Burkholderia cepacia in cystic fibrosis: novel Australian cluster strain without accelerated respiratory deterioration.
OBJECTIVE
To determine whether 4 years of colonization with a novel Australian cluster strain (The 'Hunter' strain) of Burkholderia cepacia (B. cepacia) in cystic fibrosis (CF) patients was associated with more rapid decline in nutritional status and pulmonary function than in non-colonized contemporaries from the same CF clinic.


METHODS
A retrospective review of respiratory function and nutritional data from a single multidisciplinary paediatric CF clinic over 4 years (1993-97).


RESULTS
Paired spirometry data for 1993 and 1997 were available in 47 patients without (n = 31) and with B. cepacia (n = 16) colonization (mean (+/- SD) ages in 1993: 12.1 years +/- 4.0 vs 12.6 years +/- 6.5; P = 0.83). Their percentage predicted forced expiratory volume in 1 s (FEV1) (94.2% +/- 16.7 vs 85.9% +/- 21.2; P = 0.19) were not significantly different. The averaged annual fall in FEV1 over 4 years was also not significantly different (3.8% +/- 3.8 vs 3.6% +/- 3.7; P = 0.82). Weight percentile (Wt%), height percentile (Ht%) and percentage age weight for height (%WFH) were not significantly different between groups in 1993. By 1997, Wt% (36.7% +/- 25.1 vs 22.3% +/- 19.6; P = 0.04) and Ht% (42.5% +/- 29.6 vs 17.6% +/- 19.4; P = 0.002) but not %WFH (102% +/- 10.0 vs 106% +/- 11.2; P > 0.10) were lower in subjects with B. cepacia.


CONCLUSIONS
In adolescent CF patients, colonization with the Hunter strain of B. cepacia was associated with a deterioration in some nutritional parameters but not with an accelerated decline in FEV1 over 4 years. As varying pathogenicity of B. cepacia strains may account for differing rates of pulmonary decline, further assessment of the consequences of colonization with certain strains of B. cepacia in CF is needed.
Fitzgerald
D A
DA
Department of Respiratory Medicine, John Hunter Children's Hospital, Newcastle, New South Wales, Australia. dominif2@chw.edu.au
Cooper
D M
DM
Paul
M
M
Tiley
S
S
Kado
J
J
Cordwell
J
J
Collins
C
C
D000293:Adolescent; D016956:Burkholderia cepacia / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity; D002648:Child; D003550:Cystic Fibrosis / Q000382:microbiology* / Q000503:physiopathology; D005541:Forced Expiratory Volume; D006801:Humans; D009517:New South Wales; D015596:Nutrition Assessment; D012131:Respiratory Insufficiency / Q000382:microbiology* / Q000503:physiopathology; D012189:Retrospective Studies