Eur Respir J 2001; 17:295-301
Copyright ©ERS Journals Ltd 2001
Burkholderia cepacia: current clinical issues, environmental controversies and ethical dilemmas
A.M. Jones,
M.E. Dodd and
A.K. Webb
Manchester Adult Cystic Fibrosis Unit, Wythenshawe Hospital, Southmoor
Road, Manchester, UK
CORRESPONDENCE: A.K. Webb, Manchester Adult Cystic Fibrosis Unit, Wythenshawe Hospital,
Southmoor Road, Manchester, UK. Fax: 44 1612912080
Keywords: agricultural industry, Burkholderia cepacia, cystic fibrosis, petrochemical industry, pulmonary
colonisation
Received: April 5, 2000
Accepted April 27, 2000
Abstract
Burkholderia cepacia is a plant phytogen and is known as a hardy
and versatile organism.
Over the past two decades it has emerged as a pathogen in the cystic fibrosis (CF)
community, with devastating effects. Pulmonary colonisation can lead to an
accelerated decline in lung function. In some cases, it causes a rapid and
progressive pneumonic illness termed "cepacia syndrome",
which is untreatable and fatal.
B. cepacia is inherently resistant to multiple antibiotics and
highly transmissible and virulent strains have been identified. CF patients
colonised with the organism have to be segregated from their peers to try
to prevent cross-infection.
However, the pathogenicity of B. cepacia is not limited to CF.
Other groups, such as individuals with chronic granulomatous disease and immunocompromised
patients are vulnerable and it has caused disease in healthy individuals.
However, the agricultural and petrochemical industries are attempting to exploit
properties of B. cepacia for use as a biopesticide and biodegradation
agent.
This article provides an up to date review of clinically based literature
on the Burkholderia cepacia complex, highlighting clinical management
issues for both cystic fibrosis and non-cystic fibrosis patients. The
article also addresses the potential conflict between medicine and agriculture
on plans to reintroduce strains of Burkholderia cepacia back into
the environment.
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Copyright © 2001 by the European Respiratory Society.
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