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Volume 20, Number 2—February 2014

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)

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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.

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