Burkholderia gladioli: five year experience in a cystic fibrosis and lung transplantation center.
BACKGROUND
The impact of infection with Burkholderia gladioli in cystic fibrosis, other chronic airway diseases and immunosuppressed patients is unknown.


METHODS
A six-year retrospective review of all patients with B. gladioli infection was performed in a tertiary referral center with cystic fibrosis and lung transplantation programs. In addition, a targeted survey of all 251 lung transplant recipients was performed. Available B. gladioli isolates were analyzed via pulsed field gel electrophoresis.


RESULTS
Thirty-five patients were culture positive for B. gladioli, including 33 CF patients. No bacteremia was identified. Isolates were available in 18 patients and all were genetically distinct. Two-thirds of these isolates were susceptible to usual anti-pseudomonal antibiotics. After acquisition, only 40% of CF patients were chronically infected (> or =2 positive cultures separated by at least 6 months). Chronic infection was associated with resistance to > or =2 antibiotic groups on initial culture and failure of eradication after antibiotic therapy. The impact of acquisition of B. gladioli infection in chronic infection was variable. Three CF patients with chronic infection underwent lung transplantation. One post-transplant patient developed a B. gladioli mediastinal abscess, which was treated successfully.


CONCLUSIONS
The majority of patients' culture positive for B. gladioli at our center have CF. B. gladioli infection is often transient and is compatible with satisfactory post-lung transplantation outcomes.
Kennedy
Marcus P
MP
Department of Pulmonary Medicine, Unit 403, M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. mpkenned@mdanderson.org
Coakley
Raymond D
RD
Donaldson
Scott H
SH
Aris
Robert M
RM
Hohneker
Kathy
K
Wedd
Joel P
JP
Knowles
Michael R
MR
Gilligan
Peter H
PH
Yankaskas
James R
JR
D000293:Adolescent; D000328:Adult; D019121:Burkholderia Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D042725:Burkholderia gladioli / Q000302:isolation & purification*; D002648:Child; D003428:Cross Infection / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D003550:Cystic Fibrosis / Q000150:complications* / Q000601:surgery; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation; D008297:Male; D012124:Respiratory Care Units / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology