Journal of Microbiology

The Microbiological Society of Korea (한국미생물학회)
권호 표지

Burkholderia cepacia Complex Infection in a Cohort of Italian Patients with Cystic Fibrosis

  • Lambiase, Antonietta (Department of Biology and Pathology Cellular and Molecular "Luigi Califano") ;
  • Raia, Valeria (Department of Pediatrics, Regional Cystic Fibrosis Center, University of Naples "Federico II") ;
  • Stefani, Stefania (Department of Microbiological and Gynecological Sciences, University of Catania) ;
  • Sepe, Angela (Department of Pediatrics, Regional Cystic Fibrosis Center, University of Naples "Federico II") ;
  • Ferri, Pasqualina (Department of Pediatrics, Regional Cystic Fibrosis Center, University of Naples "Federico II") ;
  • Buonpensiero, Paolo (Department of Pediatrics, Regional Cystic Fibrosis Center, University of Naples "Federico II") ;
  • Rossano, Fabio (Department of Biology and Pathology Cellular and Molecular "Luigi Califano") ;
  • Pezzo, Mariassunta Del (Department of Biology and Pathology Cellular and Molecular "Luigi Califano")
  • Published : 2007.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The aims of this study were to detect Burkholderia cepacia complex (Bcc) strains in a cohort of Cystic Fibrosis patients (n=276) and to characterize Bcc isolates by molecular techniques. The results showed that 11.23% of patients were infected by Bcc. Burkholderia cenocepacia lineage III-A was the most prevalent species (64.3%) and, of these, 10% was cblA positive and 50% esmR positive. Less than half of the strains were sensitive to ceftazidime, meropenem, piperacillin-tazobactam, and trimethoprim-sulfamethoxazole. About half of the strains (41%) had homogeneous profiles, suggesting cross-transmission. The infection by B. cenocepacia was associated to a high rate of mortality (p=0.01).

Keywords

References

  1. Agodi, A., E. Mahenthiralingam, M. Barchitta, V. Giannino, A. Sciacca, and S. Stefani. 2001. Burkholderia cepacia complex in fection in italian patients with cystic fibrosis: prevalence, epidemiology and genomovar status. J. Clin. Microbiol. 39, 2891-2896 https://doi.org/10.1128/JCM.39.8.2891-2896.2001
  2. Allice, T., S. Scutera, M.G. Chirillo, and D. Savoia. 2006. Burkholderia respiratory tract infections in Italian patients with cystic fibrosis: molecular characterization. J. Infect. 53, 159-165 https://doi.org/10.1016/j.jinf.2005.11.005
  3. Cystic Fibrosis Foundation. 2003. Patient Registry: Annual Data Report. Bethesda
  4. Coenye, T., P. Vandamme, J.R.W. Govan, and J.J. LiPuma. 2001. Taxonomy and identification of the Burkholderia cepacia complex. J. Clin. Microbiol. 39, 3427-3436 https://doi.org/10.1128/JCM.39.10.3427-3436.2001
  5. Frederiksen, B., C. Koch, and N. Hoiby. 1999. Changing epidemiology of Pseudomonas aeruginosa infection in Danish Cystic Fibrosis patients (1974-1995). Pediatr Pulmonol. 28, 159-166 https://doi.org/10.1002/(SICI)1099-0496(199909)28:3<159::AID-PPUL1>3.0.CO;2-1
  6. Gilligan, P.H. 1991. Microbiology of airway disease in patients with Cystic Fibrosis. Clin. Microbiol. Rev. 4, 35-51 https://doi.org/10.1128/CMR.4.1.35
  7. Goldstein, R., L. Sun, R.Z. Jiang, U. Sajjan, J. Forstner, and C. Campanelli. 1995. Structurally variant classes of pilus appendage fibers coexpressed from Burkholderia (Pseudomonas) cepacia. J. Bacteriol. 177, 1039-1052 https://doi.org/10.1128/jb.177.4.1039-1052.1995
  8. Grothues, D., U. Koopmann, H. Van der Hardt, and B. Tummler. 1988. Genome fingerprinting of Pseudomonas aeruginosa indicates colonization of cystic fibrosis siblings with closely related strains. J. Clin. Microbiol. 26, 115-123
  9. Lambiase, A., V. Raia, M. Del Pezzo, A. Sepe, V. Carnovale, and F. Rossano. 2006. Microbiology airway disease in a cohort of patients with cystic fibrosis. BMC Infect. Dis. 6, 4 https://doi.org/10.1186/1471-2334-6-64
  10. LiPuma, J.J. 1998. Burkholderia cepacia. Management issues and new insights. Clin. Chest Med. 19, 473-486 https://doi.org/10.1016/S0272-5231(05)70094-0
  11. LiPuma, J.J., T. Spilker, L.H. Gill, P.W. Campbell, L. Liu, and E. Mahenthiralingam. 2001. Disproportionate distribution of Burkholderia cepacia complex species and transmissibility markers in cystic fibrosis. Am. J. Respir. Crit. Care Med. 164, 92-99 https://doi.org/10.1164/ajrccm.164.1.2011153
  12. Lipuma, J.J. 2005. Update on the Burkholderia cepacia complex. Curr. Opin. Pulm. Med. 11, 528-533 https://doi.org/10.1097/01.mcp.0000181475.85187.ed
  13. Mahenthiralingam, E., D. Simpson, and D.P. Speert. 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, 808-816
  14. Mahenthiralingam, E., J. Bischof, S.K. Byrne, C. Radomski, J.E. Davies, Y. Av-Gay, and P. Vandamme. 2000. DNA-based diagnostic approaches for identification of Burkholderia cepacia complex, Burkholderia vietnamiensis, Burkholderia multivorans, Burkholderia stabilis, and Burkholderia cepacia genomovars I and III. J. Clin. Microbiol. 38, 3165-3173
  15. Mahenthiralingam, E. and P. Vandamme. 2005. Taxonomy and pathogenesis of the Burkholderia cepacia complex. Chron. Respir. Dis. 2, 209-217 https://doi.org/10.1191/1479972305cd053ra
  16. Manno, G., C. Dalmastri, S. Tabacchioni, P. Vandamme, R. Lorini, L. Minicicci, L. Romano, A. Giannattasio, L. Chiarini, and A. Bevivino. 2004. Epidemiology and clinical course of Burkholderia cepacia complex infections, particularly those caused by different Burkholderia cenocepacia strains, among patients attending an Italian Cystic Fibrosis Center. J. Clin. Microbiol. 42, 1491-1497 https://doi.org/10.1128/JCM.42.4.1491-1497.2004
  17. McDowell, A., E. Mahenthiralingam, J.E. Moore, K.E.A. Dunbar, A.K. Webb, M.E. Dodd, S.L. Martin, B.C. Millar, C.J. Scott, M. Crowe, and J.S. Elborn. 2001. PCR-based detection and identification of Burkholderia cepacia complex pathogens in sputum from cystic fibrosis patients. J. Clin. Microbiol. 39, 4247-4255 https://doi.org/10.1128/JCM.39.12.4247-4255.2001
  18. National Committee for Clinical Laboratory Standards. 1997. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. 4th ed. Approved standard M7-A4. National Committee for Clinical Laboratory Standards, Villanova, Pa, USA
  19. Saiman, L, N. MacDonald, J.L. Burns, N. Hoiby, D.P. Speert, and D. Weber. 2000. Infection control in cystic fibrosis: practical recommendations for the hospital, clinic, and social setting. Am. J. Infect. Control. 28, 381-385 https://doi.org/10.1067/mic.2000.106337
  20. Saiman, L., N.E. MacDonald, and S. Whittier. 1996. The microbiological basis for antimicrobial therapy. In Tenth Annual North American Cystic Fibrosis Conference. Cystic Fibrosis Foundation. Orlando, USA
  21. Saiman, L. and J. Siegel. 2003. Infection control recommendations for patients with cystic fibrosis: microbiology, important pathogens and infection control practices to prevent patient-to-patient transmission. Am. J. Infect. Control. 3 (Suppl)
  22. Sajjan, U., L. Sun, R. Goldstein, and J. Forstner. 1995. Cable (Cbl) type II pili of cystic fibrosis-associated Burkholderia (Pseudomonas) cepacia: nucleotide sequence of the cblA major subunit pilin gene and novel morphology of the assembled appendage fibers. J. Bacteriol. 177, 1030-1038 https://doi.org/10.1128/jb.177.4.1030-1038.1995
  23. Sun, L., R. Jiang, S. Steinbach, A. Holmes, C. Campanelli, J. Forstner, Y. Tan, M. Riley, and R. Goldstein. 1995. The emergence of a highly transmissible lineage of cbl+ Pseudomonas (Burkholderia) cepacia causing Cystic Fibrosis centre epidemics in North America and Britan. Nat. Med. 1, 661-666 https://doi.org/10.1038/nm0795-661
  24. Tablan, O.C., T.L. Chorba, D.V. Schidlow, J.W. White, K.A. Hardy, P.H. Gilligan, W.M. Morgan, L.A. Carson, W.J. Martone, J.M. Jason, and W.R. Jarvis. 1985. Pseudomonas cepacia colonization in patients with Cystic Fibrosis: risk factors and clinical outcome. J. Pediatr. 107, 382-387 https://doi.org/10.1016/S0022-3476(85)80511-4
  25. Tenover, F., R. Arbeit, R. Goering, P. Mickelsen, B. Murray, D. Persing, and B. Swaminathan. 1995. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J. Clin. Microbiol. 33, 2233-2239
  26. Vandamme, P., D. Henry, T. Coenye, S. Nuzla, M. Vancanneyt, J.J. LiPuma, D.P. Speert, J.R.W. Govan, and E. Mahenthiralingam. 2002. Burkholderia anthina sp. nov. and Burkholderia pyrrocinia, two additional Burkholderia cepacia complex bacteria, may confound results of new molecular diagnostic tools. FEMS Immunol. Med. Microbiol. 33, 143-149 https://doi.org/10.1111/j.1574-695X.2002.tb00584.x
  27. Vermis, K., T. Coenye, J.J. LiPuma, E. Mahentheralingam, H.J. Nelis, and P. Vandamme. 2004. Proposal to accomodate Burkholderia cepacia genomovar VI as Burkholderia dolosa sp. nov. Int. J. Syst. Evol. Microbiol. 54, 689-691 https://doi.org/10.1099/ijs.0.02888-0