title: Genotyping of Burkholderia mallei from an outbreak of glanders in Bahrain suggests multiple introduction events.
abstract: BACKGROUND
  Glanders, caused by the gram-negative bacterium Burkholderia mallei, is a highly infectious zoonotic disease of solipeds causing severe disease in animals and men. Although eradicated from many Western countries, it recently emerged in Asia, the Middle-East, Africa, and South America. Due to its rareness, little is known about outbreak dynamics of the disease and its epidemiology.
  
  
  RESULTS
  We investigated a recent outbreak of glanders in Bahrain by applying high resolution genotyping (multiple locus variable number of tandem repeats, MLVA) and comparative whole genome sequencing to B. mallei isolated from infected horses and a camel. These results were compared to samples obtained from an outbreak in the United Arab Emirates in 2004, and further placed into a broader phylogeographic context based on previously published B. mallei data. The samples from the outbreak in Bahrain separated into two distinct clusters, suggesting a complex epidemiological background and evidence for the involvement of multiple B. mallei strains. Additionally, the samples from Bahrain were more closely related to B. mallei isolated from horses in the United Arab Emirates in 2004 than other B. mallei which is suggestive of repeated importation to the region from similar geographic sources.
  
  
  CONCLUSIONS
  High-resolution genotyping and comparative whole genome analysis revealed the same phylogenetic patterns among our samples. The close relationship of the Dubai/UAE B. mallei populations to each other may be indicative of a similar geographic origin that has yet to be identified for the infecting strains. The recent emergence of glanders in combination with worldwide horse trading might pose a new risk for human infections.
authors.affiliation: Department of Bacteriology and Toxinology, Bundeswehr Institute of Microbiology, German Center for Infection Research (DZIF), Munich, Germany.
authors.forename: Holger C
authors.initials: HC
authors.lastname: Scholz
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Talima
authors.initials: T
authors.lastname: Pearson
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Heidie
authors.initials: H
authors.lastname: Hornstra
authors.affiliation: Department of Bacteriology and Toxinology, Bundeswehr Institute of Microbiology, German Center for Infection Research (DZIF), Munich, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Projahn
authors.affiliation: Department of Bacteriology and Toxinology, Bundeswehr Institute of Microbiology, German Center for Infection Research (DZIF), Munich, Germany.
authors.forename: Rahime
authors.initials: R
authors.lastname: Terzioglu
authors.affiliation: Central Veterinary Research Laboratory, Dubai, United Arab Emirates.
authors.forename: Renate
authors.initials: R
authors.lastname: Wernery
authors.affiliation: Department of Bacteriology and Toxinology, Bundeswehr Institute of Microbiology, German Center for Infection Research (DZIF), Munich, Germany.
authors.forename: Enrico
authors.initials: E
authors.lastname: Georgi
authors.affiliation: Department of Bacteriology and Toxinology, Bundeswehr Institute of Microbiology, German Center for Infection Research (DZIF), Munich, Germany.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Riehm
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: David M
authors.initials: DM
authors.lastname: Wagner
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Keim
authors.affiliation: Central Veterinary Research Laboratory, Dubai, United Arab Emirates.
authors.forename: Marina
authors.initials: M
authors.lastname: Joseph
authors.affiliation: Central Veterinary Research Laboratory, Dubai, United Arab Emirates.
authors.forename: Bobby
authors.initials: B
authors.lastname: Johnson
authors.affiliation: Central Veterinary Research Laboratory, Dubai, United Arab Emirates.
authors.forename: Joerg
authors.initials: J
authors.lastname: Kinne
authors.affiliation: Central Veterinary Research Laboratory, Dubai, United Arab Emirates.
authors.forename: Shanti
authors.initials: S
authors.lastname: Jose
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Crystal M
authors.initials: CM
authors.lastname: Hepp
authors.affiliation: Department of Microbiology, Immunbiology and Genetics, MFPL laboratories, University of Vienna, Vienna, Austria.
authors.forename: Angela
authors.initials: A
authors.lastname: Witte
authors.affiliation: Central Veterinary Research Laboratory, Dubai, United Arab Emirates.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wernery
mesh_terms: D000818:Animals; D001445:Bahrain / Q000453:epidemiology; D042726:Burkholderia mallei / Q000235:genetics*; D002162:Camelus; D004196:Disease Outbreaks / Q000662:veterinary*; D060005:Genotyping Techniques; D005896:Glanders / Q000453:epidemiology / Q000382:microbiology*; D006736:Horses