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. 1995 Nov;50(11):1194–1198. doi: 10.1136/thx.50.11.1194

Outcome of Burkholderia (Pseudomonas) cepacia colonisation in children with cystic fibrosis following a hospital outbreak.

M L Whiteford 1, J D Wilkinson 1, J H McColl 1, F M Conlon 1, J R Michie 1, T J Evans 1, J Y Paton 1
PMCID: PMC475093  PMID: 8553277

Abstract

BACKGROUND--While there are reports on the outcome in adults and teenagers with cystic fibrosis of colonisation with Burkholderia (Pseudomonas) cepacia, there is little information in children. METHODS--In December 1991 only one of 115 children with cystic fibrosis attending a paediatric centre was colonised with B cepacia. Over the next 12 months there was a rapid increase with 23 (20%) becoming colonised; eighteen (79%) of these became colonised in hospital at a time that overlapped with the admission of a B cepacia positive child. Three different bacteriocin types were isolated, with one type (S22/PO) being present in 17 (74%) patients. The outcome for children who became colonised with B cepacia was compared with that in 33 children who continued to be colonised with Pseudomonas aeruginosa alone. RESULTS--Children colonised with B cepacia were older and more poorly nourished than those colonised with P aeruginosa, but did not have poorer pulmonary function. After colonisation, the forced expiratory volume in one second (FEV1) deteriorated between consecutive annual tests, with the average deterioration being greater in those with higher initial levels. Five children with B cepacia died from respiratory failure although none showed a fulminant deterioration. Introduction of segregation measures within hospital led to a dramatic decrease in the number of newly colonised patients. CONCLUSIONS--This study provides further evidence for person-to-person spread of B cepacia and confirms the effectiveness of simple isolation measures in interrupting spread. Colonisation with B cepacia and P aeruginosa in children is associated with a more rapid decline in lung function and a significantly increased mortality compared with cases colonised with P aeruginosa alone.

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Selected References

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  1. Fisher M. C., LiPuma J. J., Dasen S. E., Caputo G. C., Mortensen J. E., McGowan K. L., Stull T. L. Source of Pseudomonas cepacia: ribotyping of isolates from patients and from the environment. J Pediatr. 1993 Nov;123(5):745–747. doi: 10.1016/s0022-3476(05)80851-0. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Govan J. R., Harris G. Typing of Pseudomonas cepacia by bacteriocin susceptibility and production. J Clin Microbiol. 1985 Oct;22(4):490–494. doi: 10.1128/jcm.22.4.490-494.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hardy K. A., McGowan K. L., Fisher M. C., Schidlow D. V. Pseudomonas cepacia in the hospital setting: lack of transmission between cystic fibrosis patients. J Pediatr. 1986 Jul;109(1):51–54. doi: 10.1016/s0022-3476(86)80571-6. [DOI] [PubMed] [Google Scholar]
  5. Humphreys H., Peckham D., Patel P., Knox A. Airborne dissemination of Burkholderia (Pseudomonas) cepacia from adult patients with cystic fibrosis. Thorax. 1994 Nov;49(11):1157–1159. doi: 10.1136/thx.49.11.1157. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Isles A., Maclusky I., Corey M., Gold R., Prober C., Fleming P., Levison H. Pseudomonas cepacia infection in cystic fibrosis: an emerging problem. J Pediatr. 1984 Feb;104(2):206–210. doi: 10.1016/s0022-3476(84)80993-2. [DOI] [PubMed] [Google Scholar]
  7. John M., Ecclestone E., Hunter E., Couroux P., Hussain Z. Epidemiology of Pseudomonas cepacia colonization among patients with cystic fibrosis. Pediatr Pulmonol. 1994 Aug;18(2):108–113. doi: 10.1002/ppul.1950180210. [DOI] [PubMed] [Google Scholar]
  8. Kaplan T. A., McKey R. M., Jr, Toraya N., Moccia G. Impact of CF summer camp. Clin Pediatr (Phila) 1992 Mar;31(3):161–167. doi: 10.1177/000992289203100307. [DOI] [PubMed] [Google Scholar]
  9. 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]
  10. Nelson J. W., Doherty C. J., Brown P. H., Greening A. P., Kaufmann M. E., Govan J. R. Pseudomonas cepacia in inpatients with cystic fibrosis. Lancet. 1991 Dec 14;338(8781):1525–1525. doi: 10.1016/0140-6736(91)92342-y. [DOI] [PubMed] [Google Scholar]
  11. SHWACHMAN H., KULCZYCKI L. L. Long-term study of one hundred five patients with cystic fibrosis; studies made over a five- to fourteen-year period. AMA J Dis Child. 1958 Jul;96(1):6–15. doi: 10.1001/archpedi.1958.02060060008002. [DOI] [PubMed] [Google Scholar]
  12. Simmonds E. J., Conway S. P., Ghoneim A. T., Ross H., Littlewood J. M. Pseudomonas cepacia: a new pathogen in patients with cystic fibrosis referred to a large centre in the United Kingdom. Arch Dis Child. 1990 Aug;65(8):874–877. doi: 10.1136/adc.65.8.874. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Tablan O. C., Chorba T. L., Schidlow D. V., White J. W., Hardy K. A., Gilligan P. H., Morgan W. M., Carson L. A., Martone W. J., Jason J. M. Pseudomonas cepacia colonization in patients with cystic fibrosis: risk factors and clinical outcome. J Pediatr. 1985 Sep;107(3):382–387. doi: 10.1016/s0022-3476(85)80511-4. [DOI] [PubMed] [Google Scholar]
  14. Tablan O. C., Martone W. J., Doershuk C. F., Stern R. C., Thomassen M. J., Klinger J. D., White J. W., Carson L. A., Jarvis W. R. Colonization of the respiratory tract with Pseudomonas cepacia in cystic fibrosis. Risk factors and outcomes. Chest. 1987 Apr;91(4):527–532. doi: 10.1378/chest.91.4.527. [DOI] [PubMed] [Google Scholar]
  15. Taylor R. F., Dalla Costa L., Kaufmann M. E., Pitt T. L., Hodson M. E. Pseudomonas cepacia pulmonary infection in adults with cystic fibrosis: is nosocomial acquisition occurring? J Hosp Infect. 1992 Jul;21(3):199–204. doi: 10.1016/0195-6701(92)90076-x. [DOI] [PubMed] [Google Scholar]
  16. Taylor R. F., Gaya H., Hodson M. E. Pseudomonas cepacia: pulmonary infection in patients with cystic fibrosis. Respir Med. 1993 Apr;87(3):187–192. doi: 10.1016/0954-6111(93)90090-m. [DOI] [PubMed] [Google Scholar]
  17. Thomassen M. J., Demko C. A., Doershuk C. F., Stern R. C., Klinger J. D. Pseudomonas cepacia: decrease in colonization in patients with cystic fibrosis. Am Rev Respir Dis. 1986 Oct;134(4):669–671. doi: 10.1164/arrd.1986.134.4.669. [DOI] [PubMed] [Google Scholar]
  18. Thomassen M. J., Demko C. A., Klinger J. D., Stern R. C. Pseudomonas cepacia colonization among patients with cystic fibrosis. A new opportunist. Am Rev Respir Dis. 1985 May;131(5):791–796. doi: 10.1164/arrd.1985.131.5.791. [DOI] [PubMed] [Google Scholar]

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