title: Incidence of Burkholderia contaminans at a cystic fibrosis centre with an unusually high representation of Burkholderia cepacia during 15 years of epidemiological surveillance.
abstract: The Burkholderia cepacia complex (Bcc) is a heterogeneous group of bacteria comprising around 20 related species. These bacteria are important opportunistic pathogens, especially in cystic fibrosis (CF) patients, and are associated with a worse prognosis and decreased life expectancy. The taxonomic position of 20 Bcc isolates retrieved from CF patients receiving care at Hospital Santa Maria (HSM), in Lisbon, from 1995 to 2006, was re-examined in the present work. These isolates, formerly classified as Burkholderia cepacia (taxon K), are here reclassified as Burkholderia contaminans, including the former B. cepacia IST408, which was the focus of previous studies regarding the biosynthesis of the exopolysaccharide 'cepacian'. The CF population examined has been previously described as having an exceptionally high representation of B. cepacia, presumably due to a contamination arising from saline solutions for nasal application. Twenty-one additional isolates, obtained from a chronically infected patient, from 2006 to 2010, were also identified as B. contaminans. This study also provides insight into the potential clinical impact of B. contaminans, a species that is rarely associated with CF infections. Isolates belonging to this species were shown to be involved in chronic and transient respiratory infections, and were associated with severe lung function deterioration and with a case of death with cepacia syndrome. However, since the patients were co-infected with Burkholderia cenocepacia and other non-Burkholderia bacteria, the role played by B. contaminans is unclear. Nevertheless, B. contaminans isolates were found to prevail over B. cenocepacia isolates during co-infection of at least one chronically infected patient.
authors.affiliation: iBB-Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal.
authors.forename: Carla P
authors.initials: CP
authors.lastname: Coutinho
authors.affiliation: Cystic Fibrosis Center, Department of Paediatrics, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: Celeste
authors.initials: C
authors.lastname: Barreto
authors.affiliation: Cystic Fibrosis Center, Department of Paediatrics, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: Luísa
authors.initials: L
authors.lastname: Pereira
authors.affiliation: Laboratório de Patologia Clínica, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Lito
authors.affiliation: Laboratório de Patologia Clínica, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Melo Cristino
authors.affiliation: iBB-Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sá-Correia
mesh_terms: D019121:Burkholderia Infections / Q000453:epidemiology* / Q000382:microbiology*; D042602:Burkholderia cepacia complex / Q000145:classification* / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D062665:Epidemiological Monitoring; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011174:Portugal / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D012189:Retrospective Studies