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David AB Dance,1 Vanaporn Wuthiekanun,2 Derek Sarovich,3 Erin P Price,3 Direk Limmathurotsakul,4 Bart J Currie,5 Trinh Thanh Trung61Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao PDR; 2Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand; 3University of the Sunshine Coast, Sippy Downs, QLD, Australia; 4Microbiology, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand; 5Infectious Diseases, Menzies School of Health Research, Darwin, NT, Australia; 6Vietnam National University, Hanoi, VietnamWe are writing, on behalf of the International Melioidosis Society Committee, as agroup of researchers and clinicians with longstanding experience of melioidosis andBurkholderia pseudomallei as we have some concerns about the above paper thatwas published in your journal recently.1Although we believe that melioidosis is undoubtedly being under-diagnosed inIndonesia,2,3 we are not convinced that the isolate in this case is B.pseudomalleibased on the information provided by the authors. Although it is difficult to becertain from the photographs in Figure 2, the colonies do not appear typical of thespecies to the microbiologists amongst us, who have seen several thousand isolates of B.pseudomallei over the past 30 years. Furthermore, the authors do not reportwhether the isolate was oxidase positive or negative. We believe that more comprehensivemethods of confirming the identity, particularly genomic analysis,should have been undertaken before publishing the case.4 Unfortunately, the postamplification16s analysis described in the paper might not have been able todistinguish between B.pseudomallei and other Burkholderia species (particularlyB.thailandensis and several as-yet-uncharacterized Burkholderia spp.), and we would have recommended additional testing, for example, multilocus sequencetyping and PCR for the TTS1 gene at least. View the original paper by Nuryastuti and colleagues. |