Genomovar status and antibiotic resistance of Burkholderia cepacia complex isolates in cystic fibrosis centre in Kosice, Slovakia
Abstract number: 902_p1313
The aims of the study were: (i) to evaluate the prevalence of Burkholderia cepacia complex (Bcc) isolates in patients with cystic fibrosis (CF) (ii) to determine their genomovar status (iii) to determine antibiotic susceptibility of each Bcc isolate and (iv) to determine the most appropriate bactericidal antibiotic combination.
From August 2000 to November 2003, we collected 506 sputum samples from 42 patients with cystic fibrosis attending The Regional CF Centre in Kosice, Slovakia. All sputum samples were examined by standard laboratory culture techniques including plating on the Burkholderia Cepacia Selective Agar (BCSA). All putative Bcc isolates were further subjected to recA-based nested PCR to confirm the correct assignment to the genus Bcc and to determine the genomovar status. Antibiotic susceptibility testing for the Bcc isolates was evaluated by standard laboratory techniques using disk-diffusion method. Multiple combination bactericidal antibiotic testing for multiresistant isolates of the Bcc was done in microtitre plates using a modified time vs. kill curve method.
The prevalence of Bcc isolates is 26.1% (11 patients). Six out of 42 CF patients (14.3%) have been infecting with multiresistant strains of genomovar III, recA subgroup IIIA. One patient harbours genomovar III, recA subgroup IIIB, and the remaining three positive patients have the infection with genomovar IV. The most effective single antibiotic against multiresistant strains of genomovar IIIA are meropenem and ceftazidim. The most effective triple-antibiotic combinations contain high-dose tobramycin, meropenem and the third additional antibiotic (ceftazidim, ciprofloxacin, amikacin)
Burkholderia cenocepacia (genomovar III) is a multiresistant opportunistic pathogen with the most pronounced negative effect in morbidity and mortality of CF patients. The accurate identification of Bcc completed with molecular genetic tools is very important from epidemiological point of view in order to control and minimise cross-infection in CF patients."
|Session name:||XXIst ISTH Congress|
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