Workflow for Identification of Burkholderia pseudomallei Clinical Isolates in Myanmar.

Burkholderia pseudomallei, the highly infectious causative organism of melioidosis, was first discovered in Myanmar in 1911. The identification of B. pseudomallei was elucidated in Myanmar because of its genetic relatedness among Burkholderia species. In this study, we identified 2 isolates of Burkholderia cenocepacia, 2 Acinetobacter baumannii complex, and 18 clinical isolates of B. pseudomallei by Vitek 2. These isolates were first screened with a latex agglutination test, which showed positive results in 20 of 22 isolates. All the isolates were cultured on Ashdown agar and further tested by molecular methods. Specific PCR for type III secretion system (TTSs) gene clusters indicated 19 B. pseudomallei isolates out of the 22 isolates. 16S rRNA and recA gene sequencing were used as the gold standard methods and displayed the same results. RapID NF Plus detected 16 B. pseudomallei out of the 22 isolates. Vitek 2 and RapID NF Plus should play key roles in the diagnosis of melioidosis and the surveillance of B. Pseudomallei in Myanmar, but accurate identification should be confirmed by TTS1 PCR. This study evaluated the presumptive workflow for the investigation of B. pseudomallei infections with different methods and options in line with the available equipment.