Impact of Burkholderia dolosa on Lung Function and Survival in Cystic Fibrosis

Abstract

B. dolosa chronic infection in cystic fibrosis is associated with accelerated loss of lung function and decreased survival.

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

“…133,161,163,164 A notable exception is B. dolosa strain SLC6, which was identified in an outbreak in a US CF center and associated with deterioration in lung function and increased mortality. 25,133 The Glasgow strain of B. multivorans was identified in an outbreak among people with CF in the city in the early 1990s. 133,165 However, the majority of Burkholderia-infected CF patients harbor genotypically distinct strains.…”

“…169,170 Overwhelming infection (the cepacia syndrome) has been reported with species of B. cepacia complex other than B. cenocepacia, including B. multivorans 164 and B. dolosa SLC6. 25 Both single-center and multicenter studies suggest that poor outcomes with B. cepacia complex may be related to species, and such strains as B. cenocepacia ET12 have been associated with the worst outcomes. 171 Among 29 lung transplant recipients infected with B. cenocepacia (n p 16), B. multivorans (n p 11), and B. vietnamiensis (n p 2), all of the deaths occurred in those infected with B. cenocepacia.…”

“…Several published experiences have described the effectiveness of stringent IP&C practices and policies for reducing the prevalence of epidemic B. cepacia complex, 25 the LES strain, 1,373,374 and other transmissible strains of P. aeruginosa. 30,185,375,376 Interventions have included education of healthcare personnel and people with CF and their families about risk factors for routes of transmission and preventive strategies, emphasizing hand hygiene for people with CF and healthcare personnel, the use of single-patient rooms when people with CF are admitted to the hospital, Contact Precautions, avoiding socializing in both healthcare and nonhealthcare settings, improving detection of CF pathogens in microbiology laboratories, decontaminating the healthcare environment, and cohort segregation of patients known to be harboring specific pathogens while in a CF clinic.…”

“…Newer CF pathogens are increasing in prevalence and are associated with increased rates of morbidity and mortality among individuals with CF. Such pathogens include MRSA, 22,23 Mycobacteria abscessus, 24 Burkholderia dolosa, 25 new species in the Burkholderia cepacia complex, 26 epidemic clones of Pseudomonas aeruginosa (eg, the Liverpool epidemic strain [LES]), [27][28][29] and others. 30 Thanks to the increasing use of molecular typing, strains that are shared among people with CF continue to be identified, suggesting that new strategies beyond those recommended in the 2003 Infection Control Guideline for CF are needed to improve the implementation of IP&C practices and to reduce the transmission of CF pathogens.…”

Growth on mannitol-rich media elicits a genome-wide transcriptional response in Burkholderia multivorans that impacts on multiple virulence traits in an exopolysaccharide-independent manner

“…The BCC is also established as a frequent cause of chronic respiratory infection in patients with cystic fibrosis (CF), and is consistently identified as an independent risk factor for mortality within this patient group (Liou et al, 2001;Jones et al, 2004;Kalish et al, 2006). Although most commonly causing a gradual deterioration in lung function like other CF pathogens, BCC can also uniquely cause systemic CF infection termed cepacia syndrome, characterized by necrotizing pneumonia, bacteraemia and sepsis (Isles et al, 1984).…”