Burkholderia pseudomallei: another emerging pathogen in cystic fibrosis

O’Carroll, Mark; Kidd, Timothy J.; Coulter, Chris; Smith, Helen; Rose, Barbara; Harbour, C.; Bell, Scott C.

doi:10.1136/thorax.58.12.1087

Cited by 68 publications

(54 citation statements)

References 23 publications

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“…They are opportunistic pathogens implicated in chronic and occasionally serious infections of patients with cystic fibrosis and chronic granulomatous disease (3,26,27,29). Although coinfection by the B. cepacia complex and B. pseudomallei in cystic fibrosis patients has been reported (31), commercial systems often fail to distinguish between the two organisms (14,24,43). Since the treatment of B. pseudomallei infection requires a prolonged course of antibiotics (46), this can directly affect management, as inadequate treatment is associated with a high rate of relapse (12).…”

mentioning

confidence: 99%

Novel Pan-Genomic Analysis Approach in Target Selection for Multiplex PCR Identification and Detection of Burkholderia pseudomallei, Burkholderia thailandensis, and Burkholderia cepacia Complex Species: a Proof-of-Concept Study

Lau

Martelli

et al. 2011

J Clin Microbiol

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Burkholderia pseudomallei, Burkholderia thailandensis, and the Burkholderia cepacia complex differ greatly in pathogenicity and epidemiology. Yet, they are occasionally misidentified by biochemical profiling, and even 16S rRNA gene sequencing may not offer adequate discrimination between certain species groups. Using the 23 B. pseudomallei, four B. thailandensis, and 16 B. cepacia complex genome sequences available, we identified gene targets specific to each of them (a Tat domain protein, a 70-kDa protein, and a 12-kDa protein for B. pseudomallei, B. thailandensis, and the B. cepacia complex, respectively), with an in-house developed algorithm. Using these targets, we designed a robust multiplex PCR assay useful for their identification and detection from soil and simulated sputum samples. For all 43 B. pseudomallei, seven B. thailandensis, and 20 B. cepacia complex (B. multivorans, n ‫؍‬ 6; B. cenocepacia, n ‫؍‬ 3; B. cepacia, n ‫؍‬ 4; B. arboris, n ‫؍‬ 2; B. contaminans, B. anthina, and B. pyrrocinia, n ‫؍‬ 1 each; other unnamed members, n ‫؍‬ 2) isolates, the assay produced specific products of predicted size without false positives or negatives. Of the 60 soil samples screened, 19 (31.6%) and 29 (48.3%) were positive for B. pseudomallei and the B. cepacia complex, respectively, and in four (6.7%) soil samples, the organisms were codetected. DNA sequencing confirmed that all PCR products originated from their targeted loci. This novel pan-genomic analysis approach in target selection is simple, computationally efficient, and potentially applicable to any species that harbors species-specific genes. A multiplex PCR assay for rapid and accurate identification and detection of B. pseudomallei, B. thailandensis, and the B. cepacia complex was developed and verified.

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confidence: 99%

Novel Pan-Genomic Analysis Approach in Target Selection for Multiplex PCR Identification and Detection of Burkholderia pseudomallei, Burkholderia thailandensis, and Burkholderia cepacia Complex Species: a Proof-of-Concept Study

Lau

Martelli

et al. 2011

J Clin Microbiol

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“…Multiple combination bactericidal testing (MCBT) allows simultaneous testing of the efficacy of double and triple combinations of antibiotics, providing a more rational basis for the treatment of multiresistant infections (1,17). MCBT performed on aerobic, planktonic cultures is currently available to guide therapy for CF and non-CF patients in North America, in several European centers, and in eastern Australia (1,17,22). An international multicenter randomized controlled trial to evaluate the clinical effectiveness of MCBT is in progress.…”

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confidence: 99%

Antibiotic Susceptibilities of Pseudomonas aeruginosa Isolates Derived from Patients with Cystic Fibrosis under Aerobic, Anaerobic, and Biofilm Conditions

et al. 2005

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Recent studies have determined that Pseudomonas aeruginosa can live in a biofilm mode within hypoxic mucus in the airways of patients with cystic fibrosis (CF). P. aeruginosa grown under anaerobic and biofilm conditions may better approximate in vivo growth conditions in the CF airways, and combination antibiotic susceptibility testing of anaerobically and biofilm-grown isolates may be more relevant than traditional susceptibility testing under planktonic aerobic conditions. We tested 16 multidrug-resistant isolates of P. aeruginosa derived from CF patients using multiple combination bactericidal testing to compare the efficacies of double and triple antibiotic combinations against the isolates grown under traditional aerobic planktonic conditions, in planktonic anaerobic conditions, and in biofilm mode. Both anaerobically grown and biofilmgrown bacteria were significantly less susceptible (P < 0.01) to single and combination antibiotics than corresponding aerobic planktonically grown isolates. Furthermore, the antibiotic combinations that were bactericidal under anaerobic conditions were often different from those that were bactericidal against the same organisms grown as biofilms. The most effective combinations under all conditions were colistin (tested at concentrations suitable for nebulization) either alone or in combination with tobramycin (10 g ml ؊1 ), followed by meropenem combined with tobramycin or ciprofloxacin. The findings of this study illustrate that antibiotic sensitivities are dependent on culture conditions and highlight the complexities of choosing appropriate combination therapy for multidrug-resistant P. aeruginosa in the CF lung.

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“…Most CF patients with B. pseudomallei present with pulmonary exacerbations (Table 2), which are indistinguishable from those due to other common CF organisms. Only one patient was reported to have developed severe pulmonary sepsis and died (14), but another five patients presented with acute pulmonary infections and recovered clinically (6,14,18). Most of the described patients have also experienced progressive clinical deterioration after the isolation of B. pseudomallei, although a few have presented no clinical change in the course of the disease (6,14).…”

Section: Case Reportmentioning

confidence: 99%

“…Only one patient was reported to have developed severe pulmonary sepsis and died (14), but another five patients presented with acute pulmonary infections and recovered clinically (6,14,18). Most of the described patients have also experienced progressive clinical deterioration after the isolation of B. pseudomallei, although a few have presented no clinical change in the course of the disease (6,14). In this case report, B. pseudomallei was detected during an episode of clinical exacerbation of the respiratory disease, although one could speculate that this organism might have already been present in the patient's airways.…”

Section: Case Reportmentioning

confidence: 99%

Cystic Fibrosis Patient with Burkholderia pseudomallei Infection Acquired in Brazil

et al. 2007

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Burkholderia pseudomallei: another emerging pathogen in cystic fibrosis

Cited by 68 publications

References 23 publications

Novel Pan-Genomic Analysis Approach in Target Selection for Multiplex PCR Identification and Detection of Burkholderia pseudomallei, Burkholderia thailandensis, and Burkholderia cepacia Complex Species: a Proof-of-Concept Study

Novel Pan-Genomic Analysis Approach in Target Selection for Multiplex PCR Identification and Detection of Burkholderia pseudomallei, Burkholderia thailandensis, and Burkholderia cepacia Complex Species: a Proof-of-Concept Study

Antibiotic Susceptibilities of Pseudomonas aeruginosa Isolates Derived from Patients with Cystic Fibrosis under Aerobic, Anaerobic, and Biofilm Conditions

Cystic Fibrosis Patient with Burkholderia pseudomallei Infection Acquired in Brazil

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