Endemicity and inter-city spread of Burkholderia cepacia genomovar III in cystic fibrosis.
ABSTRACT We sought to determine whether the same Burkholderia cepacia complex strain has persisted as the dominant clonal lineage among patients in a large cystic fibrosis (CF) treatment center during the past 2 decades.
The inter-city spread of B cepacia through transfer of a colonized patient and the impact of infection control measures in containing inter-patient transmission were investigated. We analyzed all available B cepacia complex isolates recovered from 1981 to 1987 and from 1996 to 2000 at one large CF treatment center (Center A) and from 1997 to 2000 at another center (Center B). Incidence of B cepacia complex infection and infection control measures in both centers were assessed.
Seventeen (81%) of 21 Center A patients from whom B cepacia complex bacteria were recovered between 1981 and 1987 and 40 (97%) of 41 patients culture-positive between 1996 and 2000 were infected with the same genomovar III strain. Transfer of a colonized patient from Center A to Center B was associated with an increase in B cepacia complex infection in Center B, all of which was with the Center A dominant strain. This strain, designated PHDC, lacks both B cepacia epidemic strain and cblA markers.
B cepacia complex strains may remain endemic in CF treatment centers for many years. Responsible bacterial and host factors and optimal infection control measures to prevent inter-patient spread remain to be identified.
SourceAvailable from: John J LipumaInfection Control and Hospital Epidemiology 08/2014; 35(S1):S1-S67. DOI:10.1086/676882 · 3.94 Impact Factor
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ABSTRACT: Burkholderia cepacia complex organisms are especially important pathogens in cystic fibrosis (CF), with a propensity for patient-to-patient spread and long-term respiratory colonization. B. cenocepacia and B. multivorans account for the majority of infections in CF, and major epidemic clones have been recognized throughout the world. The aim of the present study was to develop and evaluate a multilocus variable number of tandem repeat (VNTR) analysis (MLVA) scheme for B. cenocepacia. Potential VNTR loci were identified upon analysis of the annotated genome sequences of strain AU1054, J2315 and MCO-3, and 10 of them were selected on the basis of polymorphism and size. A collection of 100 B. cenocepacia strains, including epidemiologically related and unrelated strains, as well as representatives of the major epidemic lineages, was used to evaluate typeability, epidemiological concordance and discriminatory power of MLVA, compared with pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). Longitudinal stability was assessed by testing 39 successive isolates from 14 patients. Typeability ranged from 0.91 to 1, except for one marker, which was not amplified in 53% of B. cenocepacia IIIA strains. MLVA types were shown to be stable in chronically colonized patients, and within outbreak-related strains, with an excellent epidemiological concordance. Epidemic and/or globally distributed lineages (ET-12, ST-32, ST-122, ST-234, ST-241) were successfully identified. Conversely, the discriminatory power of MLVA was lower than that of PFGE or MLST, though PFGE variations within epidemic lineages sometimes masked genetic relatedness. In conclusion, MLVA represents a promising cost-effective first-line tool in B. cenocepacia surveillance. Copyright © 2014, American Society for Microbiology. All Rights Reserved.Journal of Clinical Microbiology 11/2014; 53(2). DOI:10.1128/JCM.02473-14 · 4.23 Impact Factor
American Journal of Infection Control 05/2003; 31(3):S6-S62. DOI:10.1067/mic.2003.78 · 2.33 Impact Factor