title: Identification of melioidosis outbreak by multilocus variable number tandem repeat analysis.
abstract: Endemic melioidosis is caused by genetically diverse Burkholderia pseudomallei strains. However, clonal outbreaks (multiple cases caused by 1 strain) have occurred, such as from contaminated potable water. B. pseudomallei is designated a group B bioterrorism agent, which necessitates rapidly recognizing point-source outbreaks. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) can identify genetically related isolates, but results take several days to obtain. We developed a simplified 4-locus multilocus variable number tandem repeat analysis (MLVA-4) for rapid typing and compared results with PFGE and MLST for a large number of well-characterized B. pseudomallei isolates. MLVA-4 compared favorably with MLST and PFGE for the same isolates; it discriminated between 65 multilocus sequence types and showed relatedness between epidemiologically linked isolates from outbreak clusters and between isolates from individual patients. MLVA-4 can establish or refute that a clonal outbreak of melioidosis has occurred within 8 hours of receipt of bacterial strains.
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia. bart@menzies.edu.au
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
authors.forename: Asha
authors.initials: A
authors.lastname: Haslem
authors.forename: Talima
authors.initials: T
authors.lastname: Pearson
authors.forename: Heidie
authors.initials: H
authors.lastname: Hornstra
authors.forename: Benjamin
authors.initials: B
authors.lastname: Leadem
authors.forename: Mark
authors.initials: M
authors.lastname: Mayo
authors.forename: Daniel
authors.initials: D
authors.lastname: Gal
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: Paul
authors.initials: P
authors.lastname: Keim
mesh_terms: D015373:Bacterial Typing Techniques; D001483:Base Sequence; D016957:Burkholderia pseudomallei / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D008554:Melioidosis / Q000453:epidemiology* / Q000382:microbiology; D018598:Minisatellite Repeats / Q000235:genetics*; D008969:Molecular Sequence Data; D017422:Sequence Analysis, DNA