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Journal of Clinical Microbiology, August 2003, p. 3973-3977, Vol. 41, No. 8
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.8.3973-3977.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Seronegative Bacteremic Melioidosis Caused by Burkholderia pseudomallei with Ambiguous Biochemical Profile: Clinical Importance of Accurate Identification by 16S rRNA Gene and groEL Gene Sequencing

Patrick C. Y. Woo,1 Susanna K. P. Lau,1 Gibson K. S. Woo,1 Ami M. Y. Fung,1 Antonio H. Y. Ngan,1 Wai-ting Hui,1 and Kwok-yung Yuen1,2*

Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital,1 HKU-Pasteur Research Centre, Hong Kong2

Received 21 January 2003/ Returned for modification 21 March 2003/ Accepted 28 April 2003

An aerobic gram-negative bacterium was isolated from the blood and sputum of an 84-year-old, chair-bound nursing home resident with acute bacteremic pneumonia. Although the phenotypic characteristics suggested that the bacterium could be Burkholderia pseudomallei, the Vitek 1 system (GNI+), which can successfully identify 99% of B. pseudomallei strains, showed that the bacterium was "unidentified." Immunoglobulin G against the lipopolysaccharide (LPS) of B. pseudomallei, as detected by an LPS-based enzyme-linked immunosorbent assay with 95% sensitivity, was negative in both the acute-phase and convalescent-phase sera. Sequencing of the groEL gene showed that the isolate was B. pseudomallei. Proper identification of the bacterium in this study is crucial, since there would be a radical difference in the duration of antimicrobial therapy.

* Corresponding author. Mailing address: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong. Phone: (852) 28554892. Fax: (852) 28551241. E-mail: hkumicro{at}hkucc.hku.hk.

Journal of Clinical Microbiology, August 2003, p. 3973-3977, Vol. 41, No. 8
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.8.3973-3977.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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