<i>Burkholderia cepacia</i> complex: a contraindication to lung transplantation in cystic fibrosis?

LiPuma, John J.

doi:10.1034/j.1399-3062.2001.003003149.x

Cited by 38 publications

(19 citation statements)

References 124 publications

(139 reference statements)

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“…Burkholderia cepacia has been related to a poor outcome after lung transplantation and some centres consider this an absolute contraindication to lung transplantation [21,22]. Some taxonomonic diversity has existed and early studies are unclear with regard to sub-typing.…”

Section: Discussionmentioning

confidence: 99%

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Long-term outcome of lung transplantation for cystic fibrosis ? Danish results

Bech

2004

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

“…Median time on the waiting list among recipients was 267 days (range 14-902). Most candidates were in poor nutritional status with median body-mass index of 17.7 (range [14][15][16][17][18][19][20][21]. Forty-five percent of the recipients were diagnosed with IDDM at time of transplantation.…”

Section: Patients' Clinical Characteristicsmentioning

confidence: 99%

Long-term outcome of lung transplantation for cystic fibrosis ? Danish results

Bech

2004

European Journal of Cardio-Thoracic Surgery

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“…Among the isolates in the B. cepacia complex, transmissibility is typically thought to be associated with B. cepacia genomovar III organisms (2,7,9,11,21,22,25). Person-to-person spread of B. multivorans is not as frequently described, and most patients infected with B. multivorans are infected with unique strains (1,14). Overlapping hospitalizations could be traced for all four patients infected with cluster C isolates.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, CF patients infected with B. cepacia complex isolates are stigmatized, being segregated from the general CF patient population in terms of clinical care and social interaction. In many North American transplant centers, infection with B. cepacia complex is a strict contraindication for lung transplantation in CF patients (14).…”

mentioning

confidence: 99%

Six-Year Molecular Analysis of Burkholderia cepacia Complex Isolates among Cystic Fibrosis Patients at a Referral Center for Lung Transplantation

Heath¹,

Hohneker²,

Carriker

et al. 2002

J Clin Microbiol

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Over a 6-year period, Burkholderia cepacia complex species were isolated from cystic fibrosis (CF) patients receiving care at The University of North Carolina Hospitals (clinic CF patients) and from those referred from other treatment centers. Fifty-six isolates collected from 30 referred patients and 26 clinic CF patients were characterized by pulsed-field gel electrophoresis (PFGE) and were assayed by PCR to detect the cable pilin gene, cblA. PFGE results indicated that six separate clusters (clusters A to F) were present among the 56 isolates and that three clusters (clusters A, B, and E) consisted only of isolates from referred patients infected with B. cepacia complex isolates prior to referral. However, one cluster (cluster C) consisted of isolates from four CF patients, and hospital records indicate that this cluster began with an isolate that came from a referred patient and that spread to three clinic CF patients. Cluster D consisted of two isolates from clinic CF patients, and hospitalization records are consistent with nosocomial, patient-to-patient spread. cblA was present in only 4 of the 56 isolates and included isolates in cluster E from the referred patients. Our results indicate a lack of spread of a previously characterized, transmissible clone from referred patients to our clinic CF population. Only two instances of nosocomial, patient-to-patient spread could be documented over the 6-year period. An additional spread of an isolate (cluster F) from a referred patient to a clinic patient could not be documented as nosocomial and may have been the result of spread in a nonhospitalized setting. The majority (36 of 56) of our B. cepacia complex-infected CF patients harbor isolates with unique genotypes, indicating that a diversity of sources account for infection. These data suggest that CF patients infected with B. cepacia complex and referred for lung transplantation evaluation were not a major source of B. cepacia complex strains that infected our resident CF clinic population.

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“…Importantly, infection with members of the B. cepacia complex is also regarded by many CF care centers as an absolute contraindication to lung transplantation (34). Because B. multivorans and B. cenocepacia account for the majority of B. cepacia complex infections in CF (48), we included relatively more strains from these two species.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Activities of a Novel Nanoemulsion against Burkholderia and Other Multidrug-Resistant Cystic Fibrosis-Associated Bacterial Species

LiPuma¹,

Rathinavelu²,

Foster³

et al. 2009

Antimicrob Agents Chemother

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Respiratory tract infection, most often involving opportunistic bacterial species with broad-spectrum antibiotic resistance, is the primary cause of death in persons with cystic fibrosis (CF). Species within the Burkholderia cepacia complex are especially problematic in this patient population. We investigated a novel surfactant-stabilized oil-in-water nanoemulsion (NB-401) for activity against 150 bacterial isolates recovered primarily from CF respiratory tract specimens. These specimens included 75 Burkholderia isolates and 75 isolates belonging to other CF-relevant species including Pseudomonas, Achromobacter, Pandoraea, Ralstonia, Stenotrophomonas, and Acinetobacter. Nearly one-third of the isolates were multidrug resistant, and 20 (13%) were panresistant based on standard antibiotic testing. All isolates belonging to the same species were genotyped to ensure that each isolate was a distinct strain. The MIC 90 of NB-401 was 125 g/ml. We found no decrease in activity against multidrug-resistant or panresistant strains. MBC testing showed no evidence of tolerance to NB-401. We investigated the activity of NB-401 against a subset of strains grown as a biofilm and against planktonic strains in the presence of CF sputum. Although the activity of NB-401 was decreased under both conditions, the nanoemulsion remained bactericidal for all strains tested. These results support NB-401's potential role as a novel antimicrobial agent for the treatment of infection due to CF-related opportunistic pathogens.

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Burkholderia cepacia complex: a contraindication to lung transplantation in cystic fibrosis?

Cited by 38 publications

References 124 publications

Long-term outcome of lung transplantation for cystic fibrosis ? Danish results

Long-term outcome of lung transplantation for cystic fibrosis ? Danish results

Six-Year Molecular Analysis of Burkholderia cepacia Complex Isolates among Cystic Fibrosis Patients at a Referral Center for Lung Transplantation

In Vitro Activities of a Novel Nanoemulsion against Burkholderia and Other Multidrug-Resistant Cystic Fibrosis-Associated Bacterial Species

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