Emerg Infect Dis. 2021 Dec;27(12):3030-3035. doi: 10.3201/eid2712.211756. Epub 2021 Sep 27.
Nearly all cases of melioidosis in the continental United States are related to international travel to areas to which Burkholderia pseudomallei, the bacterium that causes melioidosis, is endemic. We report the diagnosis and clinical course of melioidosis in a patient from the United States who had no international travel history and the public health investigation to determine the source of exposure. We tested environmental samples collected from the patient's home for B. pseudomallei by PCR and culture. Whole-genome sequencing was conducted on PCR-positive environmental samples, and results were compared with sequences from the patient's clinical specimen. Three PCR-positive environmental samples, all collected from a freshwater home aquarium that had contained imported tropical fish, were a genetic match to the clinical isolate from the patient. This finding suggests a novel route of exposure and a potential for importation of B. pseudomallei, a select agent, into the United States from disease-endemic areas.
几乎所有在美国大陆发生的类鼻疽病例都与伯氏考克斯体（引起类鼻疽的细菌）流行地区的国际旅行有关。我们报告了一位来自美国的患者的类鼻疽诊断和临床经过，该患者没有国际旅行史，我们也开展了公共卫生调查以确定接触源。我们通过 PCR 和培养法对来自患者家庭的环境样本进行了伯氏考克斯体检测。对 PCR 阳性的环境样本进行了全基因组测序，并将结果与患者临床标本的序列进行了比较。从一个含有进口热带鱼的淡水家庭水族馆采集的 3 个 PCR 阳性环境样本与患者的临床分离株完全匹配。这一发现提示了一种新的暴露途径，以及从疾病流行地区将伯氏考克斯体（一种选择剂）输入美国的可能性。
