An Epidemic ofBurkholderia cepaciaTransmitted between Patients with and without Cystic Fibrosis

Abstract

Burkholderia cepacia is an important pathogen in cystic fibrosis (CF) and an infrequent cause of nosocomial infection in non-CF patients. This report describes a large hospital outbreak that appeared to involve both patient groups, a previously unrecognized phenomenon. Ribotype restriction fragment length polymorphism (RFLP) profiles and pulsed-field gel electrophoresis-resolved macrochromosomal RFLPs were analyzed, a ribotype-based phylogenic tree was constructed, and case-control and cohort studies were performed. A single dominant clone was found in both CF and non-CF groups. Phylogenic analysis suggests that it has evolved independently and that such highly transmissible strains can emerge rapidly and randomly. Acquisition risk in the CF patients was linked to hospitalization (odds ratio=5.47, P=.0158, confidence interval=1. 28-26.86) and was associated with significantly increased mortality rates. Infection control policies must now consider this threat of transmission between non-CF and CF patients.

Identification of peptides from human pathogens able to cross‐activate an HIV‐1‐gag‐specific CD4+ T cell clone

“…Both bacteria are ubiquitous in the environment but rarely cause symptomatic infection in healthy individuals [29]. However, they have been associated with nosocomial infections [30][31][32][33] and with infections of the respiratory system in patients with cystic fibrosis [34][35][36]. One can hypothesize that the in vitro immunization with gag peptides led to the priming of naive cells that cross-react with peptides from these two pathogens.…”

Burkholderia cepacia: current clinical issues, environmental controversies and ethical dilemmas

“…This case is extremely unusual but raises the concern, although small, that carers of CF patients are not entirely free from risk of cross-infection with virulent pathogens. Of considerable concern is a recent report describing cross-infection by a single dominant clone of B. cepacia between patients with and without cystic fibrosis [4]. Isolates of B. cepacia were obtained from sputum (228), intravenous catheters (11), urine (10), wounds (10) and other miscellaneous sites (11) from 245 critically ill non-CF patients on intensive care units.…”

“…Nosocomial infections can occur, potentially with multidrugresistant organisms, including methicillin-resistant Staphylococcus aureus, Enterococcus, Pseudomonas and sometimes Aspergillus species. B. cepacia can now be added to this list, following recent reports describing the organism cross-infecting non-CF hospitalised patients with resultant morbidity [4]. The impact of this knowledge is discussed for both hospitalised CF and non-CF patients.…”

Phenotypic and Genotypic Characterization of Some Pseudomonas sp. Associated with Burkholderia cepacia Isolated from Various Infected Fishes

“…On the other hand, Burkholderia cepacia previously known as Pseudomonas cepacia, is a Gram-negative rod usually found in soil, vegetation, and water [24,25]. P. cepacia was firstly described by Burkholder in 1950 [26].…”