title: Burkholderia pseudomallei: First case of melioidosis in Portugal.
abstract: Burkholderia pseudomallei is a Gram-negative bacillus and the causative agent of melioidosis, a serious infection associated with high mortality rate in humans. It can be naturally found as an environmental saprophyte in soil or stagnant water, and rice paddies that predominate in regions of endemicity such as Northeast Thailand. B. pseudomallei is a Biosafety Level 3 organism due to risks of aerosolization and severe disease and is now included in formal emergency preparedness plans and guidelines issued by various authorities in the United States and Europe. Here, we report the first case of imported melioidosis in Portugal. B. pseudomallei was isolated from the patient's blood as well as from a left gluteal abscess pus. The isolate strain showed the unusual resistance profile to first-line eradication therapy trimethroprim/sulfamethoxazole. Whole genome sequencing revealed its similarity with isolates from Southeast Asia, suggesting the Thai origin of this Portuguese isolate, which is in agreement with a recent patient's travel to Thailand.
authors.affiliation: National Institute of Health, Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Pelerito
authors.affiliation: National Institute of Health, Bioinformatics Unit, Department of Infectious Diseases, Lisbon, Portugal.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nunes
authors.affiliation: Luz Hospital, Internal Medicine, Lisbon, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Coelho
authors.affiliation: Luz Hospital, Clinical Pathology Laboratory, Lisbon, Portugal.
authors.forename: Cátia
authors.initials: C
authors.lastname: Piedade
authors.affiliation: National Institute of Health, Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, Lisbon, Portugal; Nova Medical School, CEDOC, Nova Medical School, Lisbon, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Paixão
authors.affiliation: National Institute of Health, Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, Lisbon, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Cordeiro
authors.affiliation: Innovation and Technology Unit, Department of Human Genetics, National Institute of Health, Lisbon, Portugal.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sampaio
authors.affiliation: Innovation and Technology Unit, Department of Human Genetics, National Institute of Health, Lisbon, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Vieira
authors.affiliation: National Institute of Health, Bioinformatics Unit, Department of Infectious Diseases, Lisbon, Portugal.
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Gomes
authors.affiliation: National Institute of Health, Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, Lisbon, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Núncio
keywords: Burkholderia pseudomallei; Melioidosis; Whole genome sequencing