Revised Approach for Identification of Isolates within the
            <i>Burkholderia cepacia</i>
            Complex and Description of Clinical Isolates Not Assigned to Any of the Known Genomovars

Turton, Jane F.; Arif, Nazia; Hennessy, Daneeta; Kaufmann, Mary E.; Pitt, T. L.

doi:10.1128/jcm.00976-07

Cited by 15 publications

(8 citation statements)

References 20 publications

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“…These results further underscore the need for a new, more accurate practical method for examining clinical specimens. Similar ambiguous results using conventional testing protocols have been observed recently by another laboratory (31). In this case, the cable pilus gene was used as an additional molecular marker for the ET12 lineage to further differentiate BCC isolates grouped by recA cluster analysis.…”

Section: Discussionsupporting

confidence: 77%

Development of a Species-Specific fur Gene-Based Method for Identification of the Burkholderia cepacia Complex

Lynch

Dennis

2008

J Clin Microbiol

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Burkholderia is an important bacterial genus with a complex taxonomy that contains species of both ecological and pathogenic importance, including nine closely related species collectively termed the Burkholderia cepacia complex (BCC). Unfortunately, 16S rRNA gene analysis has proven to be not sensitive enough to discriminate between species of the BCC. Alternative species identification strategies such as recA-based PCR followed by restriction fragment length polymorphism analysis, although initially useful, have proven to be inaccurate with the increasing species diversity of the BCC. recA gene sequence analysis is more discriminatory and corroborates other biochemical and polyphasic means of taxonomic differentiation. However, it is limited by the fact that certain BCC species are subdivided into discrete recA sequence subgroups that may confuse clinical diagnoses. In this study, an effective approach is described for the rapid differentiation of BCC species from both environmental and clinical sources by means of a single-locus sequencing and PCR assay using fur as a target gene that provides sequence phylogenies that are species specific and, with few exceptions, not divided into subspecies clusters. This assay is specific and can be used to correctly determine the species status of BCC strains tested following sequencing and amplification of the fur gene by both general and speciesspecific primers. Based on our results, this typing strategy is simpler than and as sensitive as established tests currently in use clinically. This assay is useful for the rapid, definitive identification of all nine current BCC species and potentially novel species groups.

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Section: Discussionsupporting

confidence: 77%

Development of a Species-Specific fur Gene-Based Method for Identification of the Burkholderia cepacia Complex

Lynch

Dennis

2008

J Clin Microbiol

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“…Within the Bcc, there are nine recognized species or genomovars (genomovar I to IX), of which some are further divided into phylogenetic lineages (i.e., genomovar IIIA to IIID). B. multivorans and B. cenocepacia (particularly genomovars IIIA and IIIB) account for the majority of isolates cultured from CF patients (24). Furthermore, it is the ET12 strain of genomovar IIIA that is most associated with high transmissibility and mortality rates (21).…”

Section: Discussionmentioning

confidence: 99%

Identification of Potential Diagnostic Markers among Burkholderia cenocepacia and B. multivorans Supernatants

Mott¹,

Soler²,

Grigsby³

et al. 2010

J Clin Microbiol

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Patients with cystic fibrosis (CF) are susceptible to chronic respiratory infections with a number of bacterial pathogens. Among them, the Burkholderia cepacia complex (Bcc) bacteria, consisting of nine related species, have emerged as problematic CF pathogens due to their antibiotic resistance, incidence of nosocomial infection, and person-to-person transmission. Bcc organisms present the clinical microbiologist with a diagnostic dilemma due to the lack of phenotypic biochemical or growth-related characterization tests that reliably distinguish among these organisms. The complex taxonomy of the Bcc species colonizing the CF respiratory tract makes accurate identification problematic. Despite the clinical implications of Bcc identification, a clinical laboratory differentiation of species within the Bcc is lacking. Additionally, no commercial assays are available to further identify the Bcc species. In the current study, secretory proteins present in the cultured supernatants of Burkholderia cenocepacia and Burkholderia multivorans were analyzed by two-dimensional gel electrophoresis (2-DE), followed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). To assess differential expression, protein spots of B. cenocepacia and B. multivorans that were unique or displayed different intensities were chosen for MALDI-TOF MS analysis. In total, 341 protein spots were detected, of which 23 were unique to each species, demonstrating that potential diagnostic candidates between these two members of the Bcc exist.The Burkholderia cepacia complex (Bcc) consists of nine genetically distinct but phenotypically similar Gram-negative bacilli distinguished by their role as important agents of pulmonary disease in cystic fibrosis (CF) patients (12, 16). Associated with increased morbidity and mortality, Bcc bacteria make eradication very difficult due to their ability to establish infection and maintain chronic colonization in the CF lung (6,9,18,22). Furthermore, these organisms are capable of person-to-person spread, presenting the threat of nosocomial acquired infection. Highly variable and unpredictable, clinical outcomes of Bcc infection range from asymptomatic carriage to bacteremic disease and death (12). This variation is speculated to be the result of genomovar heterogeneity and differential expression of a virulence factor(s) during Bcc infection. Although all species of the Bcc have been recovered from CF patients, Burkholderia cenocepacia and Burkholderia multivorans are the most prevalent, accounting for 85% of pulmonary infections (16).Establishing accurate methods of Bcc identification is paramount for the implementation of infection control measures and appropriate treatment of infected and/or exposed CF patients. Furthermore, species identification within the Bcc is vital not only for surgical and clinical management of CF patients but also for the elucidation of the group's epidemiology. Bcc organisms present clinical microbiologists with a diagnostic dilemma due to the l...

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“…The molecular taxonomic analyses placed different B. cepacia strains into groups known as genomovars. Although genotypic identification with molecular tests is more accurate for definitive identification, a few genomovars can be excluded according to the phenotypic characteristics [17]. As this study was a retrospective analysis and the cases were not cummulative, we could not identify genomovars of B. cepacia strains.…”

Section: Discussionmentioning

confidence: 94%

Nosocomial Burkholderia cepacia infections in a Turkish university hospital: a five-year surveillance

Dizbay

Tunçcan

Sezer

et al. 2009

J Infect Dev Ctries

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Background: Burkholderia cepacia has the potential to cause fatal infections in ICUs, and multidrug resistance makes them a serious threat in hospital settings. The aim of this study was to evaluate the epidemiology of B. cepacia infections in our hospital. Methodology: The incidence, clinical characteristics, antimicrobial susceptibility, and outcomes of nosocomial B. cepacia infections during a five-year period were retrospectively analysed according to the infection control committee records. Results: A total of 39 cases with nosocomial B. cepacia infection were included in the study. B. cepacia was identified from 0.7% of the nosocomial isolates. Its incidence was 0.26 per 1,000 admissions with 53.8% crude mortality rate. The most frequent nosocomial B. cepacia infection was pneumonia (58.9%), followed by bloodstream infections (25.6%), surgical site infections (7.6%), urinary tract infections, (5.1%), and skin-soft tissue infections (2.5%). Nosocomial B. cepacia infections were most commonly observed in intensive care units (61.5%). The most active antimicrobial agents were piperacillin-tazobactam, cefoperazone-sulbactam, and carbapenems. Conclusions: The incidence of nosocomial B. cepacia infections was rare in our hospital, and no outbreak was detected during the study period. However, infections caused by B. cepacia should be taken into consideration because of their high mortality due to multidrug resistance in ICU settings.

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Revised Approach for Identification of Isolates within the Burkholderia cepacia Complex and Description of Clinical Isolates Not Assigned to Any of the Known Genomovars

Cited by 15 publications

References 20 publications

Development of a Species-Specific fur Gene-Based Method for Identification of the Burkholderia cepacia Complex

Development of a Species-Specific fur Gene-Based Method for Identification of the Burkholderia cepacia Complex

Identification of Potential Diagnostic Markers among Burkholderia cenocepacia and B. multivorans Supernatants

Nosocomial Burkholderia cepacia infections in a Turkish university hospital: a five-year surveillance

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