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. 2003;96(Suppl 43):66–72.

Recent advances in cross-infection in cystic fibrosis: Burkholderia cepacia complex, Pseudomonas aeruginosa, MRSA and Pandoraea spp.

Andrew M Jones 1, A Kevin Webb 1
PMCID: PMC1308790  PMID: 12906328

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Selected References

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  1. Agodi A., Mahenthiralingam E., Barchitta M., Gianninò V., Sciacca A., Stefani S. Burkholderia cepacia complex infection in Italian patients with cystic fibrosis: prevalence, epidemiology, and genomovar status. J Clin Microbiol. 2001 Aug;39(8):2891–2896. doi: 10.1128/JCM.39.8.2891-2896.2001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Armstrong David S., Nixon Gillian M., Carzino Rosemary, Bigham Andrea, Carlin John B., Robins-Browne Roy M., Grimwood Keith. Detection of a widespread clone of Pseudomonas aeruginosa in a pediatric cystic fibrosis clinic. Am J Respir Crit Care Med. 2002 Oct 1;166(7):983–987. doi: 10.1164/rccm.200204-269OC. [DOI] [PubMed] [Google Scholar]
  3. Boyce J. M., Potter-Bynoe G., Chenevert C., King T. Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol. 1997 Sep;18(9):622–627. [PubMed] [Google Scholar]
  4. Boyle M. P., Farukhi Z., Nosky M. L. Strategies for improving transition to adult cystic fibrosis care, based on patient and parent views. Pediatr Pulmonol. 2001 Dec;32(6):428–436. doi: 10.1002/ppul.1154. [DOI] [PubMed] [Google Scholar]
  5. Cheng K., Smyth R. L., Govan J. R., Doherty C., Winstanley C., Denning N., Heaf D. P., van Saene H., Hart C. A. Spread of beta-lactam-resistant Pseudomonas aeruginosa in a cystic fibrosis clinic. Lancet. 1996 Sep 7;348(9028):639–642. doi: 10.1016/S0140-6736(96)05169-0. [DOI] [PubMed] [Google Scholar]
  6. Coenye T., Liu L., Vandamme P., LiPuma J. J. Identification of Pandoraea species by 16S ribosomal DNA-based PCR assays. J Clin Microbiol. 2001 Dec;39(12):4452–4455. doi: 10.1128/JCM.39.12.4452-4455.2001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Conway S. P., Simmonds E. J., Littlewood J. M. Acute severe deterioration in cystic fibrosis associated with influenza A virus infection. Thorax. 1992 Feb;47(2):112–114. doi: 10.1136/thx.47.2.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Demko C. A., Stern R. C., Doershuk C. F. Stenotrophomonas maltophilia in cystic fibrosis: incidence and prevalence. Pediatr Pulmonol. 1998 May;25(5):304–308. doi: 10.1002/(sici)1099-0496(199805)25:5<304::aid-ppul3>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  9. Duff A. J. A. Psychological consequences of segregation resulting from chronic Burkholderia cepacia infection in adults with CF. Thorax. 2002 Sep;57(9):756–758. doi: 10.1136/thorax.57.9.756. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Enright M. C., Day N. P., Davies C. E., Peacock S. J., Spratt B. G. Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol. 2000 Mar;38(3):1008–1015. doi: 10.1128/jcm.38.3.1008-1015.2000. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Farr B. M., Salgado C. D., Karchmer T. B., Sherertz R. J. Can antibiotic-resistant nosocomial infections be controlled? Lancet Infect Dis. 2001 Aug;1(1):38–45. doi: 10.1016/S1473-3099(01)00020-2. [DOI] [PubMed] [Google Scholar]
  12. Frederiksen B., Koch C., Høiby N. Antibiotic treatment of initial colonization with Pseudomonas aeruginosa postpones chronic infection and prevents deterioration of pulmonary function in cystic fibrosis. Pediatr Pulmonol. 1997 May;23(5):330–335. doi: 10.1002/(sici)1099-0496(199705)23:5<330::aid-ppul4>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  13. Garred P., Pressler T., Madsen H. O., Frederiksen B., Svejgaard A., Høiby N., Schwartz M., Koch C. Association of mannose-binding lectin gene heterogeneity with severity of lung disease and survival in cystic fibrosis. J Clin Invest. 1999 Aug;104(4):431–437. doi: 10.1172/JCI6861. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Govan J. R., Brown P. H., Maddison J., Doherty C. J., Nelson J. W., Dodd M., Greening A. P., Webb A. K. Evidence for transmission of Pseudomonas cepacia by social contact in cystic fibrosis. Lancet. 1993 Jul 3;342(8862):15–19. doi: 10.1016/0140-6736(93)91881-l. [DOI] [PubMed] [Google Scholar]
  15. Govan J. R., Deretic V. Microbial pathogenesis in cystic fibrosis: mucoid Pseudomonas aeruginosa and Burkholderia cepacia. Microbiol Rev. 1996 Sep;60(3):539–574. doi: 10.1128/mr.60.3.539-574.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Govan J. R. Infection control in cystic fibrosis: methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and the Burkholderia cepacia complex. J R Soc Med. 2000;93 (Suppl 38):40–45. [PMC free article] [PubMed] [Google Scholar]
  17. Govan J. R., Nelson J. W. Microbiology of lung infection in cystic fibrosis. Br Med Bull. 1992 Oct;48(4):912–930. doi: 10.1093/oxfordjournals.bmb.a072585. [DOI] [PubMed] [Google Scholar]
  18. Grothues D., Koopmann U., von der Hardt H., Tümmler B. Genome fingerprinting of Pseudomonas aeruginosa indicates colonization of cystic fibrosis siblings with closely related strains. J Clin Microbiol. 1988 Oct;26(10):1973–1977. doi: 10.1128/jcm.26.10.1973-1977.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Holmes A., Govan J., Goldstein R. Agricultural use of Burkholderia (Pseudomonas) cepacia: a threat to human health? Emerg Infect Dis. 1998 Apr-Jun;4(2):221–227. doi: 10.3201/eid0402.980209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Hunfeld K. P., Schmidt C., Krackhardt B., Posselt H. G., Bargon J., Yahaf Y., Schäfer V., Brade V., Wichelhaus T. A. Risk of Pseudomonas aeruginosa cross-colonisation in patients with cystic fibrosis within a holiday camp--a molecular-epidemiological study. Wien Klin Wochenschr. 2000 Apr 7;112(7):329–333. [PubMed] [Google Scholar]
  21. Jones A. M., Dodd M. E., Doherty C. J., Govan J. R. W., Webb A. K. Increased treatment requirements of patients with cystic fibrosis who harbour a highly transmissible strain of Pseudomonas aeruginosa. Thorax. 2002 Nov;57(11):924–925. doi: 10.1136/thorax.57.11.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Jones A. M., Dodd M. E., Webb A. K. Burkholderia cepacia: current clinical issues, environmental controversies and ethical dilemmas. Eur Respir J. 2001 Feb;17(2):295–301. doi: 10.1183/09031936.01.17202950. [DOI] [PubMed] [Google Scholar]
  23. Jones A. M., Govan J. R., Doherty C. J., Dodd M. E., Isalska B. J., Stanbridge T. N., Webb A. K. Spread of a multiresistant strain of Pseudomonas aeruginosa in an adult cystic fibrosis clinic. Lancet. 2001 Aug 18;358(9281):557–558. doi: 10.1016/s0140-6736(01)05714-2. [DOI] [PubMed] [Google Scholar]
  24. Kelly N. M., Fitzgerald M. X., Tempany E., O'Boyle C., Falkiner F. R., Keane C. T. Does pseudomonas cross-infection occur between cystic-fibrosis patients. Lancet. 1982 Sep 25;2(8300):688–690. doi: 10.1016/s0140-6736(82)90714-0. [DOI] [PubMed] [Google Scholar]
  25. Kreiswirth B., Kornblum J., Arbeit R. D., Eisner W., Maslow J. N., McGeer A., Low D. E., Novick R. P. Evidence for a clonal origin of methicillin resistance in Staphylococcus aureus. Science. 1993 Jan 8;259(5092):227–230. doi: 10.1126/science.8093647. [DOI] [PubMed] [Google Scholar]
  26. Kuroda M., Ohta T., Uchiyama I., Baba T., Yuzawa H., Kobayashi I., Cui L., Oguchi A., Aoki K., Nagai Y. Whole genome sequencing of meticillin-resistant Staphylococcus aureus. Lancet. 2001 Apr 21;357(9264):1225–1240. doi: 10.1016/s0140-6736(00)04403-2. [DOI] [PubMed] [Google Scholar]
  27. Ledson M. J., Gallagher M. J., Corkill J. E., Hart C. A., Walshaw M. J. Cross infection between cystic fibrosis patients colonised with Burkholderia cepacia. Thorax. 1998 May;53(5):432–436. doi: 10.1136/thx.53.5.432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. LiPuma J. J., Dasen S. E., Nielson D. W., Stern R. C., Stull T. L. Person-to-person transmission of Pseudomonas cepacia between patients with cystic fibrosis. Lancet. 1990 Nov 3;336(8723):1094–1096. doi: 10.1016/0140-6736(90)92571-x. [DOI] [PubMed] [Google Scholar]
  29. LiPuma John J., Spilker Theodore, Coenye Tom, Gonzalez Carlos F. An epidemic Burkholderia cepacia complex strain identified in soil. Lancet. 2002 Jun 8;359(9322):2002–2003. doi: 10.1016/S0140-6736(02)08836-0. [DOI] [PubMed] [Google Scholar]
  30. MRSA in cystic fibrosis. London, 16 June 1997. J Hosp Infect. 1998 Nov;40(3):179–191. [PubMed] [Google Scholar]
  31. Mahadeva R., Webb K., Westerbeek R. C., Carroll N. R., Dodd M. E., Bilton D., Lomas D. A. Clinical outcome in relation to care in centres specialising in cystic fibrosis: cross sectional study. BMJ. 1998 Jun 13;316(7147):1771–1775. doi: 10.1136/bmj.316.7147.1771. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Mahenthiralingam E., Coenye T., Chung J. W., Speert D. P., Govan J. R., Taylor P., Vandamme P. Diagnostically and experimentally useful panel of strains from the Burkholderia cepacia complex. J Clin Microbiol. 2000 Feb;38(2):910–913. doi: 10.1128/jcm.38.2.910-913.2000. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Mahenthiralingam E., Simpson D. A., Speert D. P. Identification and characterization of a novel DNA marker associated with epidemic Burkholderia cepacia strains recovered from patients with cystic fibrosis. J Clin Microbiol. 1997 Apr;35(4):808–816. doi: 10.1128/jcm.35.4.808-816.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Mahenthiralingam E., Vandamme P., Campbell M. E., Henry D. A., Gravelle A. M., Wong L. T., Davidson A. G., Wilcox P. G., Nakielna B., Speert D. P. Infection with Burkholderia cepacia complex genomovars in patients with cystic fibrosis: virulent transmissible strains of genomovar III can replace Burkholderia multivorans. Clin Infect Dis. 2001 Oct 4;33(9):1469–1475. doi: 10.1086/322684. [DOI] [PubMed] [Google Scholar]
  35. McCallum S. J., Corkill J., Gallagher M., Ledson M. J., Hart C. A., Walshaw M. J. Superinfection with a transmissible strain of Pseudomonas aeruginosa in adults with cystic fibrosis chronically colonised by P aeruginosa. Lancet. 2001 Aug 18;358(9281):558–560. doi: 10.1016/s0140-6736(01)05715-4. [DOI] [PubMed] [Google Scholar]
  36. Miall L. S., McGinley N. T., Brownlee K. G., Conway S. P. Methicillin resistant Staphylococcus aureus (MRSA) infection in cystic fibrosis. Arch Dis Child. 2001 Feb;84(2):160–162. doi: 10.1136/adc.84.2.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Máiz L., Cantón R., Mir N., Baquero F., Escobar H. Aerosolized vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infection in cystic fibrosis. Pediatr Pulmonol. 1998 Oct;26(4):287–289. doi: 10.1002/(sici)1099-0496(199810)26:4<287::aid-ppul9>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  38. Nelson J. W., Tredgett M. W., Sheehan J. K., Thornton D. J., Notman D., Govan J. R. Mucinophilic and chemotactic properties of Pseudomonas aeruginosa in relation to pulmonary colonization in cystic fibrosis. Infect Immun. 1990 Jun;58(6):1489–1495. doi: 10.1128/iai.58.6.1489-1495.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Ojeniyi B., Frederiksen B., Hoiby N. Pseudomonas aeruginosa cross-infection among patients with cystic fibrosis during a winter camp. Pediatr Pulmonol. 2000 Mar;29(3):177–181. doi: 10.1002/(sici)1099-0496(200003)29:3<177::aid-ppul4>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  40. Oliveira Duarte C., Tomasz Alexander, de Lencastre Hermínia. Secrets of success of a human pathogen: molecular evolution of pandemic clones of meticillin-resistant Staphylococcus aureus. Lancet Infect Dis. 2002 Mar;2(3):180–189. doi: 10.1016/s1473-3099(02)00227-x. [DOI] [PubMed] [Google Scholar]
  41. Oliver A., Cantón R., Campo P., Baquero F., Blázquez J. High frequency of hypermutable Pseudomonas aeruginosa in cystic fibrosis lung infection. Science. 2000 May 19;288(5469):1251–1254. doi: 10.1126/science.288.5469.1251. [DOI] [PubMed] [Google Scholar]
  42. Ong E. L., Mulvenna P., Webb K. A. Varicella-zoster infection in adults with cystic fibrosis: role of acyclovir. Scand J Infect Dis. 1991;23(3):283–285. doi: 10.3109/00365549109024311. [DOI] [PubMed] [Google Scholar]
  43. Pedersen S. S., Koch C., Høiby N., Rosendal K. An epidemic spread of multiresistant Pseudomonas aeruginosa in a cystic fibrosis centre. J Antimicrob Chemother. 1986 Apr;17(4):505–516. doi: 10.1093/jac/17.4.505. [DOI] [PubMed] [Google Scholar]
  44. Revised guidelines for the control of methicillin-resistant Staphylococcus aureus infection in hospitals. British Society for Antimicrobial Chemotherapy, Hospital Infection Society and the Infection Control Nurses Association. J Hosp Infect. 1998 Aug;39(4):253–290. doi: 10.1016/s0195-6701(98)90293-6. [DOI] [PubMed] [Google Scholar]
  45. Schülin T., Steinmetz I. Chronic melioidosis in a patient with cystic fibrosis. J Clin Microbiol. 2001 Apr;39(4):1676–1677. doi: 10.1128/JCM.39.4.1676-1677.2001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Segonds C., Heulin T., Marty N., Chabanon G. 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. 1999 Jul;37(7):2201–2208. doi: 10.1128/jcm.37.7.2201-2208.1999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Smith D. L., Smith E. G., Gumery L. B., Stableforth D. E., Dalla Costa L. M., Pitt T. L. Epidemiology of Pseudomonas aeruginosa infection in cystic fibrosis and the use of strain genotyping. J Infect. 1993 May;26(3):325–331. doi: 10.1016/0163-4453(93)95709-r. [DOI] [PubMed] [Google Scholar]
  48. Speert D. P., Campbell M. E. Hospital epidemiology of Pseudomonas aeruginosa from patients with cystic fibrosis. J Hosp Infect. 1987 Jan;9(1):11–21. doi: 10.1016/0195-6701(87)90089-2. [DOI] [PubMed] [Google Scholar]
  49. Speert D. P., Lawton D., Damm S. Communicability of Pseudomonas aeruginosa in a cystic fibrosis summer camp. J Pediatr. 1982 Aug;101(2):227–228. doi: 10.1016/s0022-3476(82)80127-3. [DOI] [PubMed] [Google Scholar]
  50. Speert David P., Campbell Maureen E., Henry Deborah A., Milner Ruth, Taha Fatma, Gravelle Anna, Davidson A. George F., Wong Lawrence T. K., Mahenthiralingam Eshwar. Epidemiology of Pseudomonas aeruginosa in cystic fibrosis in British Columbia, Canada. Am J Respir Crit Care Med. 2002 Oct 1;166(7):988–993. doi: 10.1164/rccm.2203011. [DOI] [PubMed] [Google Scholar]
  51. Stover C. K., Pham X. Q., Erwin A. L., Mizoguchi S. D., Warrener P., Hickey M. J., Brinkman F. S., Hufnagle W. O., Kowalik D. J., Lagrou M. Complete genome sequence of Pseudomonas aeruginosa PAO1, an opportunistic pathogen. Nature. 2000 Aug 31;406(6799):959–964. doi: 10.1038/35023079. [DOI] [PubMed] [Google Scholar]
  52. Thomas S. R., Gyi K. M., Gaya H., Hodson M. E. Methicillin-resistant Staphylococcus aureus: impact at a national cystic fibrosis centre. J Hosp Infect. 1998 Nov;40(3):203–209. doi: 10.1016/s0195-6701(98)90138-4. [DOI] [PubMed] [Google Scholar]
  53. Vandamme P., Holmes B., Vancanneyt M., Coenye T., Hoste B., Coopman R., Revets H., Lauwers S., Gillis M., Kersters K. Occurrence of multiple genomovars of Burkholderia cepacia in cystic fibrosis patients and proposal of Burkholderia multivorans sp. nov. Int J Syst Bacteriol. 1997 Oct;47(4):1188–1200. doi: 10.1099/00207713-47-4-1188. [DOI] [PubMed] [Google Scholar]
  54. Visca P., Cazzola G., Petrucca A., Braggion C. Travel-associated Burkholderia pseudomallei infection (Melioidosis) in a patient with cystic fibrosis: a case report. Clin Infect Dis. 2000 Dec 11;32(1):E15–E16. doi: 10.1086/317528. [DOI] [PubMed] [Google Scholar]
  55. Weaver L. T., Green M. R., Nicholson K., Mills J., Heeley M. E., Kuzemko J. A., Austin S., Gregory G. A., Dux A. E., Davis J. A. Prognosis in cystic fibrosis treated with continuous flucloxacillin from the neonatal period. Arch Dis Child. 1994 Feb;70(2):84–89. doi: 10.1136/adc.70.2.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Webb AK. Matthew and adam. BMJ. 2000 May 13;320(7245):1324–1324. doi: 10.1136/bmj.320.7245.1324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Zimakoff J., Høiby N., Rosendal K., Guilbert J. P. Epidemiology of Pseudomonas aeruginosa infection and the role of contamination of the environment in a cystic fibrosis clinic. J Hosp Infect. 1983 Mar;4(1):31–40. doi: 10.1016/0195-6701(83)90062-2. [DOI] [PubMed] [Google Scholar]

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