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Burkholderia species infections in patients with Cystic Fibrosis in British Columbia, Canada. 30 Years' experience

Zlosnik, James E. A., Zhou, Guohai, Brant, Rollin, Henry, Deborah A., Hird, Trevor J., Mahenthiralingam, Eshwar, Chilvers, Mark A., Wilcox, Pearce and Speert, David P. 2015. Burkholderia species infections in patients with Cystic Fibrosis in British Columbia, Canada. 30 Years' experience. Annals of the American Thoracic Society 12 (1) , p. 70. 10.1513/AnnalsATS.201408-395OC

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Abstract

Rationale: We have been collecting Burkholderia species bacteria from patients with cystic fibrosis (CF) for the last 30 years. During this time, our understanding of their multispecies taxonomy and infection control has evolved substantially. Objectives: To evaluate the long-term (30 year) epidemiology and clinical outcome of Burkholderia infection in CF, and fully define the risks associated with infection by each species. Methods: Isolates from Burkholderia-positive patients (n=107) were speciated and typed annually for each infected patient. Microbiological and clinical data were evaluated by thorough review of patient charts, and statistical analyses performed to define significant epidemiological factors. Measurements and Main Results: Before 1995, the majority of new Burkholderia infections were caused by epidemic clones of Burkholderia cenocepacia. After implementation of new infection control measures in 1995, Burkholderia multivorans became the most prevalent species. Survival analysis showed that patients with CF infected with B. cenocepacia had a significantly worse outcome than those with B. multivorans, and a novel finding was that, after Burkholderia infection, the prognosis for females was significantly worse than for males. Conclusions: B. multivorans and B. cenocepacia have been the predominant Burkholderia species infecting people with CF in Vancouver. The implementation of infection control measures were successful in preventing new acquisition of epidemic strains of B. cenocepacia, leaving nonclonal B. multivorans as the most prevalent species. Historically, survival after infection with B. cenocepacia has been significantly worse than B. multivorans infection, and, of new significance, we show that females tend toward worse clinical outcomes.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Biosciences
Publisher: American Thoracic Society
ISSN: 2329-6933
Date of Acceptance: 2 December 2014
Last Modified: 15 Jun 2017 16:07
URI: http://orca.cf.ac.uk/id/eprint/99436

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