A study on the occurrence of Burkholderia cepacia complex in ultrasound gels used in different veterinary clinical settings in India.
Burkholderia cepacia complex (Bcc)
MALDI-TOF
PFGE
Ultrasound gels
Veterinary diagnostics contamination
recA sequencing
Journal
Veterinary research communications
ISSN: 1573-7446
Titre abrégé: Vet Res Commun
Pays: Switzerland
ID NLM: 8100520
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
08
11
2022
accepted:
26
02
2023
medline:
8
9
2023
pubmed:
15
3
2023
entrez:
14
3
2023
Statut:
ppublish
Résumé
Burkholderia cepacia complex (Bcc) organisms are emerging multidrug-resistant pathogens. They are opportunistic and cause severe diseases in humans that may result in fatal outcomes. They are mainly reported as nosocomial pathogens, and transmission often occurs through contaminated pharmaceutical products. From 1993 to 2019, 14 Bcc outbreaks caused by contaminated ultrasound gels (USGs) have been reported in several countries, including India. We screened a total of 63 samples of USGs from various veterinary and human clinical care centers across 17 states of India and isolated 32 Bcc strains of Burkholderia cenocepacia (46.8%), B. cepacia (31.3%), B. pseudomultivorans (18.8%) and B. contaminans (3.1%) species. Some isolates were co-existent in a single ultrasound gel sample. The isolation from unopened gel bottles revealed the intrinsic contamination from manufacturing sites. The MALDI-TOF analysis to identify the Bcc at the species level was supported by the partial sequencing of the recA gene for accurate species identification. The phylogenetic analysis revealed that isolates shared clades with human clinical isolates, which is an important situation because of the possible infections of Bcc by USGs both in humans and animals. The pulsed field gel electrophoresis (PFGE) typing identified the genetic variation among the Bcc isolates present in the USGs. The findings indicated USGs as the potential source of Bcc species.
Identifiants
pubmed: 36914918
doi: 10.1007/s11259-023-10091-4
pii: 10.1007/s11259-023-10091-4
doi:
Substances chimiques
Gels
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1413-1425Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Abdelfattah R, Al-Jumaah S, Al-Qahtani A, Al-Thawadi S, Barron I, Al-Mofada S (2018) Outbreak of Burkholderia cepacia bacteraemia in a tertiary care Center due to contaminated ultrasound probe gel. J Nosocom Infect 98:289–294. https://doi.org/10.1016/j.jhin.2017.09.010
doi: 10.1016/j.jhin.2017.09.010
Ahn Y, Kim JM, Kweon O, Kim SJ, Jones RC, Woodling K, da Costa GG, LiPuma JJ, Hussong D, Marasa BS, Cerniglia CE (2016) Intrinsic resistance of Burkholderia cepacia complex to benzalkonium chloride. mBio 7:e01716–e01716. https://doi.org/10.1128/mBio.01716-16
doi: 10.1128/mBio.01716-16
pubmed: 27879334
pmcid: 5120141
Ali M (2016) Burkholderia cepacia in pharmaceutical industries. Int J Vaccines Vaccin 3(2):00064
doi: 10.15406/ijvv.2016.03.00064
Angrup A, Kanaujia R, Biswal M, Ray P (2022) Systematic review of ultrasound gel associated Burkholderia cepacia complex outbreaks: clinical presentation, causes and outbreak control. Am J Infect Control (In Journal Pre-Proof). https://doi.org/10.1016/j.ajic.2022.02.005
doi: 10.1016/j.ajic.2022.02.005
Banovic F, Koch S, Robson D, Jacob M, Olivry T (2015) Deep pyoderma caused by Burkholderia cepacia complex associated with ciclosporin administration in dogs: a case series. Vet Dermatol 6(4):287–e64. https://doi.org/10.1111/vde.12210
doi: 10.1111/vde.12210
Bartlett SJ, Rosenkrantz WS, Sanchez S (2011) Bacterial contamination of commercial ear cleaners following routine home use. Vet Dermatol 22(6):546–553. https://doi.org/10.1111/j.1365-3164.2011.00988.x
doi: 10.1111/j.1365-3164.2011.00988.x
pubmed: 21645141
Becker SL, Berger FK, Feldner SK, Karliova I, Haber M, Mellmann A, Schäfers HJ, Gärtner B (2018) Outbreak of Burkholderia cepacia complex infections associated with contaminated octenidine mouthwash solution, Germany, August to September 2018. Euro Surveill 23(42):1800540. https://doi.org/10.2807/1560-7917.ES.2018.23.42.1800540
doi: 10.2807/1560-7917.ES.2018.23.42.1800540
pubmed: 30352639
pmcid: 6199865
Bharara T, Chakravarti A, Sharma M, Agarwal P (2020) Investigation of Burkholderia cepacia complex bacteremia outbreak in a neonatal intensive care unit: a case series. J Med Case Rep 14(1):1–5. https://doi.org/10.1186/s13256-020-02415-8
doi: 10.1186/s13256-020-02415-8
Burgalassi S, Ceccanti S, Vecchiani S, Leonangeli G, Federigi I, Carducci A, Verani M (2021) Objectionable microorganisms in pharmaceutical production: validation of a decision tree. Eur J Pharm Sci 166:105984. https://doi.org/10.1016/j.ejps.2021.105984
doi: 10.1016/j.ejps.2021.105984
pubmed: 34455086
CDC, Division of Healthcare Quality Promotion (DHQP) (2021) Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID),. Retrieved from: https://www.cdc.gov/hai/outbreaks/b-cepacia-ultrasound-gel/index.html (on June 25, 2022)
Clode FE, Kaufmann ME, Malnick H, Pitt TL (2000) Distribution of genes encoding putative transmissibility factors among epidemic and nonepidemic strains of Burkholderia cepacia from cystic fibrosis patients in the United Kingdom. J Clin Microbiol 38:1763–1766. https://doi.org/10.1128/JCM.38.5.1763-1766.2000
doi: 10.1128/JCM.38.5.1763-1766.2000
pubmed: 10790095
pmcid: 86581
Cohen J (1960) A coefficient of agreement for nominal scales. Educational and psychological measurement 20(1):37–46. https://doi.org/10.1177/001316446002000104
doi: 10.1177/001316446002000104
Corda A, Corda F, Secchi V, Pentcheva P, Tamponi C, Tilocca L, Varcasia A, Scala A (2022) Ultrasonography of Parasitic Diseases in domestic animals: a systematic review. Animals 12(10):1252. https://doi.org/10.3390/ani12101252
doi: 10.3390/ani12101252
pubmed: 35625097
pmcid: 9137995
Cundell T (2019) Exclusion of objectionable microorganisms from non-sterile pharmaceutical drug products. Pharmaceutical Microbiological Quality Assurance and Control: Practical Guide for Non‐Sterile Manufacturing. 5:371–400. https://doi.org/10.1002/9781119356196.ch11
Cunningham-Oakes E, Weiser R, Pointon T, Mahenthiralingam E (2019) Understanding the challenges of non-food industrial product contamination. FEMS Microbiol Lett 366(23):fnaa010. https://doi.org/10.1093/femsle/fnaa010
doi: 10.1093/femsle/fnaa010
pubmed: 31977006
De Dios J, Martínez CL, Tato M, Morosini MI, Cobo M, Del Campo R, Canton R (2016) 94 comparison between MALDI-TOF and recA gene sequencing for the identification of Burkholderia cepacia complex species isolated in a cystic fibrosis unit. J Cyst Fibros 1(15):S75. https://doi.org/10.1016/S1569-1993(16)30333-2
doi: 10.1016/S1569-1993(16)30333-2
De Volder AL, Teves S, Isasmendi A, Pinheiro JL, Ibarra L, Breglia N, Herrera T, Vazquez M, Hernandez C, Degrossi J (2021) Distribution of Burkholderia cepacia complex species isolated from industrial processes and contaminated products in Argentina. Int Microbiol 24(2):157–167. https://doi.org/10.1007/s10123-020-00151-z
doi: 10.1007/s10123-020-00151-z
pubmed: 33184776
Depoorter E, Bull MJ, Peeters C, Coenye T, Vandamme P, Mahenthiralingam E (2016) Burkholderia: an update on taxonomy and biotechnological potential as antibiotic producers. Appl Microbiol Biotechnol 100:5215–5229. https://doi.org/10.1007/s00253-016-7520-x
doi: 10.1007/s00253-016-7520-x
pubmed: 27115756
Depoorter E, De Canck E, Peeters C, Wieme AD, Zlosnik JEA, LiPuma JJ, Coenye T, Vandamme P (2020) Burkholderia cepacia complex taxon K: where to split? Front Microbiol 11:1594. https://doi.org/10.3389/fmicb.2020.01594
doi: 10.3389/fmicb.2020.01594
pubmed: 32760373
pmcid: 7372133
Drevinek P, Vosahlikova S, Cinek O, Vavrova V, Bartosova J, Pohunek P, Mahenthiralingam E (2005) Widespread clone of Burkholderia cenocepacia in cystic fibrosis patients in the Czech Republic. J Med Microbiol 54(7):655–659
doi: 10.1099/jmm.0.46025-0
pubmed: 15947430
Du M, Song L, Wang Y, Suo J, Bai Y, Xing Y, Xie L, Liu B, Li L, Luo Y, Liu Y (2021) Investigation and control of an outbreak of urinary tract infections caused by Burkholderia cepacia-contaminated anaesthetic gel. Antimicrob Resist Infect Control 10(1):1–7. https://doi.org/10.1186/s13756-020-00855-x
doi: 10.1186/s13756-020-00855-x
pubmed: 33407871
pmcid: 7789005
Esmaeel Q, Issa A, Sanchez L, Clement C, Jacquard C, Barka EA (2018) Draft genome sequence of Burkholderia reimsis BE15, a plant associated bacterium isolated from agricultural rhizosphere. Microb Resourc Announc 7(13):e00978–e1018. https://doi.org/10.1128/MRA
doi: 10.1128/MRA
Fehlberg LC, Andrade LH, Assis DM, Pereira RH, Gales AC, Marques EA (2013) Performance of MALDI-ToF MS for species identification of Burkholderia cepacia complex clinical isolates. Diagn Microbiol Infect Dis 77(2):126–128. https://doi.org/10.1016/j.diagmicrobio.2013.06.011
doi: 10.1016/j.diagmicrobio.2013.06.011
pubmed: 23891221
Furlan JP, Pitondo-Silva A, Braz VS, Gallo IF, Stehling EG (2019) Evaluation of different molecular and phenotypic methods for identification of environmental Burkholderia cepacia complex. World J Microbiol Biotechnol 35(3):1–6. https://doi.org/10.1007/s11274-019-2614-0
doi: 10.1007/s11274-019-2614-0
Gautam V, Sharma M, Singhal L, Kumar S, Kaur P, Tiwari R, Ray P (2017) MALDI-TOF mass spectrometry: an emerging tool for unequivocal identifcation of non-fermenting gram-negative bacilli. Indian J Med Res 145(5):665–672. https://doi.org/10.4103/ijmr.IJMR_1105_15
doi: 10.4103/ijmr.IJMR_1105_15
pubmed: 28948958
pmcid: 5644302
Ghazal SS, Al-Mudaimeegh K, Al Fakihi EM, Asery AT (2006) Outbreak of Burkholderia cepacia bacteremia in immunocompetent children caused by contaminated nebulized sulbutamol in Saudi Arabia. Am J Infect Control 34:394–398. https://doi.org/10.1016/j.ajic.2006.03.003
doi: 10.1016/j.ajic.2006.03.003
pubmed: 16877110
Govan JR, Brown AR, Jones AM (2007) Evolving epidemiology of Pseudomonas aeruginosa and the Burkholderia cepacia complex in cystic fibrosis lung infection. Future Microbiol 2(2):153–156. https://doi.org/10.2217/17460913.2.2.153
doi: 10.2217/17460913.2.2.153
pubmed: 17661652
Graindorge A, Menard A, Neto M, Bouvet C, Miollan R, Gaillard S, De Montclos H, Laurent F, Cournoyer B (2010) Epidemiology and molecular characterization of a clone of Burkholderia cenocepacia responsible for nosocomial pulmonary tract infections in a french intensive care unit. Diagn Microbiol Infect Dis 66(1):29–40. https://doi.org/10.1016/j.diagmicrobio.2009.06.008
doi: 10.1016/j.diagmicrobio.2009.06.008
pubmed: 19716254
Hutchinson J, Runge W, Mulvey M, Norris G, Yetman M, Valkova N, Villemur R, Lepine F (2004) Burkholderia cepacia infections associated with intrinsically contaminated ultrasound gel: the role of microbial degradation of parabens. Infect Control Hosp Epidemiol 25(4):291–296. https://doi.org/10.1086/502394
doi: 10.1086/502394
pubmed: 15108725
Jacobson M, Wray R, Kovach D, Henry D, Speert D, Matlow A (2006) Sustained endemicity of Burkholderia cepacia complex in a pediatric institution, associated with contaminated ultrasound gel. Infect Control Hosp Epidemiol 27(4):362–366. https://doi.org/10.1086/503343
doi: 10.1086/503343
pubmed: 16622813
Jimenez L (2019) Analysis of FDA enforcement reports (2012–2019) to determine the microbial diversity in contaminated non-sterile and sterile Drugs. Am Pharm Review 1–21. Available from: https://www.americanpharmaceuticalreview.com/Featured-Articles/518912-Analysis-of-FDA-Enforcement-Reports-2012-2019-to-Determine-the-Microbial-Diversity-in-Contaminated-Non-Sterile-and-Sterile-Drugs/ (accessed on 25 June 2022)
Jimenez L, Kulko E, Barron E, Flannery T (2015) Burkholderia cepacia: a problem that does not go away! EC Microbiol 2:205–210
Jin Y, Zhou J, Zhou J, Hu M, Zhang Q, Kong N, Ren H, Liang L, Yue J (2020) Genome-based classification of Burkholderia cepacia complex provides new insight into its taxonomic status. Biol Direct 15(1):1–4
doi: 10.1186/s13062-020-0258-5
Keizur JJ, Lavin B, Leidich RB (1993) Iatrogenic urinary tract infection with Pseudomonas cepacia after transrectal ultrasound guided needle biopsy of the prostate. J Urol 149(3):523–526. https://doi.org/10.1016/S0022-5347(17)36135-9
doi: 10.1016/S0022-5347(17)36135-9
pubmed: 7679757
Ko S, An HS, Bang JH, Park SW (2015) An outbreak of Burkholderia cepacia complex pseudobacteremia associated with intrinsically contaminated commercial 0.5% chlorhexidine solution. Am J Infect Control 43(3):266–268. https://doi.org/10.1016/j.ajic.2014.11.010
doi: 10.1016/j.ajic.2014.11.010
pubmed: 25557770
Łagowski D, Nowicka B, Nowakiewicz A, Polkowska I, Gnat S (2021) Unusual penile prolapse with an infectious background caused by the Burkholderia cepacia Complex in a stallion. J Equine Vet Sci 97:103353. https://doi.org/10.1016/j.jevs.2020.103353
doi: 10.1016/j.jevs.2020.103353
pubmed: 33478767
Lalitha P, Das M, Purva PS, Karpagam R, Geetha M, Priya JL, Babu KN (2014) Postoperative endophthalmitis due to Burkholderia cepacia complex from contaminated anaesthetic eye drops. Br J Ophthalmol 98(11):1498–1502. https://doi.org/10.1136/bjophthalmol-2013-304129
doi: 10.1136/bjophthalmol-2013-304129
pubmed: 24947905
Lawrence MW, Blanks J, Ayala R, Talk D, Macian D, Glasser J, Schofer JM (2014) Hospital-wide survey of bacterial contamination of Point‐of‐Care Ultrasound Probes and Coupling Gel. J Ultrasound Med 33(3):457–462
doi: 10.7863/ultra.33.3.457
pubmed: 24567457
Leong LE, Lagana D, Carter GP, Wang Q, Smith K, Stinear TP, Shaw D, Sintchenko V, Wesselingh SL, Bastian I, Rogers GB (2018) Burkholderia lata infections from intrinsically contaminated chlorhexidine mouthwash, Australia, 2016. Emerg Infect Dis 24:2109–2111. https://doi.org/10.3201/eid2411.171929
doi: 10.3201/eid2411.171929
pubmed: 30334703
pmcid: 6199994
Letunic I, Bork P (2007) Interactive tree of life (iTOL): an online tool for phylogenetic tree display and annotation. Bioinformatics 23(1):127–128. https://doi.org/10.1093/bioinformatics/btl529
doi: 10.1093/bioinformatics/btl529
pubmed: 17050570
Luk KS, Tsang YM, Ho AY, To WK, Wong BK, Wong MM, Wong YC (2022) Invasive Burkholderia cepacia Complex Infections among persons who inject drugs, Hong Kong, China, 2016–2019. Emerg Infect Dis 28(2):323. https://doi.org/10.3201/eid2802.210945
doi: 10.3201/eid2802.210945
pubmed: 34906288
pmcid: 8798689
Mahenthiralingam E, Baldwin A, Dowson CG (2008) Burkholderia cepacia complex bacteria: opportunistic pathogens with important natural biology. J Appl Microbiol 104:1539–1551. https://doi.org/10.1111/j.1365-2672.2007.03706.x
doi: 10.1111/j.1365-2672.2007.03706.x
pubmed: 18217926
Mahenthiralingam E, Simpson DA, Speert DP (1997) Identification and characterization of a novel DNA marker associated with epidemic Burkholderia cepacia strains recovered from patients with cystic fibrosis. J Clin Microbiol 35(4):808–816. https://doi.org/10.1128/jcm.35.4.808-816.1997
doi: 10.1128/jcm.35.4.808-816.1997
pubmed: 9157133
pmcid: 229681
Marigliano A, D’Errico MM, Pellegrini I, Savini S, Prospero E, Barbadoro P (2010) Ultrasound echocardiographic gel contamination by Burkholderia cepacia in an italian hospital. J Hosp Infect 76(4):360–361. https://doi.org/10.1016/j.jhin.2010.07.017
doi: 10.1016/j.jhin.2010.07.017
pubmed: 20970887
Marquez L, Jones KN, Whaley EM, Koy TH, Revell PA, Taylor RS, Bernhardt MB, Wagner JL, Dunn JJ, LiPuma JJ, Campbell JR (2017) An outbreak of Burkholderia cepacia complex infections associated with contaminated liquid docusate. Infect Control Hosp Epidemiol 38(5):567–573. https://doi.org/10.1017/ice.2017.11
doi: 10.1017/ice.2017.11
pubmed: 28166854
Morales-Ruíz LM, Rodríguez-Cisneros M, Kerber-Díaz JC, Rojas-Rojas FU, Ibarra JA, Estrada-de Los Santos P (2022) Burkholderia orbicola sp. nov., a novel species within the Burkholderia cepacia complex. Arch Microbiol 204(3):1–9. https://doi.org/10.1007/s00203-022-02778-0
doi: 10.1007/s00203-022-02778-0
Moreira BM, Leobons MB, Pellegrino FL, Santos M, Teixeira LM, de Andrade Marques E, Sampaio JL, Pessoa-Silva CL (2005) Ralstonia pickettii and Burkholderia cepacia complex bloodstream infections related to infusion of contaminated water for injection. J Hosp Infect 60(1):51–55. https://doi.org/10.1016/j.jhin.2004.09.036
doi: 10.1016/j.jhin.2004.09.036
pubmed: 15823657
Murphy CP, Weese JS, Reid-Smith RJ, McEwen SA (2010) The prevalence of bacterial contamination of surgical cold sterile solutions from community companion animal veterinary practices in southern Ontario. Can Vet J 51(6):634–636
pubmed: 20808576
pmcid: 2871362
Myemba DT, Bwire GM, Sangeda RZ (2022) Microbiological Quality of Selected Local and Imported Non-Sterile Pharmaceutical Products in Dar es Salaam, Tanzania. Infect Drug Resist 15:2021. doi: https://doi.org/10.2147/IDR.S355331
Nannini EC, Ponessa A, Muratori R, Marchiaro P, Ballerini V, Flynn L, Limansky AS (2015) Polyclonal outbreak of bacteremia caused by Burkholderia cepacia complex and the presumptive role of ultrasound gel. Braz J Infect Dis 19:543–545. https://doi.org/10.1016/j.bjid.2015.06.009
doi: 10.1016/j.bjid.2015.06.009
pubmed: 26322722
pmcid: 9427536
Okere P (2019) Low-cost antimicrobial fortification of ultrasound coupling gel: an ergonomic innovation to combat sonology-acquired nosocomial infections. Malawi Med J 31(1):45–49. https://doi.org/10.4314/mmj.v31i1.8
doi: 10.4314/mmj.v31i1.8
pubmed: 31143396
pmcid: 6526342
Ong KS, Aw YK, Lee LH, Yule CM, Cheow YL, Lee SM (2016) Burkholderia paludis sp. nov., an antibiotic-siderophore producing novel Burkholderia cepacia complex species, isolated from malaysian tropical peat swamp soil. Front Microbiol 7:1–14. https://doi.org/10.3389/fmicb.2016.02046
doi: 10.3389/fmicb.2016.02046
Papaleo MC, Perrin E, Maida I, Fondi M, Fani R, Vandamme P (2010) Identifcation of species of the Burkholderia cepacia complex by sequence analysis of the hisA gene. J Med Microbiol 59(10):1163–1170. https://doi.org/10.1099/jmm.0.019844-0
doi: 10.1099/jmm.0.019844-0
pubmed: 20651037
Payne GW, Vandamme P, Morgan SH, Lipuma JJ, Coenye T, Weightman AJ, Jones TH, Mahenthiralingam E (2005) Development of a recA gene-based identification approach for the entire Burkholderia genus. Appl Environ Microbiol 71:3917–3927. https://doi.org/10.1128/AEM.71.7.3917-3927.2005
doi: 10.1128/AEM.71.7.3917-3927.2005
pubmed: 16000805
pmcid: 1169057
Provenzano DA, Liebert MA, Steen B, Lovetro D, Somers DL (2013) Investigation of current infection-control practices for ultrasound coupling gel: a survey, microbiological analysis, and examination of practice patterns. Reg Anesth Pain Med 38(5):415–424. https://doi.org/10.1097/AAP.0b013e3182a0e12f
doi: 10.1097/AAP.0b013e3182a0e12f
pubmed: 23974866
Ragupathi NKD, Veeraraghavan B (2019) Accurate identification and epidemiological characterization of Burkholderia cepacia complex: an update. Ann Clin Microbiol Antimicrob 18(1):1–10. https://doi.org/10.1186/s12941-019-0306-0
doi: 10.1186/s12941-019-0306-0
Shaban RZ, Maloney S, Gerrard J, Collignon P, Macbeth D, Cruickshank M, Hume A, Jennison AV, Graham RM, Bergh H, Wilson HL (2017) Outbreak of health care-associated Burkholderia cenocepacia bacteremia and infection attributed to contaminated sterile gel used for central line insertion under ultrasound guidance and other procedures. Am J Infect Control 45(9):954–958. https://doi.org/10.1016/j.ajic.2017.06.025
doi: 10.1016/j.ajic.2017.06.025
pubmed: 28757084
Silmon T, Chapman D (2019) What‟s in your bottle? Investigating a pseudo-outbreak of Burkholderia cepacia. Am J Infect Control 47:S8–S9. https://doi.org/10.1016/j.ajic.2019.04.152
doi: 10.1016/j.ajic.2019.04.152
Solaimalai D, Ragupathi NK, Ranjini K, Paul H, Verghese VP, Michael JS, Veeraraghavan B, James EJ (2019) Ultrasound gel as a source of hospital outbreaks: indian experience and literature review. Indian J Med Microbiol 37:263. https://doi.org/10.4103/ijmm.IJMM_19_249
doi: 10.4103/ijmm.IJMM_19_249
pubmed: 31745029
Song JE, Kwak YG, Um TH, Cho CR, Kim S, Park IS, Hwang JH, Kim N, Oh GB (2018) Outbreak of Burkholderia cepacia pseudobacteraemia caused by intrinsically contaminated commercial 0.5% chlorhexidine solution in neonatal intensive care units. J Hosp Infect 98(3):295–299. https://doi.org/10.1016/j.jhin.2017.09.012
doi: 10.1016/j.jhin.2017.09.012
pubmed: 28935523
Tavares M, Kozak M, Balola A, Sá-Correia I (2020) Burkholderia cepacia complex bacteria: a feared contamination risk in water-based pharmaceutical products. Clin Microbiol Rev 33(3):e00139–e00119. https://doi.org/10.1128/CMR.00139-19
doi: 10.1128/CMR.00139-19
pubmed: 32295766
pmcid: 7194853
Trifinopoulos J, Nguyen LT, von Haeseler A, Minh BQ (2016) W-IQ-TREE: a fast online phylogenetic tool for maximum likelihood analysis. Nucl Acids Res 44(W1):W232–W235. https://doi.org/10.1093/nar/gkw256
doi: 10.1093/nar/gkw256
pubmed: 27084950
pmcid: 4987875
Tseng SP, Tsai WC, Liang CY, Lin YS, Huang JW, Chang CY, Tyan YC, Lu PL (2014) The contribution of antibiotic resistance mechanisms in clinical Burkholderia cepacia complex isolates: an emphasis on efflux pump activity. PLoS One 9(8):e104986. https://doi.org/10.1371/journal.pone.0104986
doi: 10.1371/journal.pone.0104986
pubmed: 25153194
pmcid: 4143217
USP. <60 > Microbiological Examination of Nonsterile Products-Tests for Burkholderia Cepacia Complex. 2018. Available online: http://www.usppf.com/pf/pub/data/v445/CHA_IPR_445_c60.xml (accessed on 17 June 2022).
Vandamme P, Eberl L (2015) Burkholderia. Bergey’s Manual of Systematics of Archaea and Bacteria. 17:1–45. https://doi.org/10.1002/9781118960608.gbm00935.pub2
doi: 10.1002/9781118960608.gbm00935.pub2
Vandamme P, Eberl L (2018) Burkholderia. In: Trujillo ME, Dedysh S, DeVos P, Hedlund B, Kämpfer P, Rainey FA, Whitman WB (eds) Bergey’s Manual of Systematics of Archaea and Bacteria. John Wiley & Sons, Inc., pp 1–45 https://doi.org/10.1002/9781118960608.gbm00935.pub2
Wong JK, Chambers LC, Elsmo EJ, Jenkins TL, Howerth EW, Sánchez S, Sakamoto K (2018) Cellulitis caused by the Burkholderia cepacia complex associated with contaminated chlorhexidine 2% scrub in five domestic cats. J Vet Diagn Invest 30(5):763–769. https://doi.org/10.1177/1040638718782333
doi: 10.1177/1040638718782333
pubmed: 29877147
pmcid: 6505800
Wong MY, Tseng YH, Huang TY, Lin BS, Tung CW, Chu C, Huang YK (2020) Comparison of microbiological characteristics and genetic diversity between Burkholderia cepacia complex isolates from vascular access and other clinical infections. Microorganisms 9(1):51. https://doi.org/10.3390/microorganisms9010051
doi: 10.3390/microorganisms9010051
pubmed: 33375496
pmcid: 7824166
Woo PC, Leung PK, Wong SS, Ho PL, Yuen KY (2001) groEL encodes a highly antigenic protein in Burkholderia pseudomallei. Clin diagn lab Immunol 8(4):832–836. https://doi.org/10.1128/CDLI.8.4.832-836.2001
doi: 10.1128/CDLI.8.4.832-836.2001
pubmed: 11427437
pmcid: 96153