Vannachone Souphaphone, Luangraj Manophab, Dance David, Chantratita Narisara, Saiprom Natnaree, Seng Rathanin, Tandhavanant Sarunporn, Rattanavong Sayaphet, Simpson Andrew, Roberts Tamalee
Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Vientiane, Vientiane Capital, 0100, Lao People's Democratic Republic.
Nuffield Department of Medicine, Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK.
Wellcome Open Res. 2024 Nov 28;9:421. doi: 10.12688/wellcomeopenres.22706.3. eCollection 2024.
is an environmental bacteria closely related to that rarely causes infection in humans. Some environmental isolates have shown to express a capsular polysaccharide known as capsular variant (BTCV), but human infection has not previously been reported. Although has been identified in environmental samples in Laos before, there have not been any human cases reported.
A 44-year-old man presented to a district hospital in Laos with a short history of fever and pain in his left foot. Physical examination identified a deep soft-tissue abscess in his left foot and an elevated white blood count. A deep pus sample was taken and melioidosis was suspected from preliminary laboratory tests. The patient was initially started on cloxacillin, ceftriaxone and metronidazole, and was then changed to ceftazidime treatment following local melioidosis treatment guidelines.
A deep pus sample was sent to Mahosot Hospital microbiology laboratory where a mixed infection was identified including sp. Conventional identification tests and API 20NE were inconclusive, and the -specific latex agglutination was positive. The isolate then underwent a species specific PCR which identified the isolate as The isolate was sent for sequencing on the Illumina NovaSeq 6000 system and multi-locus sequence typing analysis identified the isolate had the same sequence type (ST696) as E555, a strain which expresses a -like capsular polysaccharide.
This is the first report of human infection with in Laos, and the first report of any human infection with the capsular variant. Due to the potential for laboratory tests to incorrectly identify this bacteria, staff in endemic areas for and should be aware and ensure that appropriate confirmatory methods are used to differentiate between the species.
[细菌名称]是一种与[相关细菌名称]密切相关的环境细菌，很少引起人类感染。一些环境分离株已显示表达一种称为[荚膜变体名称]荚膜多糖（BTCV），但此前尚未报道过人类感染情况。尽管之前在老挝的环境样本中已鉴定出[细菌名称]，但尚未有任何人类病例报告。
一名44岁男子因发热和左脚疼痛病史较短就诊于老挝一家地区医院。体格检查发现左脚深部软组织脓肿，白细胞计数升高。采集了深部脓液样本，初步实验室检查怀疑为类鼻疽。患者最初开始使用氯唑西林、头孢曲松和甲硝唑治疗，随后根据当地类鼻疽治疗指南改为头孢他啶治疗。
一份深部脓液样本被送至马哈索医院微生物实验室，在那里鉴定出混合感染，包括[细菌名称]菌属。传统鉴定试验和API 20NE试验结果不明确，而[细菌名称]特异性乳胶凝集试验呈阳性。然后该分离株进行了[细菌名称]种特异性PCR，鉴定该分离株为[细菌名称]。该分离株被送去在Illumina NovaSeq 6000系统上进行测序，多位点序列分型分析确定该分离株与表达类似[荚膜多糖名称]荚膜多糖的菌株E555具有相同的序列类型（ST696）。
这是老挝首例人类感染[细菌名称]的报告，也是首例任何人类感染[荚膜变体名称]荚膜变体的报告。由于实验室检测可能错误鉴定这种细菌，在[细菌名称]和[相关细菌名称]流行地区的工作人员应予以注意，并确保使用适当的确认方法来区分这两种细菌。
