LETTERS

Bordetella hinzii the genus level as a sp. contact with birds (2–5), suggesting (score 1.7). alternative sources of contamination. in , To identify the Bordetella Thus, transmission routes and Southeast Asia species, DNA from the isolate was reservoirs of B. hinzii infection are extracted by using the QIAamp DNA ambiguous. B. hinzii infection has also To the Editor: of the Kit (QIAGEN, Hilden, Germany). been reported in rabbits and laboratory genus Bordetella are gram-negative, Partial PCR amplification and mice in Hungary and (8–10). rod-shaped organisms that cause sequencing of 16S rRNA gene was Rodents were suspected to be potential respiratory tract diseases in humans performed as described (7). Sequence reservoirs but, to the best of our and . In 1995, Bordetella analysis showed that the isolate was knowledge, this emerging pathogen hinzii was isolated from poultry and closely related to B. hinzii LMG has not been reported in wild rodents. 2 patients in the United States and 13501 (99.0% homology), which was We detected in B. hinzii in a France (1). This pathogen colonizes isolated from the blood of a patient tanezumi rat that was trapped the respiratory tract of poultry and who died of septicemia in 2000 (2). in upland agricultural area in . R. is closely related to B. avium, which The 16S rRNA sequence of our isolate tanezumi rats are the most common is a commensal species in poultry. (B. hinzii L135) has been deposited in southeastern Asia and can However, information on the etiologic in GenBank under accession no. be found in various habitats, including role, hosts, and transmission routes JX188059. A phylogenetic analysis forests, agricultural areas, and houses. of B. hinzii is incomplete because of the new sequence and sequences of In Southeast Asia, human populations infections in human who did not other bacteria in the genus Bordetella in several countries (, Laos, have any close contact with poultry is shown in the Figure. and ) live in close contact have been reported, mainly in B. hinzii is a causative agent of with rodents (including R. tanezumi) or immunocompromised patients (1–5). respiratory tract illnesses in birds and share the environment with them. These We obtained a single isolate of B. has been described as an emerging rodents are known to be a reservoir and hinzii from blood agar culture during and opportunistic pathogen in possible source of bacterial zoonoses screening for bacterial zoonotic immunocompromised patients; and such as leptospirosis, , scrub diseases in blood samples of rodents in patients with AIDS, , , and . in Southeast Asia during the Ceropath and fatal septicemia (1–5). However, Our findings suggest thatB. hinzii project (www.ceropath.org). the source of transmission is not clear. isolated from wild rodents may serve During 2008–2010, we collected Although B. hinzii is commensal in as reservoir for this bacterial species rodents along the Mekong River birds, several cases were reported in that could be transmitted to human areas of 3 countries in Southeast Asia persons who did not have any close or pets. B. hinzii should be added to (Cambodia, Laos, and Thailand). Rodents were trapped in urban areas and in rural areas, which consisted of forests, upland and dry agricultural areas (orchards, cassava fields), unirrigated and irrigated agricultural areas (rice fields), and domestic areas (isolated farms and villages). Each was identified at the species level by using morphologic or molecular methods. Two hundred six blood samples were cultured on Columbia agar containing 5% sheep blood and incubated at 37°C for 3–7 days. A single atypical isolate was observed after 2 days of culture. This isolate was identified by using matrix- assisted laser desorption ionization time-of-flight mass spectrometry as Figure. Maximum-parsimony phylogenetic tree of 16S rRNA gene of Bordetella hinzii described by Seng et al. (6). However, isolate from this study (L135) and validated Bordetella species. Numbers along branches this isolate was identified only at indicate bootstrap values. Scale bar indicates nucleotide substitutions per site.

502 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 19, No. 3, March 2013 LETTERS the list of emerging bacterial zoonotic 2. Kattar MM, Chavez JF, Limaye AP, and agents in wild rodents that could Rassoulian-Barrett SL, Yarfitz SL, Carlson LC, et al. Application of 16S rRNA gene Hairy Cell be pathogenic for humans. Further sequencing to identify Bordetella hinzii as studies are warranted to evaluate the causative agent of fatal septicemia. J Leukemia in 2 the prevalence of this bacterium Clin Microbiol. 2000;38:789–94. Travelers Returning in rodents in other countries and 3. Arvand M, Feldhues R, Mieth M, Kraus T, Vandamme P. Chronic cholangitis caused from Thailand to demonstrate that rodents may by Bordetella hinzii in a liver transplant be a source of transmission of this recipient. J Clin Microbiol. 2004;42:2335– To the Editor: Patients with 7. http://dx.doi.org/10.1128/JCM.42.5. bacterium to humans, especially underlying medical conditions travel immunocompromised patients. 2335-2337.2004 4. Fry NK, Duncan J, Edwards MT, Tilley more than ever (1), and such travelers RE, Chitnavis D, Harman R, et al. A UK may be exposed to uncommon Acknowledgments clinical isolate of Bordetella hinzii from a infections (2). We report 2 cases of We thank Annick Bernard and Linda patient with myelodysplastic syndrome. J Med Microbiol. 2007;56:1700–3. melioidosis and hairy cell leukemia in Hadjadj for technical assistance. http://dx.doi.org/10.1099/jmm.0. travelers returning from Thailand. 47482-0 Case-patient 1 was a 48-year-old This study was supported by the 5. Funke G, Hess T, von Graevenitz man hospitalized in Paris with fever, French National Research Agency; A, Vandamme P. Characteristics of asthenia, chills, and pancytopenia CERoPath (Community Ecology of Bordetella hinzii strains isolated from a after returning from a 1-week visit Rodents and their Pathogens in Southeast cystic fibrosis patient over a 3-year period. J Clin Microbiol. 1996;34:966–9. to Thailand where he had been in Asia Project ANR 07 BDIV 012); 6. Seng P, Drancourt M, Gouriet F, La flooded regions (Koh Samui and Infectiopôle Sud; Center for Excellence Scola B, Fournier PE, Rolain JM, et Koh Samet). Clinical examination on Agricultural Biotechnology; the al. Ongoing revolution in bacteriology: showed a temperature of 40°C and Science and Technology Postgraduate routine identification of bacteria by matrix-assisted laser desorption ionization mucocutaneous pallor. Laboratory Education and Research Development time-of-flight mass spectrometry. Clin tests showed a hemoglobin level of 7.9 Office; the Office of Higher Education Infect Dis. 2009;49:543–51. http://dx.doi. g/dL, a platelet count of 33 × 109/L, a Commission, Ministry of Education (AG- org/10.1086/600885 leukocyte count of 1.3 × 109 cells/L, BIO/PERDO-CHE); and the Center of 7. Weisburg WG, Barns SM, Pelletier DA, Lane DJ. 16S ribosomal DNA a polymorphonuclear cell count of Advanced Studies for Agriculture and amplification for phylogenetic study. J 0.77 × 109 cells/L, a monocyte count Food, Institute for Advanced Studies, Bacteriol. 1991;173:697–703. of 0, and a C-reactive protein level of Kasetsart University. 8. Register KB, Sacco RE, Nordholm GE. Comparison of ribotyping and 158 mg/L. Results of tests for HIV, restriction enzyme analysis for inter- and dengue, and malaria were negative. Tawisa Jiyipong, Serge Morand, intraspecies discrimination of Bordetella Presumptive antimicrobial drug Sathaporn Jittapalapong, avium and Bordetella hinzii. J Clin Microbiol. 2003;41:1512–9. http://dx.doi. treatment with piperacillin/tazobactam Didier Raoult, and org/10.1128/JCM.41.4.1512-1519.2003 (12 g/1.5 g/d) was initiated at Jean-Marc Rolain 9. Hayashimoto N, Morita H, Yasuda M, admission. A blood smear showed 10% Author affiliations: Aix-Marseille Université, Ishida T, Kameda S, Takakura A, et al. hairy cells, and a bone marrow biopsy Marseille, France (T. Jiyipong, D. Raoult, Prevalence of Bordetella hinzii in mice in experimental facilities in Japan. Res Vet confirmed a diagnosis of hairy cell J.-M. Rolain); Université Montpellier Sci. 2012. 93:624–6. PubMed leukemia and interstitial infiltration of 2, Montpellier (S. Morand); Kasetsart 10. Hayashimoto N, Yasuda M, Goto K, CD20-positive, monoclonal antibody University, Bangkok, Thailand (T. Jiyipong, Takakura A, Itoh T. Study of a Bordetella DBA.44–positive, and tartrate-resistant S. Jittapalapong); Kasetsart University, hinzii isolate from a laboratory mouse. Comp Med. 2008;58:440–6. acid phosphatase–positive cells. Nakhon Pathom, Thailand (T. Jiyipong); Because of persistent unexplained Center of Excellence on Agricultural fever, full-body computed tomography Biotechnology, Bangkok (T. Jiyipong) Address for correspondence: Jean-Marc Rolain, (CT) was performed and showed Unité des Rickettsies, Unité de Recherche DOI: http://dx.doi.org/10.3201/eid1903.120987 multiple liver, spleen, and lung sur les Maladies Infectieuses et Tropicales abscesses (Figure, panels A and B). Émergentes, Centre National de la Recherche References Culture of a CT scan–guided liver Scientifique–Institut de Recherche pour le abscess puncture specimen was 1. Vandamme P, Hommez J, Vancanneyt Développement, Unités Mixtes de Recherché positive for Bukholderia pseudomallei M, Monsieurs M, Hoste B, Cookson B, 6236, Faculté de Médecine et de Pharmacie, et al. Bordetella hinzii sp. nov., isolated after 12 days of antimicrobial drug Aix-Marseille Université, 27 Bd Jean Moulin from poultry and humans. Int J Syst treatment. Treatment was changed Bacteriol. 1995;45:37–45. http://dx.doi. 13385 Marseille, France; email: jean-marc. to ceftazidime (120 mg/kg/d) org/10.1099/00207713-45-1-37 [email protected] trimethoprim/sulfamethoxazole

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