Glanders and Melioidosis
Etiologic agents: Burkholderia mallei and Burkholderia pseudomallei

Test codes:
B0025 - Ultrasensitive qualitative detection of Burkholderia mallei and Burkholderia pseudomallei by real time polymerase chain reaction

Burkholderia mallei and Burkholderia pseudomallei cause glanders and melioidosis. Melioidosis is endemic in Southeast Asia and northern Australia. Septicemic melioidosis is a major cause of high morbidity and mortality in Northeastern Thailand. Sporadic reports of melioidosis in humans and animals occur throughout the world.

Glanders, on the other hand, is a serious infectious equine disease. Human glanders is rare and is found primarily in veterinarians, horse and donkey caretakers, abattoir workers (Eitzen et al., 1999) and laboratory workers (Jenning, 1963). Glanders in humans is acquired from infected animals or by ingestion or inhalation of Burkholderia bacteria. Laboratory workers handling Burkholderia may become infected by inhaling aerosols containing these bacteria. The spectrum of disease ranges from a symptomatic infection to fulminate septicemia, which needs rapid detection and differentiation for specific treatment.

B. mallei and B. pseudomallei species are very similar in their nutritional and biochemical properties. Sequence analysis of the two bacteria indicates DNA similarity of more than 80% in these two species. For some sequences, such as 16S rRNA, homology of these two bacteria is up to 100%.

Not only are these species indistinguishable morphologically, it is also difficult to distinguish them serologically. They produce diseases in experimental animals that are practically identical, both clinically and pathologically.

In medical microbiological laboratories it is safer to examine highly pathogenic micro-organisms under kill-conditions, so live culturing of bacteria such as Burholderia should be avoided if possible. PCR detection of these bacteria is useful because it is rapid, sensitive, specific and safer than culture-based detection.

Utilities:

• Confirm the disease causing agent
• Shorten the time required to confirm a clinical diagnosis of B. mallei and B. pseudomallei infection.
• Ensure that horse populations are free of B. mallei and B. pseudomallei
• Early prevention of spread of these bacteria
• Minimize personnel exposure to these bacteria
• Safety monitoring of biological products that derive from horses

References:
Eitzen, E., Culpepper, R., Cieslak, T., Christopher, G., Rowe, J. and Pavin, J. (1999) Editors, Glanders: medical management of biological casualties handbook, US Army Medical Research Institute Diseases Fort Detrick, Maryland.
Jenning, W.E. (1963) Glanders. In: C. Charles, Editor, Diseases transmitted from animals to man, Thomas Publisher, Springfield, pp. 262–264.
Detection of Burkholderia mallei and Burkholderia pseudomallei by PCR.

Specimen requirements: 1 ml whole blood in EDTA (purple top) or ACD (yellow top) tube, or sputum, pus or bacterial subculture, shipped overnight at room temperature.

For specimen types other than those listed here, please call to confirm specimen acceptability and shipping instructions.

For all specimen types, if there will be a delay in shipping, or during very warm weather, refrigerate specimens until shipped and ship with a cold pack unless more stringent shipping requirements are specified. Frozen specimens should be shipped so as to remain frozen in transit. See shipping instructions for more information.

Turnaround time: 2 business days

Methodology: Qualitative real time PCR

Normal range: Nondetected