Open Access Open Badges Research article

Using BOX-PCR to exclude a clonal outbreak of melioidosis

Bart J Currie12*, Daniel Gal2, Mark Mayo2, Linda Ward12, Daniel Godoy3, Brian G Spratt3 and John J LiPuma4

Author Affiliations

1 Northern Territory Clinical School, Flinders University, Royal Darwin Hospital, Darwin, Northern Territory, Australia

2 Tropical and Emerging Infectious Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia

3 Department of Infectious Diseases Epidemiology, Faculty of Medicine, Imperial College London, St. Mary's Hospital, London, UK

4 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA

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BMC Infectious Diseases 2007, 7:68  doi:10.1186/1471-2334-7-68

Published: 30 June 2007



Although melioidosis in endemic regions is usually caused by a diverse range of Burkholderia pseudomallei strains, clonal outbreaks from contaminated potable water have been described. Furthermore B. pseudomallei is classified as a CDC Group B bioterrorism agent. Ribotyping, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) have been used to identify genetically related B. pseudomallei isolates, but they are time consuming and technically challenging for many laboratories.


We have adapted repetitive sequence typing using a BOX A1R primer for typing B. pseudomallei and compared BOX-PCR fingerprinting results on a wide range of well-characterized B. pseudomallei isolates with MLST and PFGE performed on the same isolates.


BOX-PCR typing compared favourably with MLST and PFGE performed on the same isolates, both discriminating between the majority of multilocus sequence types and showing relatedness between epidemiologically linked isolates from various outbreak clusters.


Our results suggest that BOX-PCR can be used to exclude a clonal outbreak of melioidosis within 10 hours of receiving the bacterial strains.