title: Burkholderia cepacia complex in Serbian patients with cystic fibrosis: prevalence and molecular epidemiology.
abstract: The Burkholderia cepacia complex (Bcc) organisms remain significant pathogens in patients with cystic fibrosis (CF). This study was performed to evaluate the prevalence, epidemiological characteristics, and presence of molecular markers associated with virulence and transmissibility of the Bcc strains in the National CF Centre in Belgrade, Serbia. The Bcc isolates collected during the four-year study period (2010-2013) were further examined by 16 s rRNA gene, pulsed-field gel electrophoresis of genomic DNA, multilocus sequence typing analysis, and phylogenetic analysis based on concatenated sequence of seven alleles. Fifty out of 184 patients (27.2 %) were colonized with two Bcc species, B. cenocepacia (n = 49) and B. stabilis (n = 1). Thirty-four patients (18.5 %) had chronic colonization. Typing methods revealed a high level of similarity among Bcc isolates, indicating a person-to-person transmission or acquisition from a common source. New sequence types (STs) were identified, and none of the STs with an international distribution were found. One centre-specific ST, B. cenocepacia ST856, was highly dominant and shared by 48/50 (96 %) patients colonized by Bcc. This clone was characterized by PCR positivity for both the B. cepacia epidemic strain marker and cable pilin, and showed close genetic relatedness to the epidemic strain CZ1 (ST32). These results indicate that the impact of Bcc on airway colonization in the Serbian CF population is high and virtually exclusively limited to a single clone of B. cenocepacia. The presence of a highly transmissible clone and probable patient-to-patient spread was observed.
authors.affiliation: Department of Clinical Microbiology, Mother and Child Health Care Institute of Serbia "Dr. Vukan Cupic", Radoja Dakica 8, 11070, Belgrade, Serbia. zorica.vasiljevic@gmail.com.
authors.forename: Z V
authors.initials: ZV
authors.lastname: Vasiljevic
authors.affiliation: Laboratory for Molecular Microbiology, Institute of Molecular Genetics and Genetic Engineering, Vojvode Stepe 444a, P.O. Box 23, 11010, Belgrade, Serbia.
authors.forename: K
authors.initials: K
authors.lastname: Novovic
authors.affiliation: Laboratory for Molecular Microbiology, Institute of Molecular Genetics and Genetic Engineering, Vojvode Stepe 444a, P.O. Box 23, 11010, Belgrade, Serbia.
authors.forename: M
authors.initials: M
authors.lastname: Kojic
authors.affiliation: Department of Pulmonology, Mother and Child Health Care Institute of Serbia "Dr. Vukan Cupic", Radoja Dakica 8, 11070, Belgrade, Serbia.|School of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.
authors.forename: P
authors.initials: P
authors.lastname: Minic
authors.affiliation: Department of Pulmonology, Mother and Child Health Care Institute of Serbia "Dr. Vukan Cupic", Radoja Dakica 8, 11070, Belgrade, Serbia.|School of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.
authors.forename: A
authors.initials: A
authors.lastname: Sovtic
authors.affiliation: Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr Subotica 1, 11000, Belgrade, Serbia.
authors.forename: S
authors.initials: S
authors.lastname: Djukic
authors.affiliation: Laboratory for Molecular Microbiology, Institute of Molecular Genetics and Genetic Engineering, Vojvode Stepe 444a, P.O. Box 23, 11010, Belgrade, Serbia.|Faculty of Biology, University of Belgrade, Studentski trg 1, 11000, Belgrade, Serbia.
authors.forename: B
authors.initials: B
authors.lastname: Jovcic
mesh_terms: D000293:Adolescent; D000328:Adult; D019121:Burkholderia Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D042602:Burkholderia cepacia complex / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications* / Q000453:epidemiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D017720:Molecular Epidemiology; D010802:Phylogeny; D015995:Prevalence; D055771:Serbia / Q000453:epidemiology; D055815:Young Adult