title: Burkholderia gladioli: five year experience in a cystic fibrosis and lung transplantation center.
abstract: 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.
authors.affiliation: Department of Pulmonary Medicine, Unit 403, M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. mpkenned@mdanderson.org
authors.forename: Marcus P
authors.initials: MP
authors.lastname: Kennedy
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Coakley
authors.forename: Scott H
authors.initials: SH
authors.lastname: Donaldson
authors.forename: Robert M
authors.initials: RM
authors.lastname: Aris
authors.forename: Kathy
authors.initials: K
authors.lastname: Hohneker
authors.forename: Joel P
authors.initials: JP
authors.lastname: Wedd
authors.forename: Michael R
authors.initials: MR
authors.lastname: Knowles
authors.forename: Peter H
authors.initials: PH
authors.lastname: Gilligan
authors.forename: James R
authors.initials: JR
authors.lastname: Yankaskas
mesh_terms: 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