Transient isolation of Burkholderia multivorans and Burkholderia cenocepacia from a Brazilian cystic fibrosis patient chronically colonized with Burkholderia vietnamiensis

Carvalho, Grasiella M.V.; Carvalho, Ana Paula D'a.; Folescu, Tânia Wrobel; Higa, Laurinda Yoko Shinzato; Teixeira, Lúcia Martins; Plotkowski, Maria-Cristina; Merquior, Vânia Lúcia Carreira; Albano, Rodolpho Mattos; Marques, Elizabeth Andrade

doi:10.1016/j.jcf.2005.08.002

Cited by 11 publications

(11 citation statements)

References 23 publications

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“…56 B. vietnamiensis was the cause of chronic respiratory infections in four CF patients in Brazil. [118][119][120] Given its rarity, the clinical importance of this organism in CF has not been elucidated.…”

Section: B Vietnamiensis (Genomovar V)mentioning

confidence: 99%

Burkholderia cepaciaComplex: Impact on the Cystic Fibrosis Lung Lesion

Lynch

2009

Semin Respir Crit Care Med

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Burkholderia cepacia complex (Bcc) is a group of phenotypically similar nonfermenting, aerobic, gram-negative rods that infect 2 to 8% of patients with cystic fibrosis (CF). Bcc comprises several distinct species (formerly termed genomovars). Infection with Bcc has been associated with worse outcomes and survival in CF patients. Additionally, colonization with Bcc has been associated with heightened mortality following lung transplantation. Currently, the role of lung transplantation in Bcc-infected patients remains controversial. Antimicrobial therapy for Bcc is often ineffective because most strains are multidrug resistant. Combination therapy with two or three agents is typically administered, but optimal therapy has not been elucidated. Certain strains (particularly B. cenocepacia) have been associated with heightened transmissibility and virulence. Several genes or gene products have important roles in virulence, persistence of the organism(s), and transmissibility. The incidence of Bcc and specific species fluctuates over time and between centers. Bcc can be transmitted by social contact, and several major epidemic strains have disseminated globally. Strict infection control measures, including cohorting (segregation) of infected patients, dramatically curtail transmission and have become the standard of care, but such measures cause social isolation, stigmatism, and psychological impact among infected patients.

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Section: B Vietnamiensis (Genomovar V)mentioning

confidence: 99%

Burkholderia cepaciaComplex: Impact on the Cystic Fibrosis Lung Lesion

Lynch

2009

Semin Respir Crit Care Med

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“…Instituto Fernandes Figueira is a cystic fibrosis centre located in Rio de Janeiro, Brazil. Samples recovered during regular follow up of the patients were processed and cultured as detailed previously (12). Preliminary identification as belonging to the BCC was performed using a panel of conventional phenotypic tests (13).…”

Section: Methodsmentioning

confidence: 99%

“…To identify the distinct genomovars of the clinical isolates, a 1043 bp PCR product, corresponding to the recA gene, was amplified by PCR using genomic DNA extracted from the BCC clinical isolates and reference strains, and sequenced as described previously (12).…”

Section: Methodsmentioning

confidence: 99%

Burkholderia cenocepacia, B. multivorans, B. ambifaria and B. vietnamiensis isolates from cystic fibrosis patients have different profiles of exoenzyme production

Carvalho

Ventura

Pereira

et al. 2007

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Knowledge about the virulence mechanisms of species from the Burkholderia cepacia complex (BCC) is still limited. The genomovar heterogeneity and production of different virulence factors are likely to contribute to the variation in the clinical outcome observed in BCC-infected cystic fibrosis (CF) patients. Therefore, in this study we investigated the genetic polimorphism, the presence of genetic makers associated with virulence and transmissibility in BCC, and the profile of exoenzyme production of 59 BCC isolates obtained from 59 CF patients attending the reference CF centre in Rio de Janeiro, Brazil. The DNA sequence analyses of the recA gene allowed us to identify 40 of these 59 BCC species as being B. cenocepacia, 9 as B. vietnamiensis, 6 as B. multivorans and 4 as B. ambifaria. The assessment of the bacterial genetic polymorphism by PFGE revealed that B. cenocepacia and the B. multivorans isolates belonged to four and two different PFGE profiles with prevalence of two clones, A and B, respectively. All B. vietnamiensis and B. ambifaria belonged to only one PFGE profile (J and E, respectively). None of the isolates exhibited the genetic markers cblA and BCESM, assessed by polymerase chain reaction. In contrast, the profile of enzymatic activity, assessed by phenotypic methods, differed among the BCC species: protease activity was detected only in B. cenocepacia and B. ambifaria isolates, whereas only B. vietnamiensis isolates produced hemolysin. Although the phospholipase C activity was similar among the different species, the level of lipase activity produced by B. multivorans was higher than in the other species. We speculate that the differential characteristics of exoenzyme production may account for the differences in the pathogenic potentials of each BCC species.

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“…Three years later (13 yo - 1995), Bcc was first isolated, and the patient fulfilled the criteria for Bcc chronic colonization [6] by 15 yo. In the following 16 years (1997–2013), there was intermittent isolation of P. aeruginosa and continuous isolation of Bcc, identified as B. vietnamiensis [7] (Fig. 1).…”

Section: Case Presentationmentioning

confidence: 99%

Monitoring clinical and microbiological evolution of a cystic fibrosis patient over 26 years: experience of a Brazilian CF Centre

et al. 2017

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Background Burkholderia cepacia complex is a group of opportunistic pathogens in cystic fibrosis (CF) patients believed to be associated with poor prognosis and patient-to-patient transmissibility. Little is known about clinical outcomes after B. vietnamiensis chronic colonization/infection.Case presentationA 33 yo male patient had diagnosis of CF by 7 yo, after recurrent pneumonia during infancy and lobectomy (left upper lobe) at 6 yo. Burkholderia cepacia complex (Bcc) was first isolated by 13 yo, and the patient fulfilled the criteria for chronic colonization by 15 yo. In the following 16 years (1997–2013), there was intermittent isolation of P. aeruginosa and continuous isolation of Bcc, identified as B. vietnamiensis. There was clinical and laboratorial stability for 16 years with annual rate of decline in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) of 1.61 and 1.35%, respectively. From 2013 to 2015, there was significant clinical and lung function deterioration: annual rate of decline in FEV1 and FVC was 3 and 4.1%, respectively while body mass index decreased from 18.1 to 17.1. Episodes of hemoptysis and respiratory exacerbations (with hospital admissions) became more frequent. CF related diabetes was diagnosed (fasting glycemia: 116 mg/dL, oral glucose tolerance test: 305 mg/dL). Because of the severity of the disease in the last years, in addition to traditional microbiological surveillance, microbiome analysis by next generation sequencing (NGS) was performed on respiratory secretions. The NGS showed that 97% of the sequencing data were attributed to genus Burkholderia. ConclusionsWe report the case of a 33-year-old male CF patient known to have chronic infection with B. vietnamiensis who remained clinically stable for 16 years and presented recent clinical and laboratorial deterioration. Microbiome analysis of respiratory secretions was performed in 3 samples collected in 2014–2015. Clinical deterioration overlapped with cystic fibrosis-related diabetes and microbiome composition revealed no significant differences when compared microbiome results to culture dependent methods.

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Transient isolation of Burkholderia multivorans and Burkholderia cenocepacia from a Brazilian cystic fibrosis patient chronically colonized with Burkholderia vietnamiensis

Cited by 11 publications

References 23 publications

Burkholderia cepaciaComplex: Impact on the Cystic Fibrosis Lung Lesion

Burkholderia cepaciaComplex: Impact on the Cystic Fibrosis Lung Lesion

Burkholderia cenocepacia, B. multivorans, B. ambifaria and B. vietnamiensis isolates from cystic fibrosis patients have different profiles of exoenzyme production

Monitoring clinical and microbiological evolution of a cystic fibrosis patient over 26 years: experience of a Brazilian CF Centre

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