. Wongsuvan, S. Ngamwilai, N. Saiprom, P. Rongkard, J. Thaipadungpanit, N. Chantratits, N.P.J. Day, S.J. Peacock); Imperial College London, London, UK (D. Aanensen); Sappasithiprasong Hospital, Ubon Ratchathani, Thailand (M. Kanoksil); Churchill Hospital, Oxford, UK (N.P.J. Day); Addenbrooke’s Hospital, Cambridge, UK (S.J. Peacock)

Main Article

Table 2

Genotyping of Burkholderia pseudomallei isolated from clinical specimens and water samples for 2 patients, Thailand, 2012*

Patient no./
age, y/sex Sample type No. colonies tested PFGE pattern
(no. colonies) No. bands different from clinical sample Sequence type determined by MLST Clinical features and outcome
1/78/F Blood 1 A (1) NA 208 No known risk factors for melioidosis; patient had acute onset of severe pneumonia and septic shock and died 48 h after hospital admission. Blood, sputum, and urine specimens were positive for B. pseudomallei. Abdominal ultrasound scan was not performed. Patient had a history of consuming untreated well water.
Well water 10 A (2) 0 208
B (2) 8 54
C (4) 11 58
D (2) 12 309
2/88/M Blood 1 E (1) NA 48 Patient had diabetes, acute onset of pneumonia, and right hemiparesis. Blood and sputum specimens were positive for B. pseudomallei. Computer tomography scan of the brain showed a ruptured mycotic aneurysm, leading to acute hematoma in the left frontoparietotemporal lobe and multiple septic emboli. Abdominal ultrasonogram was not performed. Patient had a history of consuming untreated well water and tap water. Septic shock developed on day 19 and the patient died on day 24 after hospital admission.
Tap water 10 F (7) 3 48
G (2) 6 47
H (1) 14 696

*Genotyping was performed by using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) as described (7,8). NA, not applicable.

Main Article

References
  1. Limmathurotsakul  D, Peacock  SJ. Melioidosis: a clinical overview. Br Med Bull. 2011;99:125–39 . DOIPubMedGoogle Scholar
  2. Inglis  TJ, Garrow  SC, Henderson  M, Clair  A, Sampson  J, O’Reilly  L, Burkholderia pseudomallei traced to water treatment plant in Australia. Emerg Infect Dis. 2000;6:56–9 .PubMedGoogle Scholar
  3. Currie  BJ, Mayo  M, Anstey  NM, Donohoe  P, Haase  A, Kemp  DJ. A cluster of melioidosis cases from an endemic region is clonal and is linked to the water supply using molecular typing of Burkholderia pseudomallei isolates. Am J Trop Med Hyg. 2001;65:177–9 .PubMedGoogle Scholar
  4. West  TE, Myers  ND, Limmathurotsakul  D, Liggitt  HD, Chantratita  N, Peacock  SJ, Pathogenicity of high-dose enteral inoculation of Burkholderia pseudomallei to mice. Am J Trop Med Hyg. 2010;83:1066–9. DOIPubMedGoogle Scholar
  5. Limmathurotsakul  D, Kanoksil  M, Wuthiekanun  V, Kitphati  R, deStavola  B, Day  N, Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case control study. PLoS Negl Trop Dis. 2013;7:e2072. DOIPubMedGoogle Scholar
  6. Aanensen  DM, Huntley  DM, Feil  EJ, al-Own  F, Spratt  BG. EpiCollect: linking smartphones to web applications for epidemiology, ecology and community data collection. PLoS ONE. 2009;4:e6968. DOIPubMedGoogle Scholar
  7. Maharjan  B, Chantratita  N, Vesaratchavest  M, Cheng  A, Wuthiekanun  V, Chierakul  W, Recurrent melioidosis in patients in northeast Thailand is frequently due to reinfection rather than relapse. J Clin Microbiol. 2005;43:6032–4. DOIPubMedGoogle Scholar
  8. Godoy  D, Randle  G, Simpson  AJ, Aanensen  DM, Pitt  TL, Kinoshita  R, Multilocus sequence typing and evolutionary relationships among the causative agents of melioidosis and glanders, Burkholderia pseudomallei and Burkholderia mallei. J Clin Microbiol. 2003;41:2068–79. DOIPubMedGoogle Scholar
  9. Pumpuang  A, Chantratita  N, Wikraiphat  C, Saiprom  N, Day  NP, Peacock  SJ, Survival of Burkholderia pseudomallei in distilled water for 16 years. Trans R Soc Trop Med Hyg. 2011;105:598–600. DOIPubMedGoogle Scholar
  10. Provincial Waterworks Authority of Ubon Ratchathani. Thailand. The national tap water quality assurance program [cited 2012 Feb 11]. http://www.pwa.co.th/province/cgi-bin/index.php?Province=34.
  11. Kinoshita  R. Epidemiology of melioidosis in an oceanarium: a clinical, environmental and molecular study. Hong Kong: University of Hong Kong; 2003.
  12. Wuthiekanun  V, Limmathurotsakul  D, Chantratita  N, Feil  EJ, Day  NP, Peacock  SJ. Burkholderia pseudomallei is genetically diverse in agricultural land in northeast Thailand. PLoS Negl Trop Dis. 2009;3:e496. DOIPubMedGoogle Scholar
  13. Zanetti  F, De Luca  G, Stampi  S. Recovery of Burkholderia pseudomallei and B. cepacia from drinking water. Int J Food Microbiol. 2000;59:67–72. DOIPubMedGoogle Scholar
  14. Limmathurotsakul  D, Dance  DA, Wuthiekanun  V, Kaestli  M, Mayo  M, Warner  J, Systematic review and consensus guidelines for environmental sampling of Burkholderia pseudomallei. PLoS Negl Trop Dis. 2009;3:e496 .PubMedGoogle Scholar
  15. Wuthiekanun  V, Limmathurotsakul  D, Chantratita  N, Wongsuvan  G, Thanwisai  A, Biaklang  M, Simultaneous infection with more than one strain of Burkholderia pseudomallei is uncommon in human melioidosis. J Clin Microbiol. 2007;45:3830–2 . DOIPubMedGoogle Scholar

Main Article

Page created: January 16, 2014
Page updated: January 16, 2014
Page reviewed: January 16, 2014
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external