title: Using BOX-PCR to exclude a clonal outbreak of melioidosis.
abstract: BACKGROUND
  Although melioidosis in endemic regions is usually caused by a diverse range of Burkholderia pseudomallei strains, clonal outbreaks from contaminated potable water have been described. Furthermore B. pseudomallei is classified as a CDC Group B bioterrorism agent. Ribotyping, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) have been used to identify genetically related B. pseudomallei isolates, but they are time consuming and technically challenging for many laboratories.
  
  
  METHODS
  We have adapted repetitive sequence typing using a BOX A1R primer for typing B. pseudomallei and compared BOX-PCR fingerprinting results on a wide range of well-characterized B. pseudomallei isolates with MLST and PFGE performed on the same isolates.
  
  
  RESULTS
  BOX-PCR typing compared favourably with MLST and PFGE performed on the same isolates, both discriminating between the majority of multilocus sequence types and showing relatedness between epidemiologically linked isolates from various outbreak clusters.
  
  
  CONCLUSIONS
  Our results suggest that BOX-PCR can be used to exclude a clonal outbreak of melioidosis within 10 hours of receiving the bacterial strains.
authors.affiliation: Northern Territory Clinical School, Flinders University, Royal Darwin Hospital, Darwin, Northern Territory, Australia. bart@menzies.edu.au
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
authors.forename: Daniel
authors.initials: D
authors.lastname: Gal
authors.forename: Mark
authors.initials: M
authors.lastname: Mayo
authors.forename: Linda
authors.initials: L
authors.lastname: Ward
authors.forename: Daniel
authors.initials: D
authors.lastname: Godoy
authors.forename: Brian G
authors.initials: BG
authors.lastname: Spratt
authors.forename: John J
authors.initials: JJ
authors.lastname: LiPuma
mesh_terms: D016957:Burkholderia pseudomallei / Q000145:classification* / Q000235:genetics; D016172:DNA Fingerprinting / Q000379:methods*; D017931:DNA Primers; D004196:Disease Outbreaks; D019353:Endemic Diseases; D006801:Humans; D008554:Melioidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D010802:Phylogeny; D016133:Polymerase Chain Reaction / Q000379:methods*
chemical_list: D017931:DNA Primers