title: Epidemiology of Burkholderia cepacia complex species recovered from cystic fibrosis patients: issues related to patient segregation.
abstract: Studies of the prevalence of Burkholderia cepacia complex species amongst cystic fibrosis (CF) patients in different geographical regions, and the association between cross-infection and putative transmissibility markers, will further our understanding of these organisms and help to address infection-control issues. In this study, B. cepacia complex isolates from CF patients in different regions of Europe were analysed. Isolates were examined for B. cepacia complex species and putative transmissibility markers [cable pilin subunit gene (cblA) and the B. cepacia epidemic strain marker (BCESM)]. Sporadic and cross-infective strains were identified by random amplification of polymorphic DNA (RAPD). In total, 79% of patients were infected with Burkholderia cenocepacia (genomovar III), 18% with Burkholderia multivorans (genomovar II) and less than 5% of patients with B. cepacia (genomovar I), Burkholderia stabilis (genomovar IV) or Burkholderia vietnamiensis (genomovar V). The cblA and BCESM transmissibility markers were only detected in strains of B. cenocepacia. The BCESM was a more sensitive marker for transmissible B. cenocepacia strains than cblA, although sporadic B. cenocepacia strains containing the BCESM, but lacking cblA, were also observed. Furthermore, clusters of cross-infection with transmissibility marker-negative strains of B. multivorans were identified. In conclusion, B. cenocepacia was the greatest cause of cross-infection, and the most widely distributed B. cepacia complex species, within these CF populations. However, cross-infection was not exclusive to B. cenocepacia and cblA and the BCESM were not absolute markers for transmissible B. cenocepacia, or other B. cepacia complex strains. It is therefore suggested that CF centres cohort patients based on the presence or absence of B. cepacia complex infection and not on the basis of transmissibility marker-positive B. cenocepacia as previously suggested.
authors.affiliation: Department of Bacteriology, Northern Ireland Public Health Laboratory1 and Northern Ireland Regional Adult Cystic Fibrosis Centre3, Belfast City Hospital, Belfast BT9 7AB, UK 2Cardiff School of Biosciences, Cardiff University, Cardiff CF1 3US, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: McDowell
authors.affiliation: Department of Bacteriology, Northern Ireland Public Health Laboratory1 and Northern Ireland Regional Adult Cystic Fibrosis Centre3, Belfast City Hospital, Belfast BT9 7AB, UK 2Cardiff School of Biosciences, Cardiff University, Cardiff CF1 3US, UK.
authors.forename: Eshwar
authors.initials: E
authors.lastname: Mahenthiralingam
authors.affiliation: Department of Bacteriology, Northern Ireland Public Health Laboratory1 and Northern Ireland Regional Adult Cystic Fibrosis Centre3, Belfast City Hospital, Belfast BT9 7AB, UK 2Cardiff School of Biosciences, Cardiff University, Cardiff CF1 3US, UK.
authors.forename: Kerstin E A
authors.initials: KEA
authors.lastname: Dunbar
authors.affiliation: Department of Bacteriology, Northern Ireland Public Health Laboratory1 and Northern Ireland Regional Adult Cystic Fibrosis Centre3, Belfast City Hospital, Belfast BT9 7AB, UK 2Cardiff School of Biosciences, Cardiff University, Cardiff CF1 3US, UK.
authors.forename: John E
authors.initials: JE
authors.lastname: Moore
authors.affiliation: Department of Bacteriology, Northern Ireland Public Health Laboratory1 and Northern Ireland Regional Adult Cystic Fibrosis Centre3, Belfast City Hospital, Belfast BT9 7AB, UK 2Cardiff School of Biosciences, Cardiff University, Cardiff CF1 3US, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Crowe
authors.affiliation: Department of Bacteriology, Northern Ireland Public Health Laboratory1 and Northern Ireland Regional Adult Cystic Fibrosis Centre3, Belfast City Hospital, Belfast BT9 7AB, UK 2Cardiff School of Biosciences, Cardiff University, Cardiff CF1 3US, UK.
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Elborn
mesh_terms: D015373:Bacterial Typing Techniques; D015415:Biomarkers / Q000032:analysis; D019117:Burkholderia / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D019121:Burkholderia Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D003550:Cystic Fibrosis / Q000150:complications*; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000032:analysis / Q000302:isolation & purification / Q000378:metabolism; D015252:Deoxyribonucleases, Type II Site-Specific / Q000378:metabolism; D005060:Europe / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D017720:Molecular Epidemiology; D012150:Polymorphism, Restriction Fragment Length; D019105:Random Amplified Polymorphic DNA Technique; D013183:Sputum / Q000382:microbiology
chemical_list: D015415:Biomarkers; D004269:DNA, Bacterial; C056436:endodeoxyribonuclease SpeI; D015252:Deoxyribonucleases, Type II Site-Specific