title: Infection with Burkholderia cepacia complex genomovars in patients with cystic fibrosis: virulent transmissible strains of genomovar III can replace Burkholderia multivorans.
abstract: Infection with Burkholderia cepacia complex in patients with cystic fibrosis (CF) results in highly variable clinical outcomes. The purpose of this study was to determine if there are genomovar-specific disparities in transmission and disease severity. B. cepacia complex was recovered from 62 patients with CF on > or =1 occasions (genomovar III, 46 patients; genomovar II [B. multivorans], 19 patients; genomovar IV [B. stabilis], 1 patient; genomovar V [B. vietnamiensis], 1 patient; and an unclassified B. cepacia complex strain, 1 patient). Patient-to-patient spread was observed with B. cepacia genomovar III, but not with B. multivorans. Genomovar III strains replaced B. multivorans in 6 patients. Genomovar III strains were also associated with a poor clinical course and high mortality. Infection control practices should be designed with knowledge about B. cepacia complex genomovar status; patients infected with transmissible genomovar III strains should not be cohorted with patients infected with B. multivorans and other B. cepacia genomovars.
authors.affiliation: Department of Pediatrics, University of British Columbia and British Columbia's Children's Hospital, British Columbia's Research Institute for Children's and Women's Health, Vancouver, British Columbia, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Mahenthiralingam
authors.forename: P
authors.initials: P
authors.lastname: Vandamme
authors.forename: M E
authors.initials: ME
authors.lastname: Campbell
authors.forename: D A
authors.initials: DA
authors.lastname: Henry
authors.forename: A M
authors.initials: AM
authors.lastname: Gravelle
authors.forename: L T
authors.initials: LT
authors.lastname: Wong
authors.forename: A G
authors.initials: AG
authors.lastname: Davidson
authors.forename: P G
authors.initials: PG
authors.lastname: Wilcox
authors.forename: B
authors.initials: B
authors.lastname: Nakielna
authors.forename: D P
authors.initials: DP
authors.lastname: Speert
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D019117:Burkholderia / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D019121:Burkholderia Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality / Q000635:transmission; D016956:Burkholderia cepacia / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D006801:Humans; D015995:Prevalence; D014774:Virulence