Seronegative bacteremic melioidosis caused by Burkholderia pseudomallei with ambiguous biochemical profile: clinical importance of accurate identification by 16S rRNA gene and groEL gene sequencing

J Clin Microbiol. 2003 Aug;41(8):3973-7. doi: 10.1128/JCM.41.8.3973-3977.2003.

Abstract

An aerobic gram-negative bacterium was isolated from the blood and sputum of an 84-year-old, chair-bound nursing home resident with acute bacteremic pneumonia. Although the phenotypic characteristics suggested that the bacterium could be Burkholderia pseudomallei, the Vitek 1 system (GNI+), which can successfully identify 99% of B. pseudomallei strains, showed that the bacterium was "unidentified." Immunoglobulin G against the lipopolysaccharide (LPS) of B. pseudomallei, as detected by an LPS-based enzyme-linked immunosorbent assay with 95% sensitivity, was negative in both the acute-phase and convalescent-phase sera. Sequencing of the groEL gene showed that the isolate was B. pseudomallei. Proper identification of the bacterium in this study is crucial, since there would be a radical difference in the duration of antimicrobial therapy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Base Sequence
  • Burkholderia pseudomallei / classification
  • Burkholderia pseudomallei / genetics*
  • Burkholderia pseudomallei / isolation & purification*
  • Chaperonin 60 / genetics*
  • DNA Primers
  • DNA, Ribosomal / genetics
  • Diagnosis, Differential
  • Female
  • Humans
  • Melioidosis / diagnosis*
  • Molecular Sequence Data
  • Phylogeny
  • RNA, Ribosomal, 16S / genetics*

Substances

  • Chaperonin 60
  • DNA Primers
  • DNA, Ribosomal
  • RNA, Ribosomal, 16S

Associated data

  • GENBANK/AF104907
  • GENBANK/AF104908
  • GENBANK/AF287633
  • GENBANK/AY198338
  • GENBANK/AY198339