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Journal of Clinical Microbiology, February 2008, p. 447-455, Vol. 46, No. 2
0095-1137/08/$08.00+0 doi:10.1128/JCM.01460-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
Received 19 July 2007/ Returned for modification 11 September 2007/ Accepted 16 November 2007
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The accurate identification of BCC members is currently carried out by means of a polyphasic approach, employing biochemical metabolic testing, DNA-DNA genome hybridization, whole-cell protein electrophoresis, and recA gene sequence analysis. Various molecular typing methods are currently being evaluated to accurately identify and categorize strains belonging to the BCC, although a single test that does this has yet to be found. Although 16S rRNA gene sequence analysis is an acceptable means of differentiating many bacterial species, it is of limited use in accurately separating species of the BCC due to high (98 to 99%) sequence identity (5, 20, 21). Techniques using the recA gene locus have proven to be the most successful. Originally designed to be used primarily as an assay to separate strains at the species level, recent modifications to this procedure permit discrimination between all Burkholderia genus members (21, 25, 33). recA-based typing has been used to identify BCC strains from both environmental samples and sputa as well as to identify other Burkholderia species (7, 12, 24, 27). However, misidentification of BCC species has occurred using this approach as a restriction fragment length polymorphism-based strategy (23, 24). Furthermore, the medically important BCC member B. cenocepacia is divided into four different recA phylotypes, complicating the identification of this species (32).
Recently, a multilocus sequence typing (MLST) scheme has been developed for the precise differentiation of the species and strains of the BCC (3). PCR amplification of seven conserved housekeeping genes was used to first obtain sequencing targets, followed by DNA sequencing using nested oligonucleotide primers. Extensive nucleotide sequence diversity was found within all seven genetic loci, ranging from 13.1% for atpD to 37.4% for gyrB. This MLST scheme differentiated all nine BCC species and 114 of 119 BCC strains, but as expected, no differentiation was observed between strains obtained from environmental or clinical sources (3). Unfortunately, DNA sequencing and comparison of seven gene targets for each BCC isolate are not within the capabilities of many clinical laboratories, and therefore, simpler, effective strategies for BCC classification are still needed.
In spite of the numerous methods available for separating BCC species, a single well-conserved gene locus that would provide a simple method for unambiguous species-specific identification is highly desirable. While studying the potential of using virulence factor genes for the purpose of distinguishing virulent BCC strains from environmental strains, we discovered that the BCC fur gene (encoding the ferric uptake regulator protein) was useful for differentiating between members of the BCC. Subsequent to DNA sequencing and alignment, it was discovered that this single conserved gene contained sufficient polymorphisms to not only allow species level differentiation of the nine BCC species but also permit the creation of a PCR strategy that could be employed to rapidly identify specific BCC species.
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TABLE 1. Strains and clinical isolates used in this studya
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10 ng of genomic DNA. PCRs were performed with an Eppendorf Mastercycler gradient DNA thermal cycler (Westbury, NY) under the following conditions: 96°C for 2 min for the first cycle, followed by 30 cycles of 96°C for 1 min, 55°C for 1 min, and 72°C for 1 min, with a final extension step of 72°C for 2 min. PCR products were separated on 0.8% (wt/vol) agarose gels in 1x Tris-acetate-EDTA (pH 8.0). fur gene sequencing. The fur gene (located on chromosome 1 [bp 3702141 to 3702734] in B. cenocepacia J2315 [http://www.sanger.ac.uk/Projects/B_cenocepacia]; Sanger Centre) was initially amplified from various BCC strains using primers JD490 and JD491 (Table 2). The DNA sequences were determined by direct sequencing from amplicons purified using a Geneclean II kit (Qbiogene, Irvine, CA) or from amplicons cloned into pJET1.2/blunt (Fermentas, Burlington, Ontario, Canada). Nucleotide sequences were determined at least once on each DNA strand using BigDye Terminator reaction mixtures according to the manufacturer's recommendations (PE Biosystems, Foster City, CA), and the products were separated and collected using an ABI Prism 3100 genetic analyzer (PE Biosystems) using standard sequencing conditions. The sequences were aligned and edited using EditView and AutoAssembler software (PE Biosystems). These sequences were analyzed using BLASTN (NCBI) to verify amplification of the correct product. When aligned, the resulting DNA sequences from different BCC species showed heterogeneity at several sites. These sites were used to design PCR primers that would specifically amplify species-specific products. Primers were designed to possess similar melting and optimum annealing temperatures and to specifically amplify a fur product from each of the BCC species, as shown in Table 2. All primers were purchased from Sigma/Genosys Canada (Oakville, Ontario, Canada). To identify strains that were not amplified by JD490 and JD491, 16S rRNA gene sequences were determined. Primers 27F and 1522R were used to amplify a partial region of the 16S rRNA gene (18). This product was cloned into pJET1.2/blunt (Fermentas) and sequenced as described above.
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TABLE 2. Species-specific primers used for amplification of the BCC fur gene
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FIG. 1. Phylogenetic tree comparing sequences of a 429-bp fur fragment from strains and isolates of the BCC. The phylogenies are rooted due to the assumption of a common ancestor and biological clock. Genetic distance is shown on the scale, with demarcations representing 2% estimated substitutions. The genomovar status (I through IX) of each BCC species is shown in parentheses following the strain or isolate name. Abbreviations are as follows: Bg, Burkholderia gladioli; Bp, Burkholderia pseudomallei; Bsp, Burkholderia species; Bx, Burkholderia xenovorans.
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The 69 aligned fur sequences were used to construct a phylogenetic tree (Fig. 1). The fur gene sequences from B. xenovorans, Burkholderia sp. strain JS150, and B. pseudomallei were included in the tree as outliers. The clinical isolates R406 and R1879, although putatively identified as being BCC species, also appeared to be outliers. To confirm the identities of these two isolates, 16S rRNA gene sequencing was performed. Sequence data showed that these two strains were not part of the BCC but were instead Burkholderia gladioli, a closely related Burkholderia species. Both of these isolates were able to grow on BCSA selective medium (Table 1).
Of the strains that had been previously characterized, 38 of 40 grouped according to species level on the tree (Fig. 1). One exception was C1469, a B. pyrrocinia strain that appears to be more closely related to BCC recA group K isolates than to other B. pyrrocinia strains. A second exception was LMG 19240, a B. cenocepacia strain that belongs to the recA IIIC subgroup. The fur gene sequence of LMG 19240 is substantially different from the sequences of the other B. cenocepacia strains and isolates tested. As such, it forms an isolated B. cenocepacia branch on the tree (Fig. 1). Despite these two exceptions, the strong correlation between the position of any BCC strain's fur sequence on the tree and its species designation suggested that the addition of fur gene sequences from unidentified strains would allow unambiguous identification at the species level. As predicted, the 21 uncharacterized clinical isolates clustered on the tree among the previously characterized strains. The largest cluster of these isolates, 13 of 21 (62%), was B. cenocepacia based on their position in the tree. The next largest cluster was B. multivorans, a group in which 4 of the 21 (19%) isolates belonged. These values are consistent with previous reports showing that the majority of BCC clinical isolates are either B. cenocepacia or B. multivorans isolates (28). The remainder of the uncharacterized clinical isolates belonged to Burkholderia stabilis (three isolates) and BCC group K (one isolate). The fur gene sequence from isolate R445 was more closely related to BCC group K strains (33) than to prototypical B. cepacia strains (21) (Fig. 1).
With the exception of C1469 and LMG 19240, fur gene sequence analysis separates strains and isolates of a single species into a single cluster on the phylogenetic tree. However, like recA analysis, subgroups are present within these clusters (Fig. 1). For example, B. multivorans strains and isolates branch into two discrete groups, the first including M1512, M1865, R810, C5274, and LMG 13010 and the second including ATCC 17616, C3430, C5393, R1159, and C5568. For previously characterized B. cenocepacia strains, the phylogenetic clusters based on the fur sequence match the groupings assigned by recA analysis. The strains belonging to groups IIIA to IIID all form discrete groups on the tree. The cluster formed by the IIIA strains is the most diffuse. It branches into two groups, one including R1284, R1314, and C1257 and the second including all other IIIA strains and isolates tested. Based on this analysis, all of the uncharacterized B. cenocepacia clinical isolates are most closely related to strains in the IIIA subgroup.
Design and application of species-specific primers. While analysis of the fur gene sequence allowed the BCC strains and isolates to be easily and accurately identified to the species level, a complementary PCR protocol was developed to make the classification process more rapid. There are several sites in the fur gene where a single base pair difference can be used to differentiate strains of one BCC species from others. These polymorphisms were used to design primer sets that would amplify the fur gene in a species-specific fashion. These primers, the expected products, and the species from which the products can be amplified are shown in Table 2. Primers were tested against a panel of nine representative BCC strains (Table 1) in order to verify that the primer sets would result in the synthesis of a product of the expected size for only one of the nine species. The primers designed for B. cepacia/BCC recA group K, B. multivorans, B. cenocepacia, B. vietnamiensis, B. dolosa, B. ambifaria, and B. pyrrocinia were highly specific. When tested with the nine representative BCC strains, these primers amplified a product of the expected size from only a single species. Although a small number of nonspecific products were amplified in some cases, these amplicons could be distinguished from the expected product by their sizes (Fig. 2). Each amplicon of the correct size was sequenced in order to verify amplification of the expected product. In addition to the nine representative BCC strains, these primer sets were subsequently tested with an additional 50 strains and isolates: 5 B. cepacia and BCC group K strains/isolates for primer set F1/R1, 9 B. multivorans strains/isolates for primer set F2/R2, 23 B. cenocepacia strains/isolates for primer set F/R3, 3 B. vietnamiensis strains for primer set F/R5, 4 B. dolosa strains for primer set F6/R, 3 B. ambifaria strains for primer set F7/R7, and 3 B. pyrrocinia strains for primer set F1/R9. In each reaction, a product of the expected size was amplified for each of the strains, except for LMG 19240, which lacks the fur gene polymorphism used to design the F/3R primer set.
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FIG. 2. Gel electrophoresis of fur PCR products for the BCC species B. vietnamiensis, B. dolosa, B. ambifaria, B. anthina, and B. pyrrocinia. PCR products were electrophoresed on a 0.8% agarose gel prior to visualization with ethidium bromide. Molecular weight standards (MW) are shown in lane 1, with the corresponding base pair sizes shown at the left of the gel. Shown below each BCC species name is the fur primer set used and the size of the obtained PCR product (in base pairs) with the following template DNAs: lane 2, PC259/LMG 18835; lane 3, G4; lane 4, ATCC 29424; lane 5, STM1441/LMG 21443; lane 6, CEP021/LMG 21819; lane 7, E12/LMG 21820; lane 8, L06; lane 9, CEP0996/LMG 19467; lane 10, M53; lane 11, J2552/LMG 16670; lane 12, C1765/LMG 20983; lane 13, AU1293/LMG 21821; lane 14, ATCC 39277/LMG 21822; lane 15, BC011/LMG 21823; lane 16, C1469/LMG 21824.
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We have developed a simple, specific, and accurate procedure to identify BCC isolates to the species level based on the sequence of the gene encoding the ferric uptake regulator, or fur. As shown in Fig. 1, for 97% of the strains and isolates tested, members of a single species cluster together on a phylogenetic tree based on their fur gene sequences. To identify the species of an uncharacterized strain or isolate with relative certainty, one can PCR amplify and sequence its fur gene for comparison to those of other BCC species. One of the main benefits of this procedure is its simplicity. Another benefit of this protocol is that PCR with primers JD490 and JD491 will be unsuccessful if the isolate is not of the genus Burkholderia. As such, this step permits rapid discrimination between Burkholderia and non-Burkholderia samples. In our analysis of 27 previously uncharacterized clinical isolates, negative JD490/JD491 PCR amplification results were the first indication that four of the samples did not represent Burkholderia strains (Table 1). Growth on BCSA was an unreliable measure in this case, as one of the four strains (Pandoraea sp.) was able to grow on this medium.
In order to take advantage of the single-base polymorphisms present in the fur gene, a PCR protocol that would allow the rapid determination of BCC species status was designed. The base pair changes in fur tend to be consistent among strains of a single BCC species, indicating that this gene is an appropriate target for species-specific PCR. The percent sequence diversity of fur is 18%, which is intermediate to that of other genetic loci used for similar purposes, such as atpD (13.1%) and recA (26.7%) (3). Testing of an unknown strain in a PCR protocol with fur gene-based primer sets can identify the species to which a strain or isolate belongs using only one set of nine PCRs. The protocol was designed such that the sequencing data, which are highly accurate but take some time to collect, can be used in concert with the PCR, which is less specific but more rapid. It therefore fulfils the need for a diagnostic procedure that is both effective and efficient at identifying clinical and environmental BCC samples.
In practical use, the procedure was successful in classifying 27 clinical isolates from CF patients putatively identified as being BCC species. As predicted, the majority of the isolates were either B. cenocepacia or B. multivorans, with a lesser number identified as being either B. stabilis or BCC group K isolates. This system was also able to determine that there was a misidentification of 6 of the 27 isolates. These isolates were identified as being B. gladioli, Pseudomonas aeruginosa, Herbaspirillum sp., Pandoraea sp., or Listeria monocytogenes isolates. As shown in Table 1, three of these six isolates were able to grow on BCSA selective medium. These results further underscore the need for a new, more accurate practical method for examining clinical specimens. Similar ambiguous results using conventional testing protocols have been observed recently by another laboratory (31). In this case, the cable pilus gene was used as an additional molecular marker for the ET12 lineage to further differentiate BCC isolates grouped by recA cluster analysis.
The fur gene protocol has a number of advantages over those developed previously, as it does not rely on biochemical measures; it can identify strains to the species level (unlike 16S rRNA gene sequencing); with few exceptions, it identifies members of a single species as part of a single group (unlike recA); and it uses a single gene target (unlike multilocus restriction typing and MLST). The PCR can be completed rapidly with relatively inexpensive reagents and equipment and does not require special training to complete. This fur gene protocol quickly separates the more important clinical isolates B. multivorans and B. cenocepacia from those species that are less able to cause acute disease or to undergo epidemic spread in a susceptible population. This protocol was unable to classify the recA IIIC isolate tested as part of the B. cenocepacia cluster. This result suggests that B. cenocepacia IIIC may be significantly different at other loci besides fur and that further testing should be carried out in order to confirm its phylogenetic position among BCC strains. All IIIC strains characterized to date are environmental isolates, suggesting that this lineage may not be prevalent clinically (32). If necessary, sufficient fur gene polymorphisms exist to allow the design of a IIIC subgroup-specific primer (data not shown). This protocol also demonstrates a previously observed subdivision between B. multivorans strains that is almost as significant as the subdivision of B. cenocepacia species into recA phylotypes (IIIA, IIIB, and IIID). Again, further sampling will serve to reinforce this assertion.
One potential limitation of all PCR-based classification systems is that a mutation of a single base will prevent amplification by the correct primer set or allow amplification by an incorrect primer set. However, companion DNA sequencing and comparison of the complete fur gene sequence will position the strain correctly in the BCC fur phylogenetic tree. Only in instances where there is substantial similarity between fur gene sequences of different BCC species will the PCR test results conflict with fur gene sequence analysis. This appears to be the case for the B. cepacia and B. pyrrocinia clade. Although B. cepacia strains and isolates are specifically amplified using B. cepacia-specific primer set F1/R1, and B. pyrrocinia strains are specifically amplified by primer set F1/R9, because of the high homology between fur gene sequences of these two species, B. pyrrocinia strain C1469 clusters with B. cepacia strains on the fur phylogenetic tree. Further analysis shows that the B. cepacia strains that cluster with B. pyrrocinia strain C1469 are different from prototypical B. cepacia (type strain ATCC 25416) and type as group K variants by recA analysis (33). Therefore, the fur gene alignment is sensitive enough to recognize recA-based differences between subspecies, even though the PCR assay correctly assigns strains to either B. cepacia or B. pyrrocinia.
The observed homology between fur alleles of B. cepacia/ B. pyrrocinia and B. anthina/B. stabilis is reminiscent of the homology observed with recA alleles of B. cepacia, B. cenocepacia, and B. ambifaria (33). Although the sensitivity and specificity of B. cepacia recA PCR diagnostics could undergo improvement, it bears reminding that the B. cepacia complex is just that: a group of closely related bacterial species with relatively plastic genomes. It is not surprising, then, that some BCC species possess genes that are relatively unchanged from those of other BCC species, perhaps through the mechanism of recombination, which makes the discovery of a single gene-based diagnostic classification system all the more difficult. To overcome this limitation, multigene-based diagnostic systems such as MLST have been developed (3). Although these types of analyses are beyond the capability of most clinical laboratories, they can unequivocally identify all existing BCC species and differentiate strains and isolates from various sources. The BCC MLST scheme utilizes seven conserved loci including recA, which provides the potential for distinguishing approximately 1013 different BCC genotypes (3). However, our analysis of the fur gene from the 66 BCC strains and isolates that we examined indicates that fur has a nucleotide sequence diversity that is higher than those of at least some of the BCC MLST loci used previously (3). This suggests that the fur gene sequence is conserved well enough to be accurate in PCR-based BCC diagnostics but still variable enough to be used as an ideal gene locus candidate in a BCC MLST scheme.
In summary, we have developed an effective method of differentiating BCC strains and isolates based on their fur gene sequences. Although further large-scale sensitivity and specificity testing is required to validate the clinical utility of this method, it represents a potentially very useful advance in rapid BCC diagnostics. This protocol can be used in both clinical and research laboratories to quickly and accurately classify BCC isolates. This BCC fur gene-based method permits unambiguous identification at the species level and, as evidenced by the resulting phylogenetic tree, creates a population structure that coincides with current species assignments for the BCC. It is able to resolve unknown clinical isolates into specific BCC species or subspecies, thereby providing a comprehensive framework for discriminating strain classification and epidemiological evaluation.
We thank Pamela Sokol, David Speert, and Deb Henry of the Canadian Burkholderia cepacia Complex Research and Referral Repository for providing bacterial strains. We also gratefully acknowledge Robert Rennie and LeeAnn Turnbull of the University of Alberta Hospitals Cystic Fibrosis Clinic for providing clinical isolates.
Published ahead of print on 5 December 2007. ![]()
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