title: Fatal outcome of lung transplantation in cystic fibrosis patients due to small-colony variants of the Burkholderia cepacia complex.
abstract: The aim of this study was to investigate the possible role of small-colony variant morphotypes of Burkholderia cepacia-like organisms in infectious complications in cystic fibrosis patients following lung transplantation. Respiratory tract specimens from 470 cystic fibrosis patients were screened over a 22-month period for Burkholderia cepacia-like organisms. Nineteen patients were positive for these organisms, eight of whom harboured small-colony-variant morphotypes. Three patients underwent bilateral lung transplantation during the study, two of whom harboured small-colony variants in addition to clonally identical wildtypes of Burkholderia multivorans and Burkholderia cepacia genomovar III prior to lung transplantation. Both patients developed fatal systemic infections post transplantation due to small-colony variants. In vitro testing revealed that small-colony variants exhibited increased serum resistance in comparison to wildtypes. The results of this study indicate that diagnostic efforts should be undertaken to carefully identify small-colony variants of Burkholderia cepacia complex, since they might be an indicator of poor post-transplantation outcome in patients with cystic fibrosis.
authors.affiliation: Institut für Medizinische Mikrobiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Häussler
authors.forename: C
authors.initials: C
authors.lastname: Lehmann
authors.forename: C
authors.initials: C
authors.lastname: Breselge
authors.forename: M
authors.initials: M
authors.lastname: Rohde
authors.forename: M
authors.initials: M
authors.lastname: Classen
authors.forename: B
authors.initials: B
authors.lastname: Tümmler
authors.forename: P
authors.initials: P
authors.lastname: Vandamme
authors.forename: I
authors.initials: I
authors.lastname: Steinmetz
mesh_terms: D000293:Adolescent; D000328:Adult; D001770:Blood Bactericidal Activity; D019121:Burkholderia Infections / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality*; D016956:Burkholderia cepacia / Q000145:classification* / Q000254:growth & development / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D012137:Respiratory System / Q000382:microbiology