title: Burkholderia pseudomallei: Challenges for the Clinical Microbiology Laboratory.
abstract: Melioidosis is a potentially fatal infection caused by the bacterium Burkholderia pseudomallei Clinical diagnosis of melioidosis can be challenging since there is no pathognomonic clinical syndrome, and the organism is often misidentified by methods used routinely in clinical laboratories. Although the disease is more prevalent in Thailand and northern Australia, sporadic cases may be encountered in areas where it is not endemic, including the United States. Since the organism is considered a tier 1 select agent according to the Centers for Disease Control and Prevention and the U.S. Department of Agriculture Animal and Plant Health Inspection Service, clinical laboratories must be proficient at rapidly recognizing isolates suspicious for B. pseudomallei, be able to safely perform necessary rule-out tests, and to refer suspect isolates to Laboratory Response Network reference laboratories. In this minireview, we report a case of melioidosis encountered at our institution and discuss the laboratory challenges encountered when dealing with clinical isolates suspicious for B. pseudomallei or clinical specimens from suspected melioidosis cases.
authors.affiliation: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors.forename: Peera
authors.identifier: 0000-0001-6182-9136
authors.initials: P
authors.lastname: Hemarajata
authors.affiliation: Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Baghdadi
authors.affiliation: Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors.forename: Risa
authors.initials: R
authors.lastname: Hoffman
authors.affiliation: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA rhumphries@mednet.ucla.edu.
authors.forename: Romney M
authors.initials: RM
authors.lastname: Humphries
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015373:Bacterial Typing Techniques / Q000379:methods*; D016957:Burkholderia pseudomallei / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008554:Melioidosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents