title: Virulence associated with outbreak-related strains of Burkholderia cepacia complex among a cohort of patients with bacteremia.
abstract: The Burkholderia cepacia complex includes 9 genomovars. The relative virulence of each is unknown. Host and pathogen features associated with mortality were evaluated among patients with B. cepacia complex bacteremia. Cases were ascertained through review of blood culture results for the period of May 1996 through May 2002. Isolates were identified to species level with 16S rDNA and recA-based species-specific polymerase chain reaction analyses and recA restriction fragment-length polymorphism. Strain typing was performed with pulsed-field gel electrophoresis. Fifty-three patients with B. cepacia complex bacteremia were identified; only 9 (17%) had cystic fibrosis. Twenty-five patients (47%) died within 14 days of bacteremia. After controlling for comorbid conditions and therapeutic interventions, 2 outbreak-related strains of Burkholderia cenocepacia (genomovar III) were associated with 14-day mortality (odds ratio, 5.5; 95% confidence interval, 1.20-25.02). B. cenocepacia is an emerging nosocomial pathogen. Certain strains are associated with an enhanced capacity for interpatient spread and poor outcome.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA. woods004@mc.duke.edu
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Woods
authors.forename: Adam M
authors.initials: AM
authors.lastname: Bressler
authors.forename: John J
authors.initials: JJ
authors.lastname: LiPuma
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Alexander
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Clements
authors.forename: David J
authors.initials: DJ
authors.lastname: Weber
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Moore
authors.forename: L Barth
authors.initials: LB
authors.lastname: Reller
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000401:mortality / Q000503:physiopathology*; D015373:Bacterial Typing Techniques; D019121:Burkholderia Infections / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D016956:Burkholderia cepacia / Q000145:classification / Q000472:pathogenicity*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012336:RNA, Ribosomal, 16S / Q000032:analysis; D016019:Survival Analysis
chemical_list: D012336:RNA, Ribosomal, 16S