Case Report: Soft tissue infection with Burkholderia thailandensis capsular variant: case report from the Lao PDR.

Q1 Medicine Wellcome Open Research Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI:10.12688/wellcomeopenres.22706.1

Souphaphone Vannachone, Manophab Luangraj, David Dance, Narisara Chantratita, Natnaree Saiprom, Rathanin Seng, Sarunporn Tandhavanant, Sayaphet Rattanavong, Andrew Simpson, Tamalee Roberts

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Abstract

Background: Burkholderia thailandensis is an environmental bacteria closely related to Burkholderia pseudomallei that rarely causes infection in humans. Some environmental isolates have shown to express a capsular polysaccharide known as B. thailandensis capsular variant (BTCV), but human infection has not previously been reported. Although B. thailandednisis has been identified in environmental samples in Laos before, there have not been any human cases reported.

Case: A 44-year-old man presented to a district hospital in Laos with a short history of fever and pain in his left foot. Physical examination identified a deep soft-tissue abscess in his left foot and an elevated white blood count. A deep pus sample was taken and melioidosis was suspected from preliminary laboratory tests. The patient was initially started on cloxacillin, ceftriaxone and metronidazole, and was then changed to ceftazidime treatment following local melioidosis treatment guidelines.

Laboratory methods: A deep pus sample was sent to Mahosot Hospital microbiology laboratory where a mixed infection was identified including Burkholderia sp. Conventional identification tests and API 20NE were inconclusive, and the B. pseudomallei-specific latex agglutination was positive. The isolate then underwent a Burkholderia species specific PCR which identified the isolate as B. thailandensis. The isolate was sent for sequencing on the Illumina NovaSeq 6000 system and multi-locus sequence typing analysis identified the isolate had the same sequence type (ST696) as B. thailandensis E555, a strain which expresses a B. pseudomallei-like capsular polysaccharide.

Conclusion: This is the first report of human infection with B. thailandensis in Laos, and the first report of any human infection with the B. thailandensis capsular variant. Due to the potential for laboratory tests to incorrectly identify this bacteria, staff in endemic areas for B. thailandensis and B. pseudomallei should be aware and ensure that appropriate confirmatory methods are used to differentiate between the species.

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病例报告：泰国伯克霍尔德氏菌囊变体引起的软组织感染：老挝人民民主共和国的病例报告。

背景：泰国伯克霍尔德氏菌（Burkholderia thailandensis）是一种与假马来伯克霍尔德氏菌（Burkholderia pseudomallei）密切相关的环境细菌，很少引起人类感染。一些环境分离物显示能表达一种被称为泰国伯克霍尔德氏菌荚膜变异体（BTCV）的荚膜多糖，但此前尚未有人类感染的报道。虽然以前在老挝的环境样本中发现过泰国嗜血杆菌，但还没有人类感染病例的报道：一名 44 岁的男子因发烧和左脚疼痛前往老挝一家地区医院就诊。体格检查发现他的左脚有深层软组织脓肿，白细胞计数升高。患者被采集了深部脓液样本，初步化验结果怀疑是类鼻疽。患者最初开始接受氯唑西林、头孢曲松和甲硝唑治疗，后根据当地的类鼻疽治疗指南改为头孢他啶治疗：深层脓液样本被送往马霍索特医院微生物实验室，在那里确定了包括伯克霍尔德氏菌在内的混合感染。常规鉴定测试和 API 20NE 均未得出结论，而假丝酵母菌特异性乳胶凝集试验呈阳性。随后，对分离物进行了伯克霍尔德菌种特异性聚合酶链反应（PCR），结果确定分离物为泰国伯克霍尔德菌。该分离物被送往Illumina NovaSeq 6000系统进行测序，多焦点序列分型分析确定该分离物与泰国伯克霍尔德氏菌E555具有相同的序列类型（ST696），后者是一种表达类似假丝酵母菌荚膜多糖的菌株：这是老挝首次报告人感染泰国芽胞杆菌，也是首次报告人感染泰国芽胞杆菌荚膜变异株。由于实验室检测可能会错误地识别这种细菌，因此泰国杆菌和假马来杆菌流行地区的工作人员应提高警惕，并确保使用适当的确证方法来区分这两种细菌。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Wellcome Open Research Biochemistry, Genetics and Molecular Biology-Biochemistry, Genetics and Molecular Biology (all)

CiteScore

5.50

自引率

0.00%

发文量

426

审稿时长

1 weeks

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