Burkholderia cepacia complex: clinical course in cystic fibrosis patients

Abstract

BackgroundPulmonary deterioration after B.cepacia complex (BCC) colonization has a heterogeneous pattern. The aim was to investigate the clinical outcome of BCC colonization in CF patients chronically colonized with P. aeruginosa.MethodsCF patients chronically colonized with P. aeruginosa were divided into three groups: intermittent (I), chronic (II) and no colonization (III) with BCC. Body mass index (BMI) percentile and spirometric parameters were analyzed at three different times in each group.ResultsFifty-six patients chronically colonized with P. aeruginosa were included. Of these, 27 also had evidence of BCC colonization (13 intermittent and 14 chronic). BMI percentile was significantly lower among patients chronically colonized by both P. aeruginosa and BCC. Mean values of FEV1 and FVC % were also significantly lower in these patients, both at the time of chronic BCC colonization and 24 months forward.ConclusionsChronic BCC colonization is associated with significant loss of lung function. Lower BMI might be a risk factor for chronic BCC colonization, preceding these events.

Assessment of the Bacterial Diversity of Aircraft Water: Identification of the Frequent Fliers

“…Opportunistic pathogens capable of causing infections in vulnerable individuals were also found such as the Burkholderia cepacia complex (BCC), Pseudomonas aeruginosa , Stenotrophomonas maltophilia , Acinetobacter baumannii , Ralstonia pickettii , Pseudomonas fluorescens and Sphingomonas paucimobilis [42–48]. BCC strains can infect and cause lung decline in patients with cystic fibrosis [49]. These bacteria could potentially act as a reservoir for the spread of antibiotic resistance.…”

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

“…Mean rate of FEV 1 % predicted decline in CF patients chronically colonized with Bcc was significantly higher than expected in all ages [6], although there was no correlation to Bcc species. In our report, chronic Bcc colonization and clinical stability had been present over a long period.…”

Understanding the Entanglement: Neutrophil Extracellular Traps (NETs) in Cystic Fibrosis

“…P. aeruginosa is considered the main bacterium that affects people with CF, causing chronic lung infections, which leads to high rates of morbidity and mortality, and once the bacteria is established, it is difficult to eradicate it (Winstanley et al, 2016). On the other hand, patients colonized in a chronic manner with B. cepacia present a worse prognosis of the disease, as the use of antibiotics becomes more frequent they also have a greater deterioration of lung function and the rate of mortality is higher compared to that patients colonized by only P. aeruginosa (Gilligan, 2014; Folescu et al, 2015). It has been reported that B. cepacia and P. aeruginosa can form mixed biofilms in the lungs of people with CF, since, P. aeruginosa through its extracellular products can increase the attachment of B. cepacia by modifying the lung epithelial cells on its surface; however, the same does not occur in patients previously colonized with B. cepacia (Saiman et al, 1990).…”

“…It has been reported that B. cepacia and P. aeruginosa can form mixed biofilms in the lungs of people with CF, since, P. aeruginosa through its extracellular products can increase the attachment of B. cepacia by modifying the lung epithelial cells on its surface; however, the same does not occur in patients previously colonized with B. cepacia (Saiman et al, 1990). Coinfection between the two bacteria results in a rapid decline in lung function and a high mortality rate (Folescu et al, 2015). In CF the simple colonization by S. aureus is generally considered of better prognosis than those colonized with P. aeruginosa ; but in some cases, the presence of small-colony variants (SCV) of S. aureus is associated with the most advanced lung disease in CF, and the phenotype of this bacterium in a coinfection with P. aeruginosa causes disease worsening (Besier et al, 2007; Hubert et al, 2013).…”