Burkholderia cepacia complex in an Italian cystic fibrosis centre: epidemiology and clinical course of patients infected with different, Burkholderia cenocepacia RecA strains
Abstract number: 902_p1564
Bacteria of the Burkholderia cepacia complex (Bcc) are important pathogens in cystic fibrosis (CF) patients (pts). Bcc comprises at least nine species or genomovar. Aim of this study was to assess the epidemiology of Bcc recovered from pts attending the CF Centre at the Gaslini Children's Hospital (Genova, Italy) from 1984 to 2001.
A total of 195 Bcc isolates were recovered from 75 of 326 (23%) of pts in regular follow up in the study period. The genomovar of all isolates was determined by RFLP analysis of recA gene and confirmed by PCR of recA with genomovar-specific primers. All strains were typed by RAPD analysis. The clinical course of pts infected by different species was determined comparing: infection with P. aeruginosa prior Bcc acquisition, changes in lung function (FEV1) and body weight in the 2-year Bcc postacquisition period, mortality in long-term period.
Burkholderia cenocepacia (genomovar III) is the predominant species recovered from the CF pts infected with Bcc in the Genoa Centre. Of the other eight species comprising the Bcc, only few isolates belonging to Bc genomovar I, B. stabilis, and B. pyrrocinia were found. Of the four recA lineages of B. cenocepacia, most pts harboured IIIB strains. Patient-to-patient spread of Bcc among CF pts was mostly associated with B. cenocepacia strains, in particular with IIIA and IIID recA lineages. Mortality was significantly higher in pts infected with Bcc than in noninfected pts. All deaths were associated with the presence of B. cenocepacia. Within B. cenocepacia, infection with epidemic strains belonging to lineages IIIA and IIID was associated with higher mortality than with lineage IIIB strains. No significant differences in lung function, body weight and mortality rate were observed between pts infected with epidemic strains belonging to either B. cenocepacia IIIA or B. cenocepacia IIID.
Our study confirms the prevalence of B. cenocepacia among Bcc-infected CF pts and the high percentage of mortality associated with this species. The major role of an epidemic strain belonging to the recently identified recA lineage IIID in spreading Bcc infection among CF pts has been recognised for the first time."
|Session name:||XXIst ISTH Congress|
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