Clinical outcome of Burkholderia cepacia complex infection in cystic fibrosis adults

Courtney, J.M; Dunbar, K.E.A; McDowell, A; Moore, J.E; Warke, T.J; Stevenson, M; Elborn, J.S

doi:10.1016/j.jcf.2004.01.005

« Previous Next »Journal of Cystic Fibrosis
Volume 3, Issue 2 , Pages 93-98, June 2004

Clinical outcome of Burkholderia cepacia complex infection in cystic fibrosis adults☆

J.M Courtney
- Adult Cystic Fibrosis Centre, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, North Ireland, UK
- Centre for Inflammation, Queens University, Belfast, UK
K.E.A Dunbar
- Centre for Inflammation, Queens University, Belfast, UK
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, UK
A McDowell
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, UK
J.E Moore
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, UK
T.J Warke
- Adult Cystic Fibrosis Centre, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, North Ireland, UK
- Centre for Inflammation, Queens University, Belfast, UK
M Stevenson
- Department of Medical Statistics, Queens University, Belfast, UK
J.S Elborn
- Corresponding author. Adult Cystic Fibrosis Centre, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, North Ireland, UK Tel: +44-2890-329241x3683; fax: +44-2890-263546.
- Adult Cystic Fibrosis Centre, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, North Ireland, UK
- Centre for Inflammation, Queens University, Belfast, UK

Received 2 January 2003; accepted 28 January 2004.

Abstract

Background: The Burkholderia cepacia complex (BCC) is one of the most important groups of organisms infecting cystic fibrosis (CF) patients. The aim of the study was to examine how infection with BCC affects clinical outcome. Methods: Nineteen CF adults infected with BCC and 19 controls infected with Pseudomonas aeruginosa were studied over a 4-year period. The best forced expiratory volume in 1 s (FEV₁) and body mass index (BMI) for each year were recorded and annual rate of decline calculated. Results: The BCC infected group displayed a significantly greater reduction of FEV₁ and BMI compared to the P. aeruginosa infected group (p=0.001 and p=0.009, respectively). Sixteen patients infected with a single Burkholderia cenocepacia strain had a significantly greater rate of FEV₁ decline compared to those infected with Burkholderia multivorans (n=3) or P. aeruginosa (p=0.01 and p<0.0001, respectively). The rate of BMI decline was significantly greater in patients infected with B. cenocepacia compared to those with P. aeruginosa (p=0.007), but not significantly different in those with B. multivorans (p=0.29). Conclusion: BCC infection is associated with an accelerated decline in pulmonary function and BMI. Infection with a single B. cenocepacia strain was associated with a more rapid decline in lung function than those infected with either B. multivorans or P. aeruginosa.