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Epidemiology of Burkholderia cepacia complex colonisation in cystic fibrosis patients

¹ University Hospital Gasthuisberg, Leuven, ² Academisch Ziekenhuis, Vrije Universiteit Brussels, Brussels, ³ St. Vincentiusziekenhuis, Antwerpen, ⁴ Université Catholique de Louvain, Brussels, ⁵ Hôpital Erasme, Brussels, ⁶ Ghent University, Gent, Belgium. ⁷ University of Edinburgh, Edinburgh, UK

CORRESPONDENCE: K. De Boeck, Dept Pediatric Pulmonology, University of Leuven, Herestraat 49, 3000 Leuven, Belgium. Fax: 32 16343842. E-mail:christiane.deboeck@uz.kuleuven.ac.be

Keywords: Burkholderia cepacia complex, cystic fibrosis, epidemiology, lung infection, microbiology

Received: October 23, 2003
Accepted February 4, 2004

P. Vandamme is indebted to the Fund for Scientific Research-Flanders for financial support.

In Belgian cystic fibrosis (CF) clinics, sputum samples are evaluated on selective MAST medium routinely every 3 months. In this study, in 1993 and 1999, isolates were further examined by recA restriction fragment length polymorphism analysis and pulsed-field gel electrophoresis of genomic DNA restricted with SpeI.

In 1993, 12 patients were colonised with Burkholderia cepacia complex (Bcc): B. cenocepacia (n=6), B. multivorans (n=3), B. stabilis (n=3). Four patients were colonised with the same B. cenocepacia strain; two with the same B. stabilis strain. After 5 yrs, three B. cenocepacia- and one B. multivorans-colonised patients had died.

In 1999, Bcc was isolated in 12 patients: B. multivorans (n=9), B. stabilis (n=1) and B. cenocepacia (n=2). Three patients were colonised by the same B. multivorans strain. Compared to matched controls, the 5 yr outcome was poor; four B. cepacia patients died and none of the control patients died. Lung-function evolution was poor.

In conclusion, the rate of colonisation in Belgian cystic fibrosis patients is stable and low. Burkholderia cenocepacia was most prevalent in 1993; Burkholderia multivorans in 1999. The cross-infection rate is low. Three patients had transient colonisation. The impact of Burkholderia cepacia complex on morbidity in the Belgian cystic fibrosis population is high and not limited to Burkholderia cenocepacia.

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