Risk factors for Burkholderia cepacia complex colonization and infection among patients with cystic fibrosis.
OBJECTIVE
To determine risk factors for acquiring Burkholderia cepacia complex among patients with cystic fibrosis (CF).


METHODS
A case-control study was conducted with active surveillance for B cepacia complex colonization/infection among patients at 21 CF centers from April 1986 to March 1989 (study period). A case-patient was defined as any CF patient with B cepacia complex colonization for the first time during the study period. Control patients were patients with CF not B cepacia complex colonized during the study period. For each patient, a questionnaire was completed semiannually.


RESULTS
In multivariate analyses, hospitalization for pulmonary exacerbations, living with a B cepacia complex-positive person, attending a CF summer camp, and direct contact with a B cepacia complex-colonized CF person outside of camp and home were associated with B cepacia complex acquisition. Receiving antimicrobial aerosol therapy or cleaning and drying a home-used nebulizer between uses were associated with a decrease in B cepacia complex acquisition.


CONCLUSIONS
Numerous factors inside and outside the health care setting are associated with person-to-person transmission of B cepacia complex among patients with CF. Prevention programs should reduce direct or indirect contact between noncolonized and B cepacia complex-colonized/infected patients with CF.
Walsh
Nancy Mychalak
NM
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, United States Department of Health and Human Services, Atlanta, Georgia 30333, USA.
Casano
Annelise A
AA
Manangan
Lilia P
LP
Sinkowitz-Cochran
Ronda L
RL
Jarvis
William R
WR
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D019121:Burkholderia Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D016956:Burkholderia cepacia; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009656:North America / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index