Hu Jinrui, Xue Yucheng, Zhang Jinhui, Liu Jinyue, Zheng Xiaohua, Bai Jing, Cui Zhigang, Zhong Weiqi, Zhou Haijian
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150030, China.
Infect Genet Evol. 2025 Jul;131:105760. doi: 10.1016/j.meegid.2025.105760. Epub 2025 May 8.
Burkholderia gladioli, particularly its pathovar cocovenenans, poses a significant public health threat through the production of bongkrekic acid (BA), a lethal tricarboxylic fatty acid encoded by the bon gene cluster. Despite the rarity of BA-associated outbreaks, historical cases in Asia and Mozambique demonstrate mortality rates exceeding 30 %.
In October 2020, a foodborne outbreak occurred in Heilongjiang, China, linked to homemade fermented corn. Nine symptomatic patients developed acute gastroenteritis within 3 h and died within 14 days. Routine pathogen screening, aflatoxin quantification, and toxicological analyses were performed. B. gladioli was isolated from contaminated corn flour, identified via VITEK 2 Compact and genomic sequencing. Antimicrobial susceptibility testing was conducted using the BD Phoenix system. Genomic analysis characterized the bon cluster, resistance genes, and phylogeny.
BA concentrations reached 330.16 mg/kg in corn flour and 3.16 mg/L in gastric fluid. One strain YD01, was isolated from the corn flour sample. The isolate exhibited elevated MIC values for β-lactams (e.g., ceftazidime, aztreonam), nitrofurantoin, and colistin, but susceptibility to tetracycline and meropenem using 2024 CLSI breakpoints. Whole-genome sequencing confirmed a 67.5-kbp bon cluster homologous to BA-producing strains and identified antibiotic resistance genes (smeR, smeE, mexB, LRA-1, and B. pseudomallei omp38) associated with efflux pumps and β-lactamases. Phylogenetically, YD01 clustered with clinical B. gladioli strains from the United States (ANI 99.21 %).
This outbreak highlights the dual threat of hypervirulent BA production and intrinsic multidrug resistance in B. gladioli. The absence of CLSI breakpoints for this pathogen complicates clinical susceptibility interpretations, yet YD01's resistance profile suggests limited therapeutic options in empirical treatment. Enhanced surveillance, species-specific antimicrobial guidelines, and rapid diagnostics targeting both bon and resistance genes are urgently needed to mitigate future risks.
唐菖蒲伯克霍尔德菌，尤其是其致病型椰毒伯克霍尔德菌，通过产生邦克酸（BA）对公众健康构成重大威胁，邦克酸是一种由bon基因簇编码的致命三羧酸脂肪酸。尽管与BA相关的疫情罕见，但亚洲和莫桑比克的历史病例显示死亡率超过30%。
2020年10月，中国黑龙江发生一起与自制发酵玉米有关的食源性疫情。9名有症状患者在3小时内出现急性肠胃炎，并在14天内死亡。进行了常规病原体筛查、黄曲霉毒素定量和毒理学分析。从受污染的玉米粉中分离出唐菖蒲伯克霍尔德菌，通过VITEK 2 Compact和基因组测序进行鉴定。使用BD Phoenix系统进行药敏试验。基因组分析对bon基因簇、耐药基因和系统发育进行了表征。
玉米粉中BA浓度达到330.16mg/kg，胃液中达到3.16mg/L。从玉米粉样本中分离出一株菌株YD01。该分离株对β-内酰胺类药物（如头孢他啶、氨曲南）、呋喃妥因和黏菌素的MIC值升高，但根据2024年CLSI标准对四环素和美罗培南敏感。全基因组测序证实存在一个与产BA菌株同源的67.5kbp的bon基因簇，并鉴定出与外排泵和β-内酰胺酶相关的抗生素耐药基因（smeR、smeE、mexB、LRA-1和类鼻疽伯克霍尔德菌omp38）。在系统发育上，YD01与来自美国的临床唐菖蒲伯克霍尔德菌菌株聚类（ANI 99.21%）。
此次疫情凸显了唐菖蒲伯克霍尔德菌产生高毒力BA和固有多重耐药性的双重威胁。该病原体缺乏CLSI标准使临床药敏解读复杂化，但YD01的耐药谱表明经验性治疗的选择有限。迫切需要加强监测、制定针对该物种的抗菌指南以及针对bon基因和耐药基因的快速诊断方法，以降低未来风险。
