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Microb Genom. 2017 Jun 13;3(8):e000117. doi: 10.1099/mgen.0.000117. eCollection 2017 Aug.

Whole-genome sequencing to investigate a non-clonal melioidosis cluster on a remote Australian island.

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1​Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia.
2​Centre for Animal Health Innovation, University of the Sunshine Coast, Sippy Downs, Australia.
3​Melbourne Medical School, University of Melbourne, Melbourne, Australia.
4​School of Medicine, Medical and Biological Sciences, University of St Andrews, St Andrews, UK.
5​Wellcome Trust Sanger Institute, Cambridge, UK.
6​Department of Medicine, University of Cambridge, Cambridge, UK.
7​Department of Infectious Diseases and Northern Territory Medical Program, Royal Darwin Hospital, Darwin, Australia.


Melioidosis is a tropical disease caused by the bacterium Burkholderia pseudomallei. Outbreaks are uncommon and can generally be attributed to a single point source and strain. We used whole-genome sequencing to analyse B. pseudomallei isolates collected from an historical 2-year long case cluster that occurred in a remote northern Australian indigenous island community, where infections were previously linked to a contaminated communal water supply. We analysed the genome-wide relatedness of the two most common multilocus sequence types (STs) involved in the outbreak, STs 125 and 126. This analysis showed that although these STs were closely related on a whole-genome level, they demonstrated evidence of multiple recombination events that were unlikely to have occurred over the timeframe of the outbreak. Based on epidemiological and genetic data, we also identified two additional patients not previously associated with this outbreak. Our results confirm the previous hypothesis that a single unchlorinated water source harbouring multiple B. pseudomallei strains was linked to the outbreak, and that increased melioidosis risk in this community was associated with Piper methysticum root (kava) consumption.


Burkholderia pseudomallei; melioidosis; outbreak; population genetics; recombination; source tracing

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