title: Molecular tracking investigation of melioidosis cases reveals regional endemicity in Hainan, China.
abstract: Sporadic cases of melioidosis have been reported in Hainan, China for decades; however, to the best of our knowledge, there are no accurate source-identification investigations confirming that melioidosis is endemic. Four indigenous melioidosis cases were identified, which prompted the performance of contact microbiologic and molecular techniques to evaluate endemicity. Environmental samples were collected from various locations surrounding each patient's residence. The samples were screened forBurkholderia pseudomallei(B. pseudomallei) using Ashdown culture medium, and confirmed by polymerase chain reaction and 16S ribosomal DNA sequencing. Clinical and environmental isolates ofB. pseudomalleiwere evaluated by multilocus sequence typing (MLST) and 4-locus multilocus variable number tandem repeat analysis (MLVA-4) for evidence of homology between them. Analysis by MLST indicated that one environmental sample and one clinical colony were sequence type-46, as well as type (8, 3, 11, 9) by MLVA-4. The evidence indicates a likely geographical and epidemiological association. Taken together,B. pseudomalleifrom the environmental samples in addition to the high molecular homology between the clinical and environmental isolates indicates, at least, regional endemicity of melioidosis in Hainan, China.
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Yingzi
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Sufang
authors.initials: S
authors.lastname: Dong
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Lixian
authors.initials: L
authors.lastname: Wu
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Hua
authors.initials: H
authors.lastname: Pei
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: Key Laboratory of Translational Medicine for Tropical Diseases, Ministry of Education, and Faculty of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, Hainan 571199, P.R. China.
authors.forename: Qianfeng
authors.initials: Q
authors.lastname: Xia
keywords: Burkholderia pseudomallei; Hainan; melioidosis; molecular epidemiology