Factors influencing acquisition of Burkholderia cepacia complex organisms in patients with cystic fibrosis

Ramsay, Kay A., Butler, Claire A., Paynter, Stuart, Ware, Robert S., Kidd, Timothy J., Wainwright, Claire E. and Bell, Scott C. (2013) Factors influencing acquisition of Burkholderia cepacia complex organisms in patients with cystic fibrosis. Journal of Clinical Microbiology, 51 12: 3975-3980. doi:10.1128/JCM.01360-13

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Author Ramsay, Kay A.
Butler, Claire A.
Paynter, Stuart
Ware, Robert S.
Kidd, Timothy J.
Wainwright, Claire E.
Bell, Scott C.
Title Factors influencing acquisition of Burkholderia cepacia complex organisms in patients with cystic fibrosis
Journal name Journal of Clinical Microbiology   Check publisher's open access policy
ISSN 0095-1137
1098-660X
Publication date 2013-12-01
Year available 2013
Sub-type Article (original research)
DOI 10.1128/JCM.01360-13
Open Access Status File (Publisher version)
Volume 51
Issue 12
Start page 3975
End page 3980
Total pages 6
Place of publication Washington, DC, United States
Publisher American Society for Microbiology
Language eng
Formatted abstract
Background: Stenotrophomonas maltophilia is one of the most common multi-drug resistant organisms causing pulmonary infections in CF patients. It is unknown whether S. maltophilia infection follows the same pattern and shares similar risk factors for acquisition as described for Pseudomonas aeruginosa.

Methods: We examined all clinical events from 1997 to 2008 in the Toronto CF Database to identify risk factors for the acquisition of S. maltophilia and to define distinct patterns of infection.

Results:
We followed 601 patients over 12years, during which time one quarter of subjects had at least one positive culture for S. maltophilia; the incidence rate was slightly higher in children (11.6/100personyears) compared with adults (10.6/100personyears). Using multi-variable Cox proportional hazards models, steeper rate of FEV1 decline was a significant risk factor for S. maltophilia acquisition, whereas new infections were less likely to occur with greater oral antibiotic use and a history of Burkholderia cepacia complex infection.

Conclusions:
This study illustrates the evolution of S. maltophilia infection over time in a large cohort of adults and children with CF. Younger CF patients, and those with greater lung function decline were at increased risk of S. maltophilia infection. The use of oral antibiotics to maintain lung function may be a way of decreasing the risk of infection. However, the optimal management of CF patients with persistent S. maltophilia infection is not yet known and requires further studies.
Keyword Lung Transplantation
Pseudomonas Cepacia
New Zealand
Infection
Epidemiology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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