title: Risk factors for Burkholderia cepacia complex colonization and infection among patients with cystic fibrosis.
abstract: 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.
authors.affiliation: 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.
authors.forename: Nancy Mychalak
authors.initials: NM
authors.lastname: Walsh
authors.forename: Annelise A
authors.initials: AA
authors.lastname: Casano
authors.forename: Lilia P
authors.initials: LP
authors.lastname: Manangan
authors.forename: Ronda L
authors.initials: RL
authors.lastname: Sinkowitz-Cochran
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
mesh_terms: 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