Investigation of molecular epidemiological characteristics of Burkholderia pseudomallei in Hainan Province, China
ZHU Xiong1, CHEN Hai1, LI Sha1, WANG Li-cheng1, WU Duo-rong3, WANG Xu-ming4, CHEN Ru-shou5, ZHENG Xiao2, LIU Zhi-guo1,2
1. Sanya People ’s Hospital,Sanya 572000,China; 2. State Key Laboratory for Infectious Disease Prevention and Control,National Institute for Communicable Disease Control and Prevention,China Center for Disease Control and Prevention,Beijing 102206,China; 3. Haikou People ’s Hospital,Haikou 570311,China; 4. Hainan Provincial Peoples ’s Hospital,Haikou 570311, China; 5. The third People’s Hospital of Haikou,Haikou 571100, China
Abstract:To investigate the molecular epidemiological characteristics of Burkholderia pseudomallei isolated from Hainan province, provide reference for surveillance and control of Melioidosis in this area. Samples from suspect patients were collected to isolate B. pseudomallei, both morphological characteristics observation and Gram staining were applied to identify isolated strains. HGDI was used for analysis on genetic diversity of strains, and molecular epidemiological relation among strains were investigated by MLVA_4 approach, then constructed MST based on MLVA_4 data to expound origin and evolution characteristics of isolated strains. Meanwhile, age feature, gender, occupation distribution, clinical manifestation and therapy outcome of patients were analyzed. A total of 164 strains were isolated and identified in this study, 66%(109/164)of them were distributed in southwest coastal regions, including Sanya, Dongfang and Ledong areas. MLVA_4 genotype method was shown in great high resolution to strains with HGDI of 0.9887. The order of diversity index from high to low of 4 typing loci were 0.9130 (L933), 0.8322(L2341),0.8237(L1788)and 0.8096 (L389). 164 B. pseudomallei were sorted into 97 MLVA_4 genotypes (GT1~97) in this study, 33 of them were shared in genotypes, which showed that there was a potential epidemical relations among strains from these genotypes. Others 64 were single genotypes and each one strain representing unique genotype, which indicated that more than 39% Melioidosis cases exhibited epidemiologically unrelated or sporadic characteristics. Among 33 shared genotypes, 14 shared genotypes were consisted with strains from identical regions, which confirmed that epidemic of Melioidosis in this area is characterized by multiple-point epidemics caused by multiple common sources of infectious, moreover, 28 shared genotypes were consisted with strains from two to five different regions, which suggest that there may be multiple regions cross-infection caused by multiple common sources of infectious in this area, 33 shared genotypes including 100 strains with cluster rate of 61.0% (100/164), all of them were isolated from two to five different regions, suggesting that Melioidosis was prevalent in majority areas of Hainan Province. MST based on MLVA_4 data showed that 164 B. pseudomallei were clustered into two geographic groups, strains isolated from Dingan county may be potential ancestor of isolates in Hainan Province. Average age of 164 patients was 48.5, the ratio of man to female of 5.3∶1. The most of patients were famer, accounted for 81.7% (134/164). 18 patients died, with a mortality rate of 11% (18/164). The epidemic of human Melioidosis in Hainan is becoming serious. The cases were mainly concentrated in the southwestern coastal areas, but strains may be originated from Ding’an County in north regions of Hainan Province. In conclusion,it is necessary to strengthen the monitoring, prevention and control of Melioidosis.
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