Improved cultural detection of Burkholderia cepacia from sputum in patients with cystic fibrosis

Abstract

Aims-To evaluate the sensitivity and specificity of two selective media for the isolation of Burkholderia cepacia from sputum specimens in patients with cystic fibrosis (CF). Methods-In total, 149 expectorated sputum specimens from 113 patients with CF (32 cepacia colonised patients and 81 noncepacia colonised patients) attending three CF centres were examined for the presence of B cepacia on two selective media: (1) MAST selective agar, a commercially available selective medium widely used in the UK and (2) BCSA (B cepacia selective agar), a new medium recently described, which is used predominantly in North America. Results-Burkholderia cepacia was isolated from 53 of 149 (35.6%) specimens examined, representing 32 of 113 (28.3%) patients, using both the MAST and BCSA media. Growth was most rapid on BCSA with all (53 of 53) isolates detectable after 48 hours, compared with 50 of the 53 isolates on MAST agar, with the remaining three isolates detectable at five days. Twenty eight contaminants were identified on MAST agar and 13 on BCSA agar; mainly Alcaligenes xylosoxidans and yeast on MAST agar and Flavobacterium indologenes on BCSA medium. BCSA was equivalent to MAST agar in its ability to isolate B cepacia from patients with CF with a history of B cepacia infection. Conclusions-The increased selectivity and reduced time to detection of BCSA makes it an attractive alternative to MAST. However, its present limited commercial availability in the UK may delay its use in routine diagnostic laboratories because of complications with media preparation and quality control. (J Clin Pathol 2001;54:803-805)

Characterization of clinically isolated Ralstonia mannitolilytica strains using random amplification of polymorphic DNA (RAPD) typing and antimicrobial sensitivity, and comparison of the classification efficacy of phenotypic and genotypic assays

“…In addition to Burkholderia species, growth on Burkholderia cepacia selective agar (BCSA) has essentially been described for Pseudomonas species, Flavobacterium indologenes, A. xylosoxidans and yeasts, but growth of these organisms was only observed in a minority of isolates (Henry et al, 1997(Henry et al, , 1999Wright et al, 2001). Growth of R. pickettii on this medium has been described previously, but this has not previously been studied for R. mannitolilytica.…”

Screening of photochemically grafted polymer films for compatibility with osteogenic precursor cells

“…Due to the high transmissibility of some Burkholderia cepacia complex species and their association with a poor prognosis, the use of isolation media with enhanced recovery rate for this organism are striktly recommended (e.g. MAST selective agar, Burkholderia cepacia selective agar, Pseudomonas cepacia agar, oxidation-fermentation polymyxin bacitracin lactose agar, Stewart's composite arginine medium) [16][17][18][19]. To ensure the reliable recovery of S. aureus, mannitol salt agar or other media have been used (e.g.…”

“…During chronic stages of CF pneumonia microbiological examinations are complicated by the fact that respiratory samples obtained from CF patients often contain a mixture of different species and/or high quantities of diverse morphotypes and resistotypes, such as mucoid and non-mucoid P. aeruginosa, biochemical inactive, small colony, hypermutable and multidrug resistant (MDR) variants of pathogens that persisted for years [3,13,14].Cultures performed on CF specimens commonly involve the use of many medium types, in particular selective media that facilitate the recovery of potential pathogens such as S. aureus, P. aeruginosa and B. cepacia complex from the complex microflora of CF airway secretions [15][16][17][18]. Therefore, the microbiological diagnosis of CF respiratory tract infections is labor-intensive and implies a wide experience in the field of CF microbiology.…”

A German external quality survey of diagnostic microbiology of respiratory tract infections in patients with cystic fibrosis

“…Cultures performed on CF specimens commonly involve the use of many medium types, in particular selective media that facilitate the recovery of potential pathogens such as S. aureus, P. aeruginosa and B. cepacia complex from the complex microflora of CF airway secretions [15][16][17][18][19]. Therefore, the microbiological diagnosis of CF respiratory tract infections is labor-intensive and implies a wide experience in the field of CF microbiology.…”