Volume 20, Number 2—February 2014
Melioidosis Caused by Burkholderia pseudomallei in Drinking Water, 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|
|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|
- Limmathurotsakul D, Peacock SJ. Melioidosis: a clinical overview. Br Med Bull. 2011;99:125–39 .
- 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 .
- 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 .
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Kinoshita R. Epidemiology of melioidosis in an oceanarium: a clinical, environmental and molecular study. Hong Kong: University of Hong Kong; 2003.
- 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.
- 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.
- 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 .
- 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 .