Studies of the prevalence of Burkholderia cepacia complex species amongst cystic fibrosis (CF) patients in different geographical regions, and the association between cross-infection and putative transmissibility markers, will further our understanding of these organisms and help to address infection-control issues. In this study, B. cepacia complex isolates from CF patients in different regions of Europe were analysed. Isolates were examined for B. cepacia complex species and putative transmissibility markers [cable pilin subunit gene (cblA) and the B. cepacia epidemic strain marker (BCESM)]. Sporadic and cross-infective strains were identified by random amplification of polymorphic DNA (RAPD). In total, 79 % of patients were infected with Burkholderia cenocepacia (genomovar III), 18 % with Burkholderia multivorans (genomovar II) and less than 5 % of patients with B. cepacia (genomovar I), Burkholderia stabilis (genomovar IV) or Burkholderia vietnamiensis (genomovar V). The cblA and BCESM transmissibility markers were only detected in strains of B. cenocepacia. The BCESM was a more sensitive marker for transmissible B. cenocepacia strains than cblA, although sporadic B. cenocepacia strains containing the BCESM, but lacking cblA, were also observed. Furthermore, clusters of cross-infection with transmissibility marker-negative strains of B. multivorans were identified. In conclusion, B. cenocepacia was the greatest cause of cross-infection, and the most widely distributed B. cepacia complex species, within these CF populations. However, cross-infection was not exclusive to B. cenocepacia and cblA and the BCESM were not absolute markers for transmissible B. cenocepacia, or other B. cepacia complex strains. It is therefore suggested that CF centres cohort patients based on the presence or absence of B. cepacia complex infection and not on the basis of transmissibility marker-positive B. cenocepacia as previously suggested.
BiddickR.,
SpilkerT.,
MartinA.,
LiPumaJ. J.2003; Evidence of transmission of Burkholderia cepacia , Burkholderia multivorans and Burkholderia dolosa among persons with cystic fibrosis. FEMS Microbiol Lett 228:57–62[CrossRef]
ChenJ. S.,
WitzmannK. A.,
SpilkerT.,
FinkR. J.,
LiPumaJ. J.2001; Endemicity and inter-city spread of Burkholderia cepacia genomovar III in cystic fibrosis. J Pediatr 139:643–649[CrossRef]
ClodeF. E.,
KaufmannM. E.,
MalnickH.,
PittT. L.2000; Distribution of genes encoding putative transmissibility factors among epidemic and nonepidemic strains of Burkholderia cepacia from cystic fibrosis patients in the United Kingdom. J Clin Microbiol 38:1763–1766
DrevinekP.,
CinekO.,
MelterJ.,
LangsadlL.,
NavesnakovaY.,
VavrovaV.2003; Genomovar distribution of the Burkholderia cepacia complex differs significantly between Czech and Slovak patients with cystic fibrosis. J Med Microbiol 52:603–604[CrossRef]
GovanJ. R. W.,
BrownP. H.,
MaddisonJ.,
DohertyC. J.,
NelsonJ. W.,
DoddM.,
GreeningA. P.,
WebbA. K.1993; Evidence for transmission of Pseudomonas cepacia by social contact in cystic fibrosis. Lancet 342:15–19[CrossRef]
HaworthC. S.,
DoddM. E.,
DohertyC.,
SuperM.,
HambletonG.,
VandammeP.,
GovanJ. R. W.,
WebbA. K.1997; The morbidity and mortality associated with two epidemic strains of Burkholderia cepacia with genomovar III status in cystic fibrosis patients. Pediatr PulmonolSuppl 14290
LessieT. G.,
HendricksonW.,
ManningB. D.,
DevereuxR.1996; Genomic complexity and plasticity of Burkholderia cepacia
. FEMS Microbiol Lett 144:117–128[CrossRef]
LiPumaJ. J.,
DulaneyB. J.,
McMenaminJ. D.,
WhitbyP. W.,
StullT. L.,
CoenyeT.,
VandammeP.1999; Development of rRNA-based PCR assays for identification of Burkholderia cepacia complex isolates recovered from cystic fibrosis patients. J Clin Microbiol 37:3167–3170
LiPumaJ. J.,
SpilkerT.,
GillL. H.,
CampbellP. W.III,
LiuL.,
MahenthiralingamE.2001; Disproportionate distribution of Burkholderia cepacia complex species and transmissibility markers in cystic fibrosis. Am J Respir Crit Care Med 164:92–96[CrossRef]
MahenthiralingamE.,
CampbellM. E.,
HenryD. A.,
SpeertD. P.1996; Epidemiology of Burkholderia cepacia infection in patients with cystic fibrosis: analysis by randomly amplified polymorphic DNA fingerprinting. J Clin Microbiol 34:2914–2920
MahenthiralingamE.,
SimpsonD. A.,
SpeertD. P.1997; Identification and characterisation of a novel DNA marker associated with epidemic Burkholderia cepacia strains recovered from patients with cystic fibrosis. J Clin Microbiol 35:808–816
MahenthiralingamE.,
BischofJ.,
ByrneS. K.,
RadomskiC.,
DaviesJ. E.,
Av-GayY.,
VandammeP.2000; DNA-based diagnostic approaches for identification of Burkholderia cepacia complex, Burkholderia vietnamiensis , Burkholderia multivorans , Burkholderia stabilis , and Burkholderia cepacia genomovars I and III. J Clin Microbiol 38:3165–3173
MahenthiralingamE.,
VandammeP.,
CampbellM. E. & 7 other authors; 2001; Infection with Burkholderia cepacia complex genomovars in patients with cystic fibrosis: virulent transmissible strains of genomovar III can replace Burkholderia multivorans
. Clin Infect Dis 33:1469–1475[CrossRef]
McDowellA.,
MahenthiralingamE.,
MooreJ. E. & 8 other authors; 2001; PCR-based detection and identification of Burkholderia cepacia complex pathogens in sputum from cystic fibrosis patients. J Clin Microbiol 39:4247–4255[CrossRef]
SajjanU. S.,
SunL.,
GoldsteinR.,
ForstnerJ. F.1995; Cable (Cbl) type II pili of cystic fibrosis-associated Burkholderia ( Pseudomonas ) cepacia : nucleotide sequence of the cblA major subunit pilin gene and novel morphology of the assembled appendage fibres. J Bacteriol 177:1030–1038
SegondsC.,
HeulinT.,
MartyN.,
ChabanonG.1999; Differentiation of Burkholderia species by PCR-restriction fragment length polymorphism analysis of the 16S rRNA gene and application to cystic fibrosis isolates. J Clin Microbiol 37:2201–2208
VandammeP.,
HolmesB.,
VancanneytM. & 8 other authors; 1997; Occurrence of multiple genomovars of Burkholderia cepacia in cystic fibrosis patients and proposal of Burkholderia multivorans sp.nov. Int J Syst Bacteriol 47:1188–1200[CrossRef]
WhitefordM. L.,
WilkinsonJ. D.,
McCollJ. H.,
ConlonF. M.,
MichieJ. R.,
EvansT. J.,
PatonJ. Y.1995; Outcome of Burkholderia ( Pseudomonas ) cepacia colonisation in children with cystic fibrosis following a hospital outbreak. Thorax 50:1194–1198[CrossRef]