Transmissibility and Infection Control Implications of <i>Burkolderia cepacia</i> in Cystic Fibrosis

Fung, Scott; Dick, Hani L. N.; Devlin, Hannah; Tullis, Elizabeth

doi:10.1155/1998/269157

Cited by 21 publications

(19 citation statements)

References 25 publications

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“…Although B. cepacia is considered almost exclusively a pathogen for CF patients [3,7], our study reported B. cepacia bacteraemia predominantly from burns patients. B. cepacia are considered opportunistic human pathogens and can be transmitted to patients via environmental contamination or person-to-person contact [4][5][6]8,9]. Burns patients are generally more susceptible to infection due to impaired immune function.…”

Section: Discussionmentioning

confidence: 99%

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Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

et al. 2020

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Background Burkholderia cepacia complex (Bcc) is a group of serious pathogens in cystic fibrosis patients and causes life threatening infections in immunocompromised patients. Species within the Bcc are widely distributed within the environment, can survive in the presence of disinfectants and antiseptics, and are inherently multidrug resistant (MDR). Methods Dhaka Medical College Hospital (DMCH) patients with a B. cepacia positive blood culture between 20 October 2016 to 23 rd September 2017 were considered as outbreak cases. Blood stream infections (BSIs) were detected using BacT/ALERT 3D at DMCH. B. cepacia was isolated on chromogenic UTI media followed by MALDI-TOF. Minimum inhibitory concentration (MIC) of clinically relevant antibiotics was determined by agar dilution. Whole genome sequencing was performed on an Illumina MiSeq platform. Patients' demographic and clinical data were collected. Patients' clinical history and genomic data of the outbreak strains were merged to investigate possible outbreaks. Ninety-one B. cepacia genomes were downloaded from 'Burkholderia Genome Database' and the genomic background of the global strains were compared with our outbreak strains. Results Among 236 BSIs, 6.35% (15/236) were B. cepacia. Outbreak cases were confined to the burn critical care unit and, to a lesser extent, the paediatrics department. There was a continuum of overlapping cases at DMCH between 23 October 2016 to 30 August 2017. Core genome SNPs showed that the outbreak strains were confined to a single clade, corresponded to a common clone (ST1578). The strains were shown to be MDR and associated with a mortality of 31% excluding discharge against medical advice. MIC profiles of the PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionmentioning

confidence: 99%

“…Bcc rarely cause diseases in healthy individuals and is mostly regarded as a serious pathogen in cystic fibrosis patients [7]. The pathogens are inherently multidrug resistant (MDR) and highly transmissible by direct contact [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

et al. 2020

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“…Patients with B. cepacia complex must avoid contact with each other because strains that are potentially more virulent may replace an initial infecting strain (15,37,110,123). Ongoing transmission of epidemic clones has been documented in clinics that did not implement segregation (37,69,149).…”

Section: Burkholderia Cepacia Complexmentioning

confidence: 99%

Infection Control in Cystic Fibrosis

2004

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Over the past 20 years there has been a greater interest in infection control in cystic fibrosis (CF) as patient-to-patient transmission of pathogens has been increasingly demonstrated in this unique patient population. The CF Foundation sponsored a consensus conference to craft recommendations for infection control practices for CF care providers. This review provides a summary of the literature addressing infection control in CF. Burkholderia cepacia complex, Pseudomonas aeruginosa, and Staphylococcus aureus have all been shown to spread between patients with CF. Standard precautions, transmission-based precautions including contact and droplet precautions, appropriate hand hygiene for health care workers, patients, and their families, and care of respiratory tract equipment to prevent the transmission of infectious agents serve as the foundations of infection control and prevent the acquisition of potential pathogens by patients with CF. The respiratory secretions of all CF patients potentially harbor clinically and epidemiologically important microorganisms, even if they have not yet been detected in cultures from the respiratory tract. CF patients should be educated to contain their secretions and maintain a distance of >3 ft from other CF patients to avoid the transmission of potential pathogens, even if culture results are unavailable or negative. To prevent the acquisition of pathogens from respiratory therapy equipment used in health care settings as well as in the home, such equipment should be cleaned and disinfected. It will be critical to measure the dissemination, implementation, and potential impact of these guidelines to monitor changes in practice and reduction in infections

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“…Spread may be dependent on a number of risk factors, including bacterial strain type [5][6][7][8][9], patient behavior [9], use of contaminated therapeutic devices [10], and treatment center infection control practices [11]. To reduce spread of the organism, isolation or segregation of patients who are infected with B. cepacia has been recommended [4,12]. Recent changes in the taxonomy of the species B. cepacia [13] have further complicated our understanding of the epidemiology of B. cepacia respiratory infection in patients with CF.…”

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confidence: 99%

Infection withBurkholderia cepaciaComplex Genomovars in Patients with Cystic Fibrosis: Virulent Transmissible Strains of Genomovar III Can ReplaceBurkholderia multivorans

et al. 2001

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Infection with Burkholderia cepacia complex in patients with cystic fibrosis (CF) results in highly variable clinical outcomes. The purpose of this study was to determine if there are genomovar-specific disparities in transmission and disease severity. B. cepacia complex was recovered from 62 patients with CF on > or =1 occasions (genomovar III, 46 patients; genomovar II [B. multivorans], 19 patients; genomovar IV [B. stabilis], 1 patient; genomovar V [B. vietnamiensis], 1 patient; and an unclassified B. cepacia complex strain, 1 patient). Patient-to-patient spread was observed with B. cepacia genomovar III, but not with B. multivorans. Genomovar III strains replaced B. multivorans in 6 patients. Genomovar III strains were also associated with a poor clinical course and high mortality. Infection control practices should be designed with knowledge about B. cepacia complex genomovar status; patients infected with transmissible genomovar III strains should not be cohorted with patients infected with B. multivorans and other B. cepacia genomovars.

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Transmissibility and Infection Control Implications of Burkolderia cepacia in Cystic Fibrosis

Cited by 21 publications

References 25 publications

Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

Infection Control in Cystic Fibrosis

Infection withBurkholderia cepaciaComplex Genomovars in Patients with Cystic Fibrosis: Virulent Transmissible Strains of Genomovar III Can ReplaceBurkholderia multivorans

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