Burkholderia cepacia complex infection in patients with cystic fibrosis.

The word 'complex' has several meanings and synonyms such as composite, obsession, heterogeneous, mixed and network, can all be used in its place. Our obsession with bacteria from the Burkholderia cepacia complex started in the early 1990s. In less than 10 years, we have seen the status of this bacterium move from: (i) a lesser known pseudomonad opportunist pathogen, (ii) to devastating infections transmitted between patients with cystic fibrosis (CF), (iii) through divisions into several new species, and (iv) now on towards one of the largest gram-negative genome sequencing projects. For microbiologists, hospital infection control officers, caregivers, and most of all the CF community, the changes in our understanding of the taxonomy, epidemiology and pathogenesis of the bacterium 'B. cepacia' are complex.

[1]  P. Vandamme,et al.  Occurrence of multiple genomovars of Burkholderia cepacia in cystic fibrosis patients and proposal of Burkholderia multivorans sp. nov. , 1997, International journal of systematic bacteriology.

[2]  P. Vandamme,et al.  Diagnostically and Experimentally Useful Panel of Strains from the Burkholderia cepacia Complex , 2000, Journal of Clinical Microbiology.

[3]  M. Whiteford,et al.  Outcome of Burkholderia (Pseudomonas) cepacia colonisation in children with cystic fibrosis following a hospital outbreak. , 1995, Thorax.

[4]  T. Heulin,et al.  Differentiation of Burkholderia Species by PCR-Restriction Fragment Length Polymorphism Analysis of the 16S rRNA Gene and Application to Cystic Fibrosis Isolates , 1999, Journal of Clinical Microbiology.

[5]  Tom Coenye,et al.  Taxonomy and Identification of the Burkholderia cepacia Complex , 2001, Journal of Clinical Microbiology.

[6]  Takayuki Ezaki,et al.  Proposal of Burkholderia gen. nov. and Transfer of Seven Species of the Genus Pseudomonas Homology Group II to the New Genus, with the Type Species Burkholderia cepacia (Palleroni and Holmes 1981) comb. nov. , 1992, Microbiology and immunology.

[7]  J. Elborn,et al.  PCR-Based Detection and Identification ofBurkholderiacepacia Complex Pathogens in Sputum from Cystic Fibrosis Patients , 2001, Journal of Clinical Microbiology.

[8]  P. Gilligan,et al.  Lung transplantation for cystic fibrosis patients with Burkholderia cepacia complex. Survival linked to genomovar type. , 2001, American journal of respiratory and critical care medicine.

[9]  S. Tyler,et al.  Linkage analysis of geographic and clinical clusters in Pseudomonas cepacia infections by multilocus enzyme electrophoresis and ribotyping , 1994, Journal of clinical microbiology.

[10]  V. Deretic,et al.  Microbial pathogenesis in cystic fibrosis: mucoid Pseudomonas aeruginosa and Burkholderia cepacia. , 1996, Microbiological reviews.

[11]  P. Corris,et al.  Burkholderia cepacia complex genomovars and pulmonary transplantation outcomes in patients with cystic fibrosis , 2001, The Lancet.

[12]  M. Barchitta,et al.  Burkholderia cepacia Complex Infection in Italian Patients with Cystic Fibrosis: Prevalence, Epidemiology, and Genomovar Status , 2001, Journal of Clinical Microbiology.

[13]  M. Riley,et al.  The emergence of a highly transmissible lineage of cbl+ Pseudomonas (Burkholderia) cepacia causing CF centre epidemics in North America and Britain , 1995, Nature Medicine.

[14]  P. Vandamme,et al.  DNA-Based Diagnostic Approaches for Identification of Burkholderia cepacia Complex, Burkholderia vietnamiensis, Burkholderia multivorans,Burkholderia stabilis, and Burkholderia cepacia Genomovars I and III , 2000, Journal of Clinical Microbiology.

[15]  P. Vandamme,et al.  Infection with Burkholderia cepacia complex genomovars in patients with cystic fibrosis: virulent transmissible strains of genomovar III can replace Burkholderia multivorans. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  B. Manning,et al.  Genomic complexity and plasticity of Burkholderia cepacia. , 1996, FEMS microbiology letters.

[17]  D. Simpson,et al.  Identification and characterization of a novel DNA marker associated with epidemic Burkholderia cepacia strains recovered from patients with cystic fibrosis , 1997, Journal of clinical microbiology.

[18]  M. Corey,et al.  Epidemiology of Burkholderia cepacia Complex in Patients with Cystic Fibrosis, Canada , 2002, Emerging infectious diseases.

[19]  M. Dodd,et al.  Evidence for transmission of Pseudomonas cepacia by social contact in cystic fibrosis , 1993, The Lancet.

[20]  M E Campbell,et al.  Epidemiology of Burkholderia cepacia infection in patients with cystic fibrosis: analysis by randomly amplified polymorphic DNA fingerprinting , 1996, Journal of clinical microbiology.

[21]  J. Lipuma.  Burkholderia cepacia epidemiology and pathogenesis: implications for infection control. , 1998, Current opinion in pulmonary medicine.

[22]  J. Lipuma,et al.  Disproportionate distribution of Burkholderia cepacia complex species and transmissibility markers in cystic fibrosis. , 2001, American journal of respiratory and critical care medicine.