title: Epidemic spread of Pandoraea pulmonicola in a cystic fibrosis center.
abstract: BACKGROUND
  Pandoraea spp. are recently discovered bacteria, mainly recovered from cystic fibrosis (CF) patients, but their epidemiology and clinical significance are not well known. We describe an epidemic spread of Pandoraea pulmonicola from 2009 in our CF center, involving 6 out of 243 CF patients.
  
  
  METHODS
  Bacterial identification used amplified ribosomal DNA restriction analysis (ARDRA), MALDI-TOF mass spectrometry (MALDI-TOF MS) and 16S rDNA gene sequencing. The clonal link between strains was assessed with pulsed field gel electrophoresis (PFGE) using XbaI. Clinical data were gathered for all patients.
  
  
  RESULTS
  The index case was chronically colonized since 2000. The main hypothesis for this bacterial spread was a droplet cross-transmission, due to preventive measures not being strictly followed. Antibiotic susceptibility testing revealed resistance to beta-lactams, ciprofloxacin and colistin. However, there was susceptibility to trimethoprim-sulfamethoxazole. All patients were chronically colonized with Pseudomonas aeruginosa, and the acquisition of P. pulmonicola resulted in chronic colonization in all patients. Three patients died, and two patients remained clinically stable, whereas one patient had a decline in lung function.
  
  
  CONCLUSIONS
  This study, which is the first to describe an epidemic spread of P. pulmonicola, notes the potential transmissibility of this bacterial species and the need for infection control measures.
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital Archet II, Nice, France. degand.n@chu-nice.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Degand
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital Archet II, Nice, France. lotte.r@chu-nice.fr.|INSERM 1065-Centre Méditerranéen de Médecine moléculaire, « Toxines microbiennes dans la relation hôte-agents pathogènes », Bâtiment Universitaire Archimed, Nice, France. lotte.r@chu-nice.fr.|Faculté de Médicine, Université de Nice Sophia-Antipolis, Nice, France. lotte.r@chu-nice.fr.
authors.forename: Romain
authors.initials: R
authors.lastname: Lotte
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital Archet II, Nice, France. decondelebutor.c@chu-nice.fr.
authors.forename: Célia
authors.initials: C
authors.lastname: Decondé Le Butor
authors.affiliation: Observatoire Burkholderia cepacia, Laboratoire de Bactériologie, Hôpital Purpan, Toulouse, France. segonds.c@chu-toulouse.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Segonds
authors.affiliation: Laboratoire de Bactériologie, Hôpital Jean Minjoz, Besançon, France. mthouverez@chu-besancon.fr.
authors.forename: Michelle
authors.initials: M
authors.lastname: Thouverez
authors.affiliation: Laboratoire de Bactériologie, Hôpital Necker-Enfants Malades, Paris, France. agnes.ferroni@nck.aphp.fr.
authors.forename: Agnès
authors.initials: A
authors.lastname: Ferroni
authors.affiliation: CRCM, Hôpital Renée Sabran, Giens, France. christine.vallier@chu-lyon.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Vallier
authors.affiliation: CRCM, Hôpital Renée Sabran, Giens, France. laurent.mely@chu-lyon.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Mély
authors.affiliation: Laboratoire de Biologie, Hôpital Renée Sabran, Giens, France. jackycarrere@orange.fr.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Carrère
mesh_terms: D000293:Adolescent; D000328:Adult; D042521:Burkholderiaceae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics / Q000378:metabolism; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000635:transmission*; D006801:Humans; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D015183:Restriction Mapping; D017422:Sequence Analysis, DNA; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S; D015662:Trimethoprim, Sulfamethoxazole Drug Combination