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Lee D, Park J, Kim HS. Mutations Affecting Cellular Levels of Cobalamin (Vitamin B 12) Confer Tolerance to Bactericidal Antibiotics in Burkholderia cenocepacia. J Microbiol Biotechnol 2024; 34:1609-1616. [PMID: 39049470 PMCID: PMC11380519 DOI: 10.4014/jmb.2406.06028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
The Burkholderia cepacia complex (Bcc) consists of opportunistic pathogens known to cause pneumonia in immunocompromised individuals, especially those with cystic fibrosis. Treating Bcc pneumonia is challenging due to the pathogens' high multidrug resistance. Therefore, inhalation therapy with tobramycin powder, which can achieve high antibiotic concentrations in the lungs, is a promising treatment option. In this study, we investigated potential mechanisms that could compromise the effectiveness of tobramycin therapy. By selecting for B. cenocepacia survivors against tobramycin, we identified three spontaneous mutations that disrupt a gene encoding a key enzyme in the biosynthesis of cobalamin (Vitamin B12). This disruption may affect the production of succinyl-CoA by methylmalonyl-CoA mutase, which requires adenosylcobalamin as a cofactor. The depletion of cellular succinyl-CoA may impact the tricarboxylic acid (TCA) cycle, which becomes metabolically overloaded upon exposure to tobramycin. Consequently, the mutants exhibited significantly reduced reactive oxygen species (ROS) production. Both the wild-type and mutants showed tolerance to tobramycin and various other bactericidal antibiotics under microaerobic conditions. This suggests that compromised ROS-mediated killing, due to the impacted TCA cycle, underlies the mutants' tolerance to bactericidal antibiotics. The importance of ROS-mediated killing and the potential emergence of mutants that evade it through the depletion of cobalamin (Vitamin B12) provide valuable insights for developing strategies to enhance antibiotic treatments of Bcc pneumonia.
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Affiliation(s)
- Dongju Lee
- Division of Biosystems and Biomedical Sciences, College of Health Sciences, Korea University, Seoul 02841, Republic of Korea
| | - Jongwook Park
- Division of Biosystems and Biomedical Sciences, College of Health Sciences, Korea University, Seoul 02841, Republic of Korea
| | - Heenam Stanley Kim
- Division of Biosystems and Biomedical Sciences, College of Health Sciences, Korea University, Seoul 02841, Republic of Korea
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Abnaroodheleh F, Mosavari N, Pourbakhsh SA, Tadayon K, Jamshidian M. Identification of Burkholderia mallei Isolates with Polymerase Chain Reaction-Restriction Fragment Length Polymorphism. ARCHIVES OF RAZI INSTITUTE 2023; 78:1305-1312. [PMID: 38226390 PMCID: PMC10787924 DOI: 10.32592/ari.2023.78.4.1305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/14/2021] [Indexed: 01/17/2024]
Abstract
Burkholderia mallei is the main cause of glanders as a dangerous contagious zoonosis disease that is mostly observed in single-hoofed animals, especially horses. Modern molecular techniques have been recently employed to improve epidemiology for identifying and searching for strains of this bacterium at different times and locations. Due to the unknown number of circulating strains and lack of preventive methods, glanders is still observed in the form of epidemics. The present study aimed to evaluate six field isolates plus two laboratory strains of Borkolderia mallei and Burkholderia pseudomallei using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. All the isolates and strains were microbially cultured in the glycerol nutrient and glycerol agar media. The individually grown colonies of the bacterium were used in the biochemical tests. The DNA of isolates was extracted by boiling, and the PCR-RFLP test was conducted on their genome. Finally, the bacterium was injected into guinea pigs to induce the Straus reaction. The biochemical assays (or bioassays) confirmed the isolates as Burkholderia mallei. The PCR-RFLP assay demonstrated a product for Burkholderia mallei with a length of 650 bp. Nevertheless, 250 and 400 bp were produced for Burkholderia pseudomallei. The swollen scrotum pointed to the occurrence of the Straus reaction. The PCR-RFLP is a proper differential diagnosis technique for B. mallei; moreover, it is a suitable method for differentiating between Burkholderia mallei and Burkholderia pseudomallei. This technique can detect Burkholderia mallei in a short time with high precision and sensitivity.
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Affiliation(s)
- F Abnaroodheleh
- Veterinary Department, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - N Mosavari
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - S A Pourbakhsh
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - K Tadayon
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - M Jamshidian
- Veterinary Department, Science and Research Branch, Islamic Azad University, Tehran, Iran
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Gauvreau A, Carrier FM, Poirier C, Morisset J, Lands LC, Lavoie A, Nasir B, Ferraro P, Luong ML. Post-transplant outcomes among cystic fibrosis patients undergoing lung transplantation colonized by Burkholderia: A single center cohort study. J Heart Lung Transplant 2023; 42:917-924. [PMID: 36894412 DOI: 10.1016/j.healun.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Prior infection with Burkholderia cepacia complex (BCC) has been associated with poorer outcomes after lung transplantation, posing an important dilemma for cystic fibrosis (CF). Although current guidelines consider BCC infection to be a relative contraindication, some centers continue to offer lung transplantation to BCC-infected CF patients. METHODS We conducted a retrospective cohort study which included all consecutive CF-LTR between 2000 and 2019 to compare the postoperative survival of BCC-infected CF lung transplant recipients (CF-LTR) to BCC-uninfected patients. We used a Kaplan-Meier analysis to compare survival of BCC-infected to BCC-uninfected CF-LTR and fitted a multivariable Cox model, adjusted for age, sex, BMI and year of transplantation as potential confounders. As an exploratory analysis, Kaplan-Meier curves were also stratified by the presence of BCC and urgency of transplantation. RESULTS A total of 205 patients were included with a mean age of 30.5 years. Seventeen patients (8%) were infected with BCC prior to LT. Patients were infected with the following species: B. multivorans5, B. vietnamiensis3, combined B. multivorans and B. vietnamiensis3 and others4. None of the patients were infected with B. cenocepacia. Three patients were infected with B. gladioli. One-year survival was 91.7% (188/205) for the entire cohort, 82.4% (14/17) among BCC-infected CF-LTR, and 92.5% (173/188) among BCC uninfected CF-LTR (crude HR = 2.19; 95%CI 0.99-4.85; p = 0.05). In the multivariable model, presence of BCC was not significantly associated with worse survival (adjusted HR 1.89; 95%CI 0.85-4.24; p = 0.12). In the stratified analysis for both presence of BCC and urgency of transplantation, urgency of transplantation among BCC-infected CF-LTR appeared to be associated with poorer outcome (p = 0.003 across the 4 subgroups). CONCLUSION Our results suggest that non-cenocepacia BCC-infected CF-LTR have comparable survival rate to BCC-uninfected CF-LTR.
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Affiliation(s)
- Andréa Gauvreau
- Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - François M Carrier
- Department of Anesthesiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Department of Medicine, Critical care service, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Carrefour de l'innovation et santé des populations, Centre de recherche du CHUM, Montréal, Quebec, Canada
| | - Charles Poirier
- Department of Medicine, Division of Respirology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Julie Morisset
- Department of Medicine, Division of Respirology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Larry C Lands
- Department of Medicine, Division of Respirology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Annick Lavoie
- Department of Medicine, Division of Respirology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Basil Nasir
- Department of Thoracic Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Pasquale Ferraro
- Department of Thoracic Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Me-Linh Luong
- Department of Medicine, Division of Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
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Shen BJ, Wang JT, Chang HT, Chang SC, Liao CH. Single-Center Experience of Control of Ventilator-Circuit-Transmitted Burkholderia cepacia Outbreak in an Intensive Care Unit. Trop Med Infect Dis 2023; 8:335. [PMID: 37505631 PMCID: PMC10384831 DOI: 10.3390/tropicalmed8070335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Burkholderia cepacia is an emerging nosocomial pathogen frequently associated with outbreaks, but the exact transmission route of this pathogen can at times be elusive in spite of extensive environmental investigative cultures. Active surveillance for sputum cultures was performed for all patients from September 2008 to September 2009 in an intensive care unit (ICU) with B. cepacia outbreak. With evidence of persistent positive conversion of sputum cultures (colonization) and infections among patients, discontinuing re-usable ventilator circuits was introduced. A total of 689 patients were admitted to this unit for a mean duration of 8.7 ± 7.5 days. There were 489 patients (71.0%) with a stay for one to ten days; 161 (23.4%) patients for 11 to 20 days; and 39 (5.7%) with over 20 days. In the first group, 13.5% of patients had cultures converting from negative to positive, in contrast to 66.7% in the last group (p < 0.01). With intervention of using disposable ventilator circuits since June 2009, the incidence of isolated B. cepacia decreased gradually. The estimated 30-day isolation-free probabilities of the groups before, during, one month (August 2009) after, and two months (September 2009) after this intervention were 38.5%, 47.3%, 66.5%, and 96.0%, respectively (p < 0.01). Furthermore, the effect of discontinuing reusable ventilator circuit persisted in the following 6 years; both total isolates of B. cepacia and the infection caused by it were much lower compared to the outbreak period. In summary, this six-year outbreak in a medical ICU persisted until reusable ventilator circuits were discontinued in 2009. The effect of disposable circuits on the decreased incidence of B. cepacia infection maintained in the following years.
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Affiliation(s)
- Bing-Jie Shen
- Department of Radiation Oncology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Jann-Tay Wang
- Division of Infectious Disease, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Hou-Tai Chang
- Department of Critical Care Medicine, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
| | - Shan-Chwen Chang
- Division of Infectious Disease, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Chun-Hsing Liao
- Division of Infectious Disease, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 100147, Taiwan
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Clinical Outcomes Associated with Burkholderia cepacia Complex Infection in Patients with Cystic Fibrosis. Ann Am Thorac Soc 2021; 17:1542-1548. [PMID: 32678679 DOI: 10.1513/annalsats.202003-204oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rationale: Little is known in contemporary cystic fibrosis (CF) cohorts about the outcomes after new Burkholderia species infections.Objectives: To evaluate the changing epidemiology and clinical outcomes associated with Burkholderia species infections in persons with CF.Methods: A cohort study of children and adults with CF was conducted from 1997 to 2018 in Toronto, Canada. Patients were characterized as those with no history of Burkholderia species infection and as those who were culture-positive for Burkholderia species for the first time in this time frame and were categorized by species (B. gladioli, B. cenocepacia, B. multivorans, or other) and strain (B. cenocepacia ET-12). Cox models were used to estimate the risk of death or transplantation. Mixed-effects models were used to assess the impact of Burkholderia species on odds of pulmonary exacerbations and effect on lung function (percentage predicted forced expiratory volume in 1 second [FEV1]).Results: A total of 1,196 patients were followed over 20 years; 88 patients (7.4%) had one or more culture-positive for Burkholderia species. Patients with ET-12 infection had a median time to death of 1.95 years compared with 5.30-6.72 years for those with other Burkholderia infections. ET-12 infection was associated with a greater risk of death or transplantation compared with patients with no history of Burkholderia infection in a univariate model (hazard ratio, 3.92; 95% confidence interval 2.25-6.81) but was no longer significant after adjusting for confounders. Pulmonary exacerbations were more common in those with Burkholderia infections and remained significant in the ET-12 group after adjusting for confounders (odds ratio, 2.96; 95% confidence interval, 1.17-7.53). No differences were noted in baseline FEV1% or the rate of FEV1% decline between the groups with and without Burkholderia species infection.Conclusions: With the exception of ET-12, the acquisition of Burkholderia species infection did not appear to worsen clinical outcomes compared with those with no history of infection. Given this, prognosis, management and clinical trial inclusion protocols may need to be reevaluated for persons with Burkholderia infection.
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Biofilm formation by strains of Burkholderia cenocepacia lineages IIIA and IIIB and B. gladioli pv. alliicola associated with onion bacterial scale rot. Braz J Microbiol 2021; 52:1665-1675. [PMID: 34351603 DOI: 10.1007/s42770-021-00564-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022] Open
Abstract
The Burkholderia genus has high ecological and nutritional versatility, having species capable of causing diseases in animals, humans, and plants. During chronic infections in humans, biofilm formation is a characteristic often associated with strains from different species of this genus. However, there is still no information on the formation of biofilms by plant pathogenic strains of B. cenocepacia (Bce) lineages IIIA and IIIB and B. gladioli pv. alliicola (Bga), which are associated with onion bacterial scale rot in the semi-arid region of northeast Brazil. In this study, we performed an in vitro characterization of biofilm formation ability in different culture media by the phytopathogenic strains of Bce and Bga and investigated its relationship with swarming motility. Our results indicated the existence of an intraspecific variation in biofilm formation capacity in vitro by these bacteria and the existence of a negative correlation between swarming motility and biofilm formation for strains of Bce lineage IIIB. In addition, histopathological analyses performed using optical microscopy and scanning electron microscopy revealed the formation of biofilm in vivo by Bce strains in onion tissues.
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Lood C, Peeters C, Lamy-Besnier Q, Wagemans J, De Vos D, Proesmans M, Pirnay JP, Echahidi F, Piérard D, Thimmesch M, Boeras A, Lagrou K, De Canck E, De Wachter E, van Noort V, Lavigne R, Vandamme P. Genomics of an endemic cystic fibrosis Burkholderia multivorans strain reveals low within-patient evolution but high between-patient diversity. PLoS Pathog 2021; 17:e1009418. [PMID: 33720991 PMCID: PMC7993779 DOI: 10.1371/journal.ppat.1009418] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/25/2021] [Accepted: 02/22/2021] [Indexed: 12/11/2022] Open
Abstract
Burkholderia multivorans is a member of the Burkholderia cepacia complex (Bcc), notorious for its pathogenicity in persons with cystic fibrosis. Epidemiological surveillance suggests that patients predominantly acquire B. multivorans from environmental sources, with rare cases of patient-to-patient transmission. Here we report on the genomic analysis of thirteen isolates from an endemic B. multivorans strain infecting four cystic fibrosis patients treated in different pediatric cystic fibrosis centers in Belgium, with no evidence of cross-infection. All isolates share an identical sequence type (ST-742) but whole genome analysis shows that they exhibit peculiar patterns of genomic diversity between patients. By combining short and long reads sequencing technologies, we highlight key differences in terms of small nucleotide polymorphisms indicative of low rates of adaptive evolution within patient, and well-defined, hundred kbps-long segments of high enrichment in mutations between patients. In addition, we observed large structural genomic variations amongst the isolates which revealed different plasmid contents, active roles for transposase IS3 and IS5 in the deactivation of genes, and mobile prophage elements. Our study shows limited within-patient B. multivorans evolution and high between-patient strain diversity, indicating that an environmental microdiverse reservoir must be present for this endemic strain, in which active diversification is taking place. Furthermore, our analysis also reveals a set of 30 parallel adaptations across multiple patients, indicating that the specific genomic background of a given strain may dictate the route of adaptation within the cystic fibrosis lung.
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Affiliation(s)
- Cédric Lood
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, Leuven, Belgium
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics, Laboratory of Computational Systems Biology, KU Leuven, Leuven, Belgium
| | - Charlotte Peeters
- Belgian National Reference Centre for Burkholderia, Laboratory of Microbiology, Department of Biochemistry and Microbiology, Faculty of Sciences, Ghent University, Ghent, Belgium
| | - Quentin Lamy-Besnier
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, Leuven, Belgium
| | - Jeroen Wagemans
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, Leuven, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Marijke Proesmans
- Department of Pediatrics, University Hospital Leuven, University of Leuven, Leuven, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Fedoua Echahidi
- Belgian National Reference Centre for Burkholderia, Department of Microbiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Denis Piérard
- Belgian National Reference Centre for Burkholderia, Department of Microbiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Anca Boeras
- Department of Microbiology, CHC MontLégia, Liège, Belgique
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Clinical department of Laboratory Medicine, University Hospital Leuven, Leuven, Belgium
| | - Evelien De Canck
- Belgian National Reference Centre for Burkholderia, Laboratory of Microbiology, Department of Biochemistry and Microbiology, Faculty of Sciences, Ghent University, Ghent, Belgium
| | - Elke De Wachter
- Department of Pediatric Pulmonology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Vera van Noort
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics, Laboratory of Computational Systems Biology, KU Leuven, Leuven, Belgium
- Institute of Biology, Leiden University, Leiden, The Netherlands
| | - Rob Lavigne
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, Leuven, Belgium
- * E-mail: (RL); (PV)
| | - Peter Vandamme
- Belgian National Reference Centre for Burkholderia, Laboratory of Microbiology, Department of Biochemistry and Microbiology, Faculty of Sciences, Ghent University, Ghent, Belgium
- * E-mail: (RL); (PV)
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Wong MY, Tseng YH, Huang TY, Lin BS, Tung CW, Chu C, Huang YK. Comparison of Microbiological Characteristics and Genetic Diversity between Burkholderia cepacia Complex Isolates from Vascular Access and Other Clinical Infections. Microorganisms 2020; 9:microorganisms9010051. [PMID: 33375496 PMCID: PMC7824166 DOI: 10.3390/microorganisms9010051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/19/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022] Open
Abstract
Burkholderia cepacia complex (BCC) is a group of closely related bacteria with widespread environmental distribution. BCC bacteria are opportunistic pathogens that cause nosocomial infections in patients, especially cystic fibrosis (CF). Multilocus sequence typing (MLST) is used nowadays to differentiate species within the BCC complex. This study collected 41 BCC isolates from vascular access infections (VAIs) and other clinical infections between 2014 and 2020. We preliminarily identified bacterial isolates using standard biochemical procedures and further conducted recA gene sequencing and MLST for species identification. We determined genetic diversity indices using bioinformatics software. We studied 14 isolates retrieved from patients with VAIs and observed that Burkholderia cepacia was the predominant bacterial species, and B. contaminans followed by B. cenocepacia were mainly retrieved from patients with other infections. According to MLST data, we identified that all B. contaminans isolates belonged to ST102, while a wide variety of sequence types (STs) were found in B. cenocepacia isolates. In summary, the high diversity and easy transmission of BCC increase BCC infections, which provides insights into their potential clinical effects in non-CF infections.
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Affiliation(s)
- Min Yi Wong
- Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan; (M.Y.W.); (Y.-H.T.)
- Microbiology Research and Treatment Center, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan;
- Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan 71150, Taiwan;
| | - Yuan-Hsi Tseng
- Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan; (M.Y.W.); (Y.-H.T.)
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan;
| | - Tsung-Yu Huang
- Microbiology Research and Treatment Center, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan;
- Division of Infectious Diseases, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
| | - Bor-Shyh Lin
- Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan 71150, Taiwan;
| | - Chun-Wu Tung
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan;
- Department of Nephrology, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
| | - Chishih Chu
- Department of Microbiology, Immunology and Biopharmaceuticals, National Chiayi University, Chiayi City 60004, Taiwan;
| | - Yao-Kuang Huang
- Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan; (M.Y.W.); (Y.-H.T.)
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan;
- Division of Infectious Diseases, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
- Correspondence: ; Tel.: +886-975368209
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Price EP, Soler Arango V, Kidd TJ, Fraser TA, Nguyen TK, Bell SC, Sarovich DS. Duplex real-time PCR assay for the simultaneous detection of Achromobacter xylosoxidans and Achromobacter spp. Microb Genom 2020; 6:mgen000406. [PMID: 32667877 PMCID: PMC7478622 DOI: 10.1099/mgen.0.000406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/26/2020] [Indexed: 01/10/2023] Open
Abstract
Several members of the Gram-negative environmental bacterial genus Achromobacter are associated with serious infections, with Achromobacter xylosoxidans being the most common. Despite their pathogenic potential, little is understood about these intrinsically drug-resistant bacteria and their role in disease, leading to suboptimal diagnosis and management. Here, we performed comparative genomics for 158 Achromobacter spp. genomes to robustly identify species boundaries, reassign several incorrectly speciated taxa and identify genetic sequences specific for the genus Achromobacter and for A. xylosoxidans. Next, we developed a Black Hole Quencher probe-based duplex real-time PCR assay, Ac-Ax, for the rapid and simultaneous detection of Achromobacter spp. and A. xylosoxidans from both purified colonies and polymicrobial clinical specimens. Ac-Ax was tested on 119 isolates identified as Achromobacter spp. using phenotypic or genotypic methods. In comparison to these routine diagnostic methods, the duplex assay showed superior identification of Achromobacter spp. and A. xylosoxidans, with five Achromobacter isolates failing to amplify with Ac-Ax confirmed to be different genera according to 16S rRNA gene sequencing. Ac-Ax quantified both Achromobacter spp. and A. xylosoxidans down to ~110 genome equivalents and detected down to ~12 and ~1 genome equivalent(s), respectively. Extensive in silico analysis, and laboratory testing of 34 non-Achromobacter isolates and 38 adult cystic fibrosis sputa, confirmed duplex assay specificity and sensitivity. We demonstrate that the Ac-Ax duplex assay provides a robust, sensitive and cost-effective method for the simultaneous detection of all Achromobacter spp. and A. xylosoxidans and will facilitate the rapid and accurate diagnosis of this important group of pathogens.
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Affiliation(s)
- Erin P. Price
- GeneCology Research Centre, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Sunshine Coast Health Institute, Birtinya, Queensland, Australia
| | - Valentina Soler Arango
- GeneCology Research Centre, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Sunshine Coast Health Institute, Birtinya, Queensland, Australia
| | - Timothy J. Kidd
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, St Lucia, Queensland, Australia
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Tamieka A. Fraser
- GeneCology Research Centre, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Sunshine Coast Health Institute, Birtinya, Queensland, Australia
| | - Thuy-Khanh Nguyen
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Scott C. Bell
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Derek S. Sarovich
- GeneCology Research Centre, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Sunshine Coast Health Institute, Birtinya, Queensland, Australia
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Gruzelle V, Guet-Revillet H, Segonds C, Bui S, Macey J, Chiron R, Michelet M, Murris-Espin M, Mittaine M. Management of initial colonisations with Burkholderia species in France, with retrospective analysis in five cystic fibrosis Centres: a pilot study. BMC Pulm Med 2020; 20:159. [PMID: 32503487 PMCID: PMC7275364 DOI: 10.1186/s12890-020-01190-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 05/19/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Whereas Burkholderia infections are recognized to impair prognosis in cystic fibrosis (CF) patients, there is no recommendation to date for early eradication therapy. The aim of our study was to analyse the current management of initial colonisations with Burkholderia cepacia complex (BCC) or B. gladioli in French CF Centres and its impact on bacterial clearance and clinical outcome. METHODS We performed a retrospective review of the primary colonisations (PC), defined as newly positive sputum cultures, observed between 2010 and 2018 in five CF Centres. Treatment regimens, microbiological and clinical data were collected. RESULTS Seventeen patients (14 with BCC, and 3 with B. gladioli) were included. Eradication therapy, using heterogeneous combinations of intravenous, oral or nebulised antibiotics, was attempted in 11 patients. Six out of the 11 treated patients, and 4 out of the 6 untreated patients cleared the bacterium. Though not statistically significant, higher forced expiratory volume in 1 second and forced vital capacity at PC and consistency of treatment with in vitro antibiotic susceptibility tended to be associated with eradication. The management of PC was shown to be heterogeneous, thus impairing the statistical power of our study. Large prospective studies are needed to define whom to treat, when, and how. CONCLUSIONS Pending these studies, we propose, due to possible spontaneous clearance, to check the presence of Burkholderia 1 month after PC before starting antibiotics, at least in the milder cases, and to evaluate a combination of intravenous beta-lactam + oral or intravenous fluoroquinolone + inhaled aminoglycoside.
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Affiliation(s)
- Vianney Gruzelle
- CRCM pédiatrique, Service de Pneumo-Allergologie pédiatrique, Hôpital des Enfants, Centre Hospitalier Universitaire de Toulouse, 330 avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France
| | - Hélène Guet-Revillet
- Service de Bactériologie-Hygiène, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
- Observatoire Burkholderia cepacia, Centre Hospitalier Universitaire de Toulouse, Toulouse, France / Vaincre la Mucoviscidose, Paris, France
| | - Christine Segonds
- Observatoire Burkholderia cepacia, Centre Hospitalier Universitaire de Toulouse, Toulouse, France / Vaincre la Mucoviscidose, Paris, France
| | - Stéphanie Bui
- CRCM pédiatrique, Service de pédiatrie médicale, Centre Hospitalier Universitaire de Bordeaux-GH Pellegrin, Bordeaux, France
| | - Julie Macey
- Service de pneumologie, Centre Hospitalier Universitaire de Bordeaux-GH Sud - Hôpital Haut-Lévêque, Pessac, France
| | - Raphaël Chiron
- CRCM pédiatrique, Service des maladies respiratoires, Centre Hospitalier Universitaire de Montpellier - Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Marine Michelet
- CRCM pédiatrique, Service de Pneumo-Allergologie pédiatrique, Hôpital des Enfants, Centre Hospitalier Universitaire de Toulouse, 330 avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France
| | - Marlène Murris-Espin
- Service de pneumologie - Consultation Mucoviscidose, Pôle voies respiratoires, Centre Hospitalier Universitaire de Toulouse - Hôpital Larrey, Toulouse, France
| | - Marie Mittaine
- CRCM pédiatrique, Service de Pneumo-Allergologie pédiatrique, Hôpital des Enfants, Centre Hospitalier Universitaire de Toulouse, 330 avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France.
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Freitas ADARD, Faria AR, Pinto TDCA, Merquior VLC, Neves DM, Costa RDCD, Teixeira LM. Distribution of species and antimicrobial resistance among enterococci isolated from the fecal microbiota of captive blue-fronted parrot (Amazona aestiva) in Rio de Janeiro, Brazil. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 615:1428-1437. [PMID: 29055593 DOI: 10.1016/j.scitotenv.2017.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 06/07/2023]
Abstract
Enterococcal strains recovered from fecal samples of captive blue-fronted parrots (Amazona aestiva) assisted at two wild animal screening centers in Rio de Janeiro, Brazil, were identified as Enterococcus hirae (the predominant species; 75.3%), followed by Enterococcus faecalis (17.3%), Enterococcus casseliflavus (4.8%), Enterococcus gallinarum (1.7%), and Enterococcus hermanniensis (0.9%). All strains were susceptible to linezolid and teicoplanin. Rates of nonsusceptibility (including resistant and intermediate categories) to other 16 antimicrobials tested varied from 69.3% to 0.4%, A considerable proportion (48.0%) of the strains was multidrug-resistant and diverse genetic determinants associated with antimicrobial resistance were identified. Tetracycline-resistant strains carried the tet(M) and/or tet(L) genes. Macrolides resistance was associated with the erm(B), erm(A) and mefA genes, while 43.2% of the isolates were negative for the investigated genes. High-level resistance to gentamicin associated with the aac(6')-le-aph(2″)-la gene was detected in one E. faecalis strain. The two strains presenting high-level resistance to streptomycin were negative for the ant(6')-Ia, ant(3')-Ia, ant(9')-Ia and ant(9')-Ib genes. The vat(D) gene was found in all the 47 quinupristin/dalfopristin resistant strains identified as non-E. faecalis. Analysis of PFGE profiles of E. hirae strains after restriction with SmaI demonstrated the occurrence of five clonal groups. The predominant E. hirae clone was distributed among birds in the two institutions, suggesting that this clone was well adapted to the host and environments investigated. The four clonal groups identified among E. faecalis were composed by small numbers of strains and, generally, restricted to birds in the same sector. The occurrence of enterococcal strains exhibiting antimicrobial resistance traits and carrying genetic determinants that represent potential threats to the health of both humans and animals, in the intestinal microbiota of A. aestiva, highlights the need for additional monitoring studies to elucidate the population structure and the dynamics of transmission of these microorganisms among animals, humans and the environment.
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Affiliation(s)
| | - Adriana Rocha Faria
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Departamento de Microbiologia, Imunologia e Parasitologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Vânia Lúcia Carreira Merquior
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Daniel Marchesi Neves
- Centro de Triagem de Animais Silvestres do Rio de Janeiro (CETAS-RJ), Seropédica, RJ, Brazil
| | | | - Lúcia Martins Teixeira
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Peeters C, Cooper VS, Hatcher PJ, Verheyde B, Carlier A, Vandamme P. Comparative genomics of Burkholderia multivorans, a ubiquitous pathogen with a highly conserved genomic structure. PLoS One 2017; 12:e0176191. [PMID: 28430818 PMCID: PMC5400248 DOI: 10.1371/journal.pone.0176191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/06/2017] [Indexed: 12/23/2022] Open
Abstract
The natural environment serves as a reservoir of opportunistic pathogens. A well-established method for studying the epidemiology of such opportunists is multilocus sequence typing, which in many cases has defined strains predisposed to causing infection. Burkholderia multivorans is an important pathogen in people with cystic fibrosis (CF) and its epidemiology suggests that strains are acquired from non-human sources such as the natural environment. This raises the central question of whether the isolation source (CF or environment) or the multilocus sequence type (ST) of B. multivorans better predicts their genomic content and functionality. We identified four pairs of B. multivorans isolates, representing distinct STs and consisting of one CF and one environmental isolate each. All genomes were sequenced using the PacBio SMRT sequencing technology, which resulted in eight high-quality B. multivorans genome assemblies. The present study demonstrated that the genomic structure of the examined B. multivorans STs is highly conserved and that the B. multivorans genomic lineages are defined by their ST. Orthologous protein families were not uniformly distributed among chromosomes, with core orthologs being enriched on the primary chromosome and ST-specific orthologs being enriched on the second and third chromosome. The ST-specific orthologs were enriched in genes involved in defense mechanisms and secondary metabolism, corroborating the strain-specificity of these virulence characteristics. Finally, the same B. multivorans genomic lineages occur in both CF and environmental samples and on different continents, demonstrating their ubiquity and evolutionary persistence.
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Affiliation(s)
| | - Vaughn S. Cooper
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Philip J. Hatcher
- Department of Computer Science, University of New Hampshire, Durham, NH, United States of America
| | - Bart Verheyde
- Laboratory of Microbiology, Ghent University, Ghent, Belgium
| | | | - Peter Vandamme
- Laboratory of Microbiology, Ghent University, Ghent, Belgium
- * E-mail:
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Moon H, Park HJ, Jeong AR, Han SW, Park CJ. Isolation and identification of Burkholderia gladioli on Cymbidium orchids in Korea. BIOTECHNOL BIOTEC EQ 2016. [DOI: 10.1080/13102818.2016.1268069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Hyeran Moon
- Department of Bioresources Engineering and PERI, College of Life Science, Sejong University, Seoul, Republic of Korea
| | - Hye-Jee Park
- Department of Integrative Plant Science, College of Biotechnology and Natural Resource, Chung-Ang University, Anseong, Republic of Korea
| | - A-ram Jeong
- Department of Bioresources Engineering and PERI, College of Life Science, Sejong University, Seoul, Republic of Korea
| | - Sang-Wook Han
- Department of Integrative Plant Science, College of Biotechnology and Natural Resource, Chung-Ang University, Anseong, Republic of Korea
| | - Chang-Jin Park
- Department of Bioresources Engineering and PERI, College of Life Science, Sejong University, Seoul, Republic of Korea
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Peeters C, Daenekindt S, Vandamme P. PCR detection of Burkholderia multivorans in water and soil samples. BMC Microbiol 2016; 16:184. [PMID: 27514367 PMCID: PMC4981952 DOI: 10.1186/s12866-016-0801-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 08/04/2016] [Indexed: 12/12/2022] Open
Abstract
Background Although semi-selective growth media have been developed for the isolation of Burkholderia cepacia complex bacteria from the environment, thus far Burkholderia multivorans has rarely been isolated from such samples. Because environmental B. multivorans isolates mainly originate from water samples, we hypothesized that water rather than soil is its most likely environmental niche. The aim of the present study was to assess the occurrence of B. multivorans in water samples from Flanders (Belgium) using a fast, culture-independent PCR assay. Results A nested PCR approach was used to achieve high sensitivity, and specificity was confirmed by sequencing the resulting amplicons. B. multivorans was detected in 11 % of the water samples (n = 112) and 92 % of the soil samples (n = 25) tested. The percentage of false positives was higher for water samples compared to soil samples, showing that the presently available B. multivorans recA primers lack specificity when applied to the analysis of water samples. Conclusions The results of the present study demonstrate that B. multivorans DNA is commonly present in soil samples and to a lesser extent in water samples in Flanders (Belgium). Electronic supplementary material The online version of this article (doi:10.1186/s12866-016-0801-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charlotte Peeters
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
| | - Stijn Daenekindt
- Department of Sociology, Ghent University, Ghent, Belgium.,Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Peter Vandamme
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium.
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15
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Saiman L, Siegel JD, LiPuma JJ, Brown RF, Bryson EA, Chambers MJ, Downer VS, Fliege J, Hazle LA, Jain M, Marshall BC, O’Malley C, Pattee SR, Potter-Bynoe G, Reid S, Robinson KA, Sabadosa KA, Schmidt HJ, Tullis E, Webber J, Weber DJ. Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update. Infect Control Hosp Epidemiol 2016; 35 Suppl 1:S1-S67. [DOI: 10.1086/676882] [Citation(s) in RCA: 270] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:1.The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.2.Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistantStaphylococcus aureus(MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.
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16
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Peeters C, Depoorter E, Praet J, Vandamme P. Extensive cultivation of soil and water samples yields various pathogens in patients with cystic fibrosis but not Burkholderia multivorans. J Cyst Fibros 2016; 15:769-775. [PMID: 26996269 DOI: 10.1016/j.jcf.2016.02.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/26/2016] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND While the epidemiology of Burkholderia cepacia complex (Bcc) bacteria in cystic fibrosis (CF) patients suggests that Burkholderia multivorans is acquired from environmental sources, this species has rarely been isolated from soil and water samples. METHODS Multiple isolation strategies were applied to water and soil samples that were previously shown to be B. multivorans PCR positive. These included direct plating and liquid enrichment procedures and the use of selective media, acclimatizing recovery and co-cultivation with CF sputum. MALDI-TOF mass spectrometry and sequence analysis of 16S rRNA and housekeeping genes were used to identify all isolates. RESULTS None of the approaches yielded B. multivorans isolates. Other Burkholderia species, several Gram-negative non-fermenting bacteria (including Cupriavidus, Inquilinus, Pandoraea, Pseudomonas and Stenotrophomonas) and rapidly growing mycobacteria (including Mycobacterium chelonae) were all isolated from water and soil samples. CONCLUSIONS The use of Bcc isolation media yielded a surprisingly wide array of rare but often clinically relevant CF pathogens, confirming that soil and water are reservoirs of these infectious agents.
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Affiliation(s)
- Charlotte Peeters
- Laboratory of Microbiology, Ghent University, K. L. Ledeganckstraat 35, 9000 Ghent, Belgium.
| | - Eliza Depoorter
- Laboratory of Microbiology, Ghent University, K. L. Ledeganckstraat 35, 9000 Ghent, Belgium.
| | - Jessy Praet
- Laboratory of Microbiology, Ghent University, K. L. Ledeganckstraat 35, 9000 Ghent, Belgium.
| | - Peter Vandamme
- Laboratory of Microbiology, Ghent University, K. L. Ledeganckstraat 35, 9000 Ghent, Belgium.
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Fosmidomycin decreases membrane hopanoids and potentiates the effects of colistin on Burkholderia multivorans clinical isolates. Antimicrob Agents Chemother 2014; 58:5211-9. [PMID: 24957830 DOI: 10.1128/aac.02705-14] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Burkholderia cepacia complex (Bcc) pulmonary infections in people living with cystic fibrosis (CF) are difficult to treat because of the extreme intrinsic resistance of most isolates to a broad range of antimicrobials. Fosmidomycin is an antibacterial and antiparasitic agent that disrupts the isoprenoid biosynthesis pathway, a precursor to hopanoid biosynthesis. Hopanoids are involved in membrane stability and contribute to polymyxin resistance in Bcc bacteria. Checkerboard MIC assays determined that although isolates of the Bcc species B. multivorans were highly resistant to treatment with fosmidomycin or colistin (polymyxin E), antimicrobial synergy was observed in certain isolates when the antimicrobials were used in combination. Treatment with fosmidomycin decreased the MIC of colistin for isolates as much as 64-fold to as low as 8 μg/ml, a concentration achievable with colistin inhalation therapy. A liquid chromatography-tandem mass spectrometry technique was developed for the accurate quantitative determination of underivatized hopanoids in total lipid extracts, and bacteriohopanetetrol cyclitol ether (BHT-CE) was found to be the dominant hopanoid made by B. multivorans. The amount of BHT-CE made was significantly reduced upon fosmidomycin treatment of the bacteria. Uptake assays with 1-N-phenylnaphthylamine were used to determine that dual treatment with fosmidomycin and colistin increases membrane permeability, while binding assays with boron-dipyrromethene-conjugated polymyxin B illustrated that the addition of fosmidomycin had no impact on polymyxin binding. This work indicates that pharmacological suppression of membrane hopanoids with fosmidomycin treatment can increase the susceptibility of certain clinical B. multivorans isolates to colistin, an agent currently in use to treat pulmonary infections in CF patients.
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18
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Wiener-Well Y, Segonds C, Mazuz B, Kopuit P, Assous MV. Successful outbreak investigation of Burkholderia cepacia complex bacteremia in intensive care patients. Am J Infect Control 2014; 42:580-1. [PMID: 24655899 DOI: 10.1016/j.ajic.2013.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 12/18/2013] [Indexed: 11/26/2022]
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Shahapur PR, Peerapur BV, Shahapur RP, Honnutagi RM, Biradar MS. Lymphocutaneous nocardiosis caused by Nocardia otitidiscaviarum: A case report and review of literature. J Nat Sci Biol Med 2014; 5:197-201. [PMID: 24678228 PMCID: PMC3961935 DOI: 10.4103/0976-9668.127328] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Nocardia otitidiscaviarum is a rare clinical isolate of primary cutaneous infections. This report describes a case of lymphocutaneous nocardiosis caused by N. otitidiscaviarum. Analysis of 16S ribosomal RNA gene of the isolate and the type strain of N. otitidiscaviarum DSM 43242 showed 100% similarity. The partial gene sequence of 1439 bp was submitted to GenBank. (EU031786). The isolate was susceptible only to amikacin, minocycline, linezolid and resistant to remaining other routine anti-nocardial drugs. The patient was free of nocardiosis after 12 weeks of treatment with amikacin and linezolid. We reviewed four other cases of lymphocutaneous nocardiosis caused by N. otitidiscaviarum.
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Affiliation(s)
- Praveen R Shahapur
- Department of Microbiology, BLDE University's Shri. B. M. Patil Medical College, Bijapur, Karnataka, India
| | - B V Peerapur
- Department of Microbiology, BLDE University's Shri. B. M. Patil Medical College, Bijapur, Karnataka, India
| | - R P Shahapur
- Department of Medicine, BLDE University's Shri. B. M. Patil Medical College, Bijapur, Karnataka, India
| | - R M Honnutagi
- Department of Medicine, BLDE University's Shri. B. M. Patil Medical College, Bijapur, Karnataka, India
| | - M S Biradar
- Department of Medicine, BLDE University's Shri. B. M. Patil Medical College, Bijapur, Karnataka, India
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Sharma P, Gupta SK, Rolain JM. Whole genome sequencing of bacteria in cystic fibrosis as a model for bacterial genome adaptation and evolution. Expert Rev Anti Infect Ther 2014; 12:343-55. [PMID: 24502835 DOI: 10.1586/14787210.2014.887441] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cystic fibrosis (CF) airways harbor a wide variety of new and/or emerging multidrug resistant bacteria which impose a heavy burden on patients. These bacteria live in close proximity with one another, which increases the frequency of lateral gene transfer. The exchange and movement of mobile genetic elements and genomic islands facilitate the spread of genes between genetically diverse bacteria, which seem to be advantageous to the bacterium as it allows adaptation to the new niches of the CF lungs. Niche adaptation is one of the major evolutionary forces shaping bacterial genome composition and in CF the chronic strains adapt and become less virulent. The purpose of this review is to shed light on CF bacterial genome alterations. Next-generation sequencing technology is an exciting tool that may help us to decipher the genome architecture and the evolution of bacteria colonizing CF lungs.
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Affiliation(s)
- Poonam Sharma
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergents, CNRS-IRD, UMR 7278, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, 27 Bd Jean-Moulin, Marseille Cedex 05 13385, France
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Brizendine K, Baddley J, Pappas P, Leon K, Rodriguez J. Fatal Burkholderia gladioli infection misidentified as Empedobacter brevis in a lung transplant recipient with cystic fibrosis. Transpl Infect Dis 2012; 14:E13-8. [DOI: 10.1111/j.1399-3062.2012.00726.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 12/06/2011] [Accepted: 12/08/2011] [Indexed: 12/31/2022]
Affiliation(s)
- K.D. Brizendine
- Division of Infectious Diseases; Department of Medicine; University of Alabama at Birmingham; Birmingham; Alabama; USA
| | | | - P.G. Pappas
- Division of Infectious Diseases; Department of Medicine; University of Alabama at Birmingham; Birmingham; Alabama; USA
| | - K.J. Leon
- Division of Pulmonary; Allergy and Critical Care Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham; Alabama; USA
| | - J.M. Rodriguez
- Division of Infectious Diseases; Department of Medicine; University of Alabama at Birmingham; Birmingham; Alabama; USA
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Liao CH, Chang HT, Lai CC, Huang YT, Hsu MS, Liu CY, Yang CJ, Hsueh PR. Clinical characteristics and outcomes of patients with Burkholderia cepacia bacteremia in an intensive care unit. Diagn Microbiol Infect Dis 2011; 70:260-6. [DOI: 10.1016/j.diagmicrobio.2011.01.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 01/14/2011] [Accepted: 01/16/2011] [Indexed: 01/31/2023]
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Thompson G, Wickes B, Herrera M, Haman T, Lewis J, Jorgensen J. Disseminated Burkholderia gladioli infection in a lung transplant recipient with underlying hypocomplementemic urticarial vasculitis. Transpl Infect Dis 2011; 13:641-5. [DOI: 10.1111/j.1399-3062.2011.00638.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vandamme P, Dawyndt P. Classification and identification of the Burkholderia cepacia complex: Past, present and future. Syst Appl Microbiol 2011; 34:87-95. [DOI: 10.1016/j.syapm.2010.10.002] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2010] [Revised: 10/20/2010] [Accepted: 10/24/2010] [Indexed: 11/24/2022]
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25
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Isolation and characterization of a new Burkholderia pyrrocinia strain JK-SH007 as a potential biocontrol agent. World J Microbiol Biotechnol 2011. [DOI: 10.1007/s11274-011-0686-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hauser AR, Jain M, Bar-Meir M, McColley SA. Clinical significance of microbial infection and adaptation in cystic fibrosis. Clin Microbiol Rev 2011; 24:29-70. [PMID: 21233507 PMCID: PMC3021203 DOI: 10.1128/cmr.00036-10] [Citation(s) in RCA: 287] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A select group of microorganisms inhabit the airways of individuals with cystic fibrosis. Once established within the pulmonary environment in these patients, many of these microbes adapt by altering aspects of their structure and physiology. Some of these microbes and adaptations are associated with more rapid deterioration in lung function and overall clinical status, whereas others appear to have little effect. Here we review current evidence supporting or refuting a role for the different microbes and their adaptations in contributing to poor clinical outcomes in cystic fibrosis.
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Affiliation(s)
- Alan R Hauser
- Department of Microbiology/Immunology, Northwestern University, 303 E. Chicago Ave., Searle 6-495, Chicago, IL 60611, USA.
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Abstract
Infection of the airways remains the primary cause of morbidity and mortality in persons with cystic fibrosis (CF). This review describes salient features of the epidemiologies of microbial species that are involved in respiratory tract infection in CF. The apparently expanding spectrum of species causing infection in CF and recent changes in the incidences and prevalences of infection due to specific bacterial, fungal, and viral species are described. The challenges inherent in tracking and interpreting rates of infection in this patient population are discussed.
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Streptococcus salivarius meningitis case strain traced to oral flora of anesthesiologist. J Clin Microbiol 2010; 48:2589-91. [PMID: 20504987 DOI: 10.1128/jcm.00426-10] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two women in labor received intrapartum spinal anesthesia from the same anesthesiologist approximately 1 h apart. Within 15 h, both patients developed Streptococcus salivarius meningitis and one patient died. Blood and cerebrospinal fluid (CSF) samples from both patients and tongue swab specimens from the anesthesiologist yielded isolates of an indistinguishable S. salivarius strain.
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Mil-Homens D, Rocha EPC, Fialho AM. Genome-wide analysis of DNA repeats in Burkholderia cenocepacia J2315 identifies a novel adhesin-like gene unique to epidemic-associated strains of the ET-12 lineage. Microbiology (Reading) 2010; 156:1084-1096. [DOI: 10.1099/mic.0.032623-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Members of the Burkholderia cepacia complex (Bcc) are respiratory pathogens in patients with cystic fibrosis (CF). Close repetitive DNA sequences often associate with surface antigens to promote genetic variability in pathogenic bacteria. The genome of Burkholderia cenocepacia J2315, a CF isolate belonging to the epidemic lineage Edinburgh–Toronto (ET-12), was analysed for the presence of close repetitive DNA sequences. Among the 422 DNA close repeats, 45 genes potentially involved in virulence were identified and grouped into 12 classes; of these, 13 genes were included in the antigens class. Two trimeric autotransporter adhesins (TAA) among the 13 putative antigens are absent from the other Burkholderia genomes and are clustered downstream of the cci island that is a marker for transmissible B. cenocepacia strains. This cluster contains four adhesins, one outer-membrane protein, one sensor histidine kinase and two transcriptional regulators. By using PCR, we analysed three genes among 47 Bcc isolates to determine whether the cluster was conserved. These three genes were present in the isolates of the ET-12 lineage but absent in all the other members. Furthermore, the BCAM0224 gene was exclusively detected in this epidemic lineage and may serve as a valuable new addition to the field of Bcc diagnostics. The BCAM0224 gene encodes a putative TAA that demonstrates adhesive properties to the extracellular matrix protein collagen type I. Quantitative real-time PCR analysis indicated that BCAM0224 gene expression occurred preferentially for cells grown under high osmolarity, oxygen-limited conditions and oxidative stress. Inactivation of BCAM0224 in B. cenocepacia attenuates the ability of the mutant to promote cell adherence in vitro and impairs the overall bacterial virulence against Galleria mellonella as a model of infection. Together, our data show that BCAM0224 from B. cenocepacia J2315 represents a new collagen-binding TAA with no bacterial orthologues which has an important role in cellular adhesion and virulence.
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Affiliation(s)
- Dalila Mil-Homens
- IBB-Institute for Biotechnology and Bioengineering, Center for Biological and Chemical Engineering, Instituto Superior Técnico, Lisbon 1049-001, Portugal
| | - Eduardo P. C. Rocha
- Microbial Evolutionary Genomics Group, CNRS URA2171, Institute Pasteur, F-75015 Paris, France
- Atelier de Bioinformatique, Université Pierre et Marie Curie-Paris 6, Paris, F-75005 France
| | - Arsenio M. Fialho
- IBB-Institute for Biotechnology and Bioengineering, Center for Biological and Chemical Engineering, Instituto Superior Técnico, Lisbon 1049-001, Portugal
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Dalmastri C, Fiore A, Alisi C, Bevivino A, Tabacchioni S, Giuliano G, Sprocati AR, Segre L, Mahenthiralingam E, Chiarini L, Vandamme P. A rhizospheric Burkholderia cepacia complex population: genotypic and phenotypic diversity of Burkholderia cenocepacia and Burkholderia ambifaria. FEMS Microbiol Ecol 2009; 46:179-87. [PMID: 19719571 DOI: 10.1016/s0168-6496(03)00211-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The Burkholderia cepacia'complex' (Bcc) presently comprises nine species and genomovars. In order to acquire a better comprehension of the species and genomovar distribution and of the genetic diversity among environmental Bcc bacteria, a natural population of 60 bacterial isolates recovered from the rhizosphere of maize and belonging to the Bcc has been characterised to assess the exact taxonomic position, the genetic polymorphism and the metabolic profiles of isolates. The identification of the different species and genomovars was accomplished by a combination of techniques including sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole-cell proteins and recA-based restriction fragment length polymorphism analyses. The genetic diversity among Bcc isolates was analysed by means of the random amplified polymorphic DNA and amplified fragment length polymorphism techniques; the analysis of molecular variance method was applied to estimate the genetic differences among the various species and genomovars identified within the bacterial population. Metabolic profiles based on carbon source utilisation were obtained by means of the Biolog GN assay and analysed by means of cluster analysis. Forty-four strains were identified as B. ambifaria, 11 as B. cenocepacia recA lineage III-B, four as B. pyrrocinia, and one as B. cepacia genomovar I. Marked genetic differences were observed between B. cenocepacia and B. ambifaria, whereas limited differences were found between B. pyrrocinia and B. ambifaria and between B. pyrrocinia and B. cenocepacia. No significant differences (P>0.05) were observed between the mean genetic distances of isolates belonging to B. cenocepacia, B. ambifaria, and B. pyrrocinia. Phenotypic analyses revealed that all isolates tested were able to utilise more than 75% of substrates. The highest variability in the number of utilised substrates was found among B. cenocepacia isolates, whereas the lowest was found among B. ambifaria isolates. Cluster analysis of metabolic profiles revealed pronounced differences between B. cenocepacia and B. ambifaria; in contrast, B. pyrrocinia could not be clearly separated either from B. cenocepacia or from B. ambifaria.
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Affiliation(s)
- Claudia Dalmastri
- ENEA (Ente Nazionale per le Nuove Tecnologie, l'Energia e l'Ambiente) C.R. Casaccia, Unità Biotecnologie e Protezione della Salute e degli Ecosistemi, Via Anguillarese 301, 00060 S. Maria di Galeria, Rome, Italy
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Wainwright CE, France MW, O'Rourke P, Anuj S, Kidd TJ, Nissen MD, Sloots TP, Coulter C, Ristovski Z, Hargreaves M, Rose BR, Harbour C, Bell SC, Fennelly KP. Cough-generated aerosols of Pseudomonas aeruginosa and other Gram-negative bacteria from patients with cystic fibrosis. Thorax 2009; 64:926-31. [PMID: 19574243 PMCID: PMC2764123 DOI: 10.1136/thx.2008.112466] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Pseudomonas aeruginosa is the most common bacterial pathogen in patients with cystic fibrosis (CF). Current infection control guidelines aim to prevent transmission via contact and respiratory droplet routes and do not consider the possibility of airborne transmission. It was hypothesised that subjects with CF produce viable respirable bacterial aerosols with coughing. METHODS A cross-sectional study was undertaken of 15 children and 13 adults with CF, 26 chronically infected with P aeruginosa. A cough aerosol sampling system enabled fractioning of respiratory particles of different sizes and culture of viable Gram-negative non-fermentative bacteria. Cough aerosols were collected during 5 min of voluntary coughing and during a sputum induction procedure when tolerated. Standardised quantitative culture and genotyping techniques were used. RESULTS P aeruginosa was isolated in cough aerosols of 25 subjects (89%), 22 of whom produced sputum samples. P aeruginosa from sputum and paired cough aerosols were indistinguishable by molecular typing. In four cases the same genotype was isolated from ambient room air. Approximately 70% of viable aerosols collected during voluntary coughing were of particles <or=3.3 microm aerodynamic diameter. P aeruginosa, Burkholderia cenocepacia, Stenotrophomonas maltophilia and Achromobacter xylosoxidans were cultivated from respiratory particles in this size range. Positive room air samples were associated with high total counts in cough aerosols (p = 0.003). The magnitude of cough aerosols was associated with higher forced expiratory volume in 1 s (r = 0.45, p = 0.02) and higher quantitative sputum culture results (r = 0.58, p = 0.008). CONCLUSION During coughing, patients with CF produce viable aerosols of P aeruginosa and other Gram-negative bacteria of respirable size range, suggesting the potential for airborne transmission.
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Affiliation(s)
- C E Wainwright
- Department of Respiratory Medicine, Royal Children's Hospital and Health Service District, Brisbane, Australia.
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Microbiological and epidemiological features of clinical respiratory isolates of Burkholderia gladioli. J Clin Microbiol 2009; 47:1510-6. [PMID: 19297595 DOI: 10.1128/jcm.02489-08] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Burkholderia gladioli, primarily known as a plant pathogen, is involved in human infections, especially in patients with cystic fibrosis (CF). In the present study, the first respiratory isolates recovered from 14 French patients with CF and 4 French patients without CF, identified by 16S rRNA gene analysis, were tested for growth on B. cepacia selective media, for identification by commercial systems, and for their antimicrobial susceptibilities, and were compared by pulsed-field gel electrophoresis (PFGE). Patients' data were collected. All 18 isolates grew on oxidation-fermentation-polymyxin B-bacitracin-lactose medium and Pseudomonas cepacia agar, but only 13 grew on Burkholderia cepacia selective agar. API 20NE strips did not differentiate B. gladioli from B. cepacia, whereas Vitek 2 GN cards correctly identified 15 isolates. All isolates were susceptible to piperacillin, imipenem, aminoglycosides, and ciprofloxacin and were far less resistant to ticarcillin than B. cepacia complex organisms. Fifteen PFGE types were observed among the 18 isolates, but shared types were not identified among epidemiologically related patients. The microbiological follow-up of CF patients showed that colonization was persistent in 3 of 13 documented cases; B. gladioli was isolated from posttransplantation cultures of blood from 1 patient. Among the patients without CF, B. gladioli was associated with intubation (three cases) or bronchiectasis (one case). In summary, the inclusion of B. gladioli in the databases of commercial identification systems should improve the diagnostic capabilities of those systems. In CF patients, this organism is more frequently involved in transient infections than in chronic infections, but it may be responsible for complications posttransplantation; patient-to-patient transmission has not been demonstrated to date. Lastly, B. gladioli appears to be naturally susceptible to aminoglycosides and ciprofloxacin, although resistant isolates may emerge in the course of chronic infections.
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Low rates of Pseudomonas aeruginosa misidentification in isolates from cystic fibrosis patients. J Clin Microbiol 2009; 47:1503-9. [PMID: 19261796 DOI: 10.1128/jcm.00014-09] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pseudomonas aeruginosa is an important cause of pulmonary infection in cystic fibrosis (CF). Its correct identification ensures effective patient management and infection control strategies. However, little is known about how often CF sputum isolates are falsely identified as P. aeruginosa. We used P. aeruginosa-specific duplex real-time PCR assays to determine if 2,267 P. aeruginosa sputum isolates from 561 CF patients were correctly identified by 17 Australian clinical microbiology laboratories. Misidentified isolates underwent further phenotypic tests, amplified rRNA gene restriction analysis, and partial 16S rRNA gene sequence analysis. Participating laboratories were surveyed on how they identified P. aeruginosa from CF sputum. Overall, 2,214 (97.7%) isolates from 531 (94.7%) CF patients were correctly identified as P. aeruginosa. Further testing with the API 20NE kit correctly identified only 34 (59%) of the misidentified isolates. Twelve (40%) patients had previously grown the misidentified species in their sputum. Achromobacter xylosoxidans (n = 21), Stenotrophomonas maltophilia (n = 15), and Inquilinus limosus (n = 4) were the species most commonly misidentified as P. aeruginosa. Overall, there were very low rates of P. aeruginosa misidentification among isolates from a broad cross section of Australian CF patients. Additional improvements are possible by undertaking a culture history review, noting colonial morphology, and performing stringent oxidase, DNase, and colistin susceptibility testing for all presumptive P. aeruginosa isolates. Isolates exhibiting atypical phenotypic features should be evaluated further by additional phenotypic or genotypic identification techniques.
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Naturally occurring Class A ss-lactamases from the Burkholderia cepacia complex. Antimicrob Agents Chemother 2008; 53:876-82. [PMID: 19075063 DOI: 10.1128/aac.00946-08] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Chromosomally encoded ss-lactamases from the Burkholderia cepacia complex species (formerly Pseudomonas cepacia) were characterized. Cloning and sequencing identified an Ambler class A ss-lactamase (PenB) from B. cenocepacia. It shares 82% amino acid identity with the PenA ss-lactamases previously identified from B. multivorans 249. Its expression was dependent upon a LysR-type regulatory protein. Its narrow-spectrum hydrolysis activity mostly included penicillins but also included expanded-spectrum cephalosporins and aztreonam at lower levels. In that study, Pen-like ss-lactamases (PenC, PenD, PenE, PenF) that shared 63 to 92% identity with PenB from B. cenocepacia were identified from other Burkholderia species. The corresponding ss-lactamase genes might be used as genetic tools for accurate Burkholderia species identification.
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Kotsanas D, Brett J, Kidd TJ, Stuart RL, Korman TM. Disinfection of Burkholderia cepacia complex from non-touch taps in a neonatal nursery. J Perinat Med 2008; 36:235-9. [PMID: 18576933 DOI: 10.1515/jpm.2008.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Burkholderia cepacia complex (Bcc) comprises nine closely related species or genomovars. It is an important causative agent of opportunistic infections and waterborne nosocomial infections. B. cepacia (formerly genomovar I) was identified from the blood culture of a baby in our neonatal unit (NU) in March 2005. B. cepacia was isolated four times from clinical specimens since the introduction of non-touch taps in the NU from 2000 to 2005 and only once from 1994 to 2000. Environmental samples were collected from the NU, including tap water from non-touch taps. Clinical and environmental isolates of Bcc were characterized using molecular identification and strain typing. A literature review was undertaken to delineate a method for eradication of Bcc. Several variations for hot water eradication of the organism from the taps were attempted. Genotyping and molecular analysis revealed that tap water isolates were B. cenocepacia which was a different species from the B. cepacia isolated from blood cultures of the neonate. However, B. cenocepacia has been known to cause nosocomial outbreaks and it was eventually eradicated from the NU by using repeated thermal shock (hot water at 65 degrees C for 10 min), changing taps and decolonizing sinks with hypochlorite. Molecular typing is useful in assisting the investigation of Bcc nosocomial infections.
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Affiliation(s)
- Despina Kotsanas
- Southern Health-Monash Medical Centre, Clayton, Victoria, Australia.
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The genome of Burkholderia cenocepacia J2315, an epidemic pathogen of cystic fibrosis patients. J Bacteriol 2008; 191:261-77. [PMID: 18931103 PMCID: PMC2612433 DOI: 10.1128/jb.01230-08] [Citation(s) in RCA: 273] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Bacterial infections of the lungs of cystic fibrosis (CF) patients cause major complications in the treatment of this common genetic disease. Burkholderia cenocepacia infection is particularly problematic since this organism has high levels of antibiotic resistance, making it difficult to eradicate; the resulting chronic infections are associated with severe declines in lung function and increased mortality rates. B. cenocepacia strain J2315 was isolated from a CF patient and is a member of the epidemic ET12 lineage that originated in Canada or the United Kingdom and spread to Europe. The 8.06-Mb genome of this highly transmissible pathogen comprises three circular chromosomes and a plasmid and encodes a broad array of functions typical of this metabolically versatile genus, as well as numerous virulence and drug resistance functions. Although B. cenocepacia strains can be isolated from soil and can be pathogenic to both plants and man, J2315 is representative of a lineage of B. cenocepacia rarely isolated from the environment and which spreads between CF patients. Comparative analysis revealed that ca. 21% of the genome is unique in comparison to other strains of B. cenocepacia, highlighting the genomic plasticity of this species. Pseudogenes in virulence determinants suggest that the pathogenic response of J2315 may have been recently selected to promote persistence in the CF lung. The J2315 genome contains evidence that its unique and highly adapted genetic content has played a significant role in its success as an epidemic CF pathogen.
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Murray S, Charbeneau J, Marshall BC, LiPuma JJ. Impact ofBurkholderiaInfection on Lung Transplantation in Cystic Fibrosis. Am J Respir Crit Care Med 2008; 178:363-71. [DOI: 10.1164/rccm.200712-1834oc] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of nonfermenting gram-negative bacilli isolated from cystic fibrosis patients. J Clin Microbiol 2008; 46:3361-7. [PMID: 18685005 DOI: 10.1128/jcm.00569-08] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The identification of nonfermenting gram-negative bacilli isolated from cystic fibrosis (CF) patients is usually achieved by using phenotype-based techniques and eventually molecular tools. These techniques remain time-consuming, expensive, and technically demanding. We used a method based on matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) for the identification of these bacteria. A set of reference strains belonging to 58 species of clinically relevant nonfermenting gram-negative bacilli was used. To identify peaks discriminating between these various species, the profile of 10 isolated colonies obtained from 10 different passages was analyzed for each referenced strain. Conserved peaks with a relative intensity greater than 0.1 were retained. The spectra of 559 clinical isolates were then compared to that of each of the 58 reference strains as follows: 400 Pseudomonas aeruginosa, 54 Achromobacter xylosoxidans, 32 Stenotrophomonas maltophilia, 52 Burkholderia cepacia complex (BCC), 1 Burkholderia gladioli, 14 Ralstonia mannitolilytica, 2 Ralstonia pickettii, 1 Bordetella hinzii, 1 Inquilinus limosus, 1 Cupriavidus respiraculi, and 1 Burkholderia thailandensis. Using this database, 549 strains were correctly identified. Nine BCC strains and one R. mannnitolilytica strain were identified as belonging to the appropriate genus but not the correct species. We subsequently engineered BCC- and Ralstonia-specific databases using additional reference strains. Using these databases, correct identification for these species increased from 83 to 98% and from 94 to 100% of cases, respectively. Altogether, these data demonstrate that, in CF patients, MALDI-TOF-MS is a powerful tool for rapid identification of nonfermenting gram-negative bacilli.
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Mahenthiralingam E, Baldwin A, Dowson C. Burkholderia cepacia complex bacteria: opportunistic pathogens with important natural biology. J Appl Microbiol 2008; 104:1539-51. [DOI: 10.1111/j.1365-2672.2007.03706.x] [Citation(s) in RCA: 290] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kidd TJ, Douglas JM, Bergh HA, Coulter C, Bell SC. Burkholderia cepacia complex epidemiology in persons with cystic fibrosis from Australia and New Zealand. Res Microbiol 2008; 159:194-9. [PMID: 18356026 DOI: 10.1016/j.resmic.2008.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Revised: 12/19/2007] [Accepted: 01/09/2008] [Indexed: 11/17/2022]
Abstract
The Burkholderia cepacia complex (Bcc) is a group of significant opportunistic respiratory pathogens which affect people with cystic fibrosis. In this study, we sought to ascertain the epidemiology and geographic species distribution of 116 Bcc isolates collected from people with CF in Australia and New Zealand. We performed a combination of recA-based PCR, amplified rDNA restriction analysis (ARDRA), pulsed-field gel electrophoresis and repetitive extragenic palindromic PCR on each isolate. Each Burkholderia cenocepacia isolate was also screened by PCR for the presence of the B. cepacia epidemic strain marker. One hundred and fourteen isolates were assigned to a species using recA-based PCR and ARDRA. B. cenocepacia, B. multivorans and B. cepacia accounted for 45.7%, 29.3% and 11.2% of the isolates, respectively. Strain analysis of B. cenocepacia revealed that 85.3% of the isolates were unrelated. One related B. cenocepacia strain was identified amongst 15 people. Whilst full details of person-to-person contact was not available, all patients attended CF centres in Queensland (Qld) and New South Wales (NSW). Although person-to-person transmission of B. cenocepacia strains has occurred in Australia, the majority of CF-related Bcc infections in Australia and New Zealand are most likely acquired from the environment.
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Affiliation(s)
- Timothy J Kidd
- Department of Microbiology, Pathology Queensland, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Queensland 4032, Australia.
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Elucidating global epidemiology of Burkholderia multivorans in cases of cystic fibrosis by multilocus sequence typing. J Clin Microbiol 2007; 46:290-5. [PMID: 18032622 DOI: 10.1128/jcm.01818-07] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Burkholderia multivorans is a prominent B. cepacia complex (BCC) species causing infection in people with cystic fibrosis. Despite infection control measures being introduced to reduce the spread of BCC there is a continued emergence of infections by B. multivorans. Our objective was to analyze a global collection of B. multivorans isolates, comparing those from environmental and clinical sources with those from reported outbreaks. Multilocus sequence typing (MLST) was performed on 107 B. multivorans isolates to provide a detailed analysis of the global population biology of this species. MLST resolved 64 B. multivorans sequence types. Twelve of these were globally distributed and associated with human infection; two of these (ST-21 and ST-375) were also composed of environmental isolates. These global lineages included strains previously linked to large outbreaks (e.g., French epidemic clone ST-16). Though few environmental isolates of B. multivorans were available for analysis, of six strains identified, three were identical to strains recovered from cystic fibrosis (CF) infection. Although the ability of B. multivorans to cause CF outbreaks is known, our report here concerning the existence of globally distributed B. multivorans CF strains is a new observation for this emerging B. cepacia complex pathogen and suggests that certain strain types may be better adapted to human infection than others. Common transmission-associated risk factors were not obviously linked to the globally distributed strains; however, the overlap in strains recovered from water environments, industrial products, and human infection suggests that environmental sources may be an important reservoir for infection with B. multivorans.
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Abstract
In this article, the authors outline some of the major historical events that signaled the need to better understand mechanisms of infection in cystic fibrosis (CF). The authors discuss general principles of infection control, focusing on issues of particular importance to patients who have CF. The authors also describe the major pathogens associated with the CF airway, provide a review of findings from inpatient and outpatient studies of infection control, and provide an outline of future directions for investigation.
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Affiliation(s)
- Jonathan B Zuckerman
- Department of Medicine, The University of Vermont College of Medicine, E-126 Given Building, 89 Beaumont Avenue, Burlington, VT 05405-0068, USA.
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Brown JM, Cowley KD, Manninen KI, McNeil MM. Phenotypic and molecular epidemiologic evaluation of a Nocardia farcinica mastitis epizootic. Vet Microbiol 2007; 125:66-72. [PMID: 17553640 DOI: 10.1016/j.vetmic.2007.04.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Revised: 04/24/2007] [Accepted: 04/26/2007] [Indexed: 11/22/2022]
Abstract
Nineteen putative Nocardia farcinica isolates epidemiologically associated with intramammary products containing neomycin were obtained from clinical cases in a Canada-wide mastitis epizootic. Epidemiologic investigations were unable to identify the mechanism for transmission. To evaluate the hypotheses generated (intrinsic versus extrinsic contamination) and to confirm the identity of N. farcinica, we compared these isolates phenotypically (biochemicals and antimicrobial susceptibility studies) and genotypically (16S rRNA gene sequencing analysis, chromosomal DNA and ribotyping profiles) with the type and reference strains of N. farcinica. Results of biochemical studies and 16S rRNA gene sequencing identified the isolates as N. farcinica. Results of chromosomal DNA and ribotyping profiles and antimicrobial resistance to amikacin indicated all were a unique clone of N. farcinica that differed from the control isolates. Our study suggests the epizootic was caused by transmission of a unique clone of N. farcinica through intrinsically contaminated dry cow intramammary products rather than an extrinsic source.
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Affiliation(s)
- June M Brown
- Bacterial Zoonoses Branch, Division of Foodborne, Bacterial and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Perin L, Martínez-Aguilar L, Castro-González R, Estrada-de Los Santos P, Cabellos-Avelar T, Guedes HV, Reis VM, Caballero-Mellado J. Diazotrophic burkholderia species associated with field-grown maize and sugarcane. Appl Environ Microbiol 2006; 72:3103-10. [PMID: 16672447 PMCID: PMC1472400 DOI: 10.1128/aem.72.5.3103-3110.2006] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Until recently, diazotrophy was known in only one of the 30 formally described species of Burkholderia. Novel N(2)-fixing plant-associated Burkholderia species such as B. unamae, B. tropica, and B. xenovorans have been described, but their environmental distribution is scarcely known. In the present study, the occurrence of N(2)-fixing Burkholderia species associated with different varieties of sugarcane and maize growing in regions of Mexico and Brazil was analyzed. Only 111 out of more than 900 isolates recovered had N(2)-fixing ability as demonstrated by the acetylene reduction assay. All 111 isolates also yielded a PCR product with primers targeting the nifH gene, which encodes a key enzyme in the process of nitrogen fixation. These 111 isolates were confirmed as belonging to the genus Burkholderia by using a new 16S rRNA-specific primer pair for diazotrophic species (except B. vietnamiensis) and closely related nondiazotrophic Burkholderia. In Mexico, many isolates of B. unamae (predominantly associated with sugarcane) and B. tropica (more often associated with maize) were recovered. However, in Brazil B. tropica was not identified among the isolates analyzed, and only a few B. unamae isolates were recovered from one sugarcane variety. Most Brazilian diazotrophic Burkholderia isolates (associated with both sugarcane and maize plants) belonged to a novel species, as revealed by amplified 16S rRNA gene restriction profiles, 16S rRNA gene sequencing, and protein electrophoresis. In addition, transmissibility factors such as the cblA and esmR genes, identified among clinical and environmental isolates of opportunistic pathogens of B. cenocepacia and other species of the B. cepacia complex, were not detected in any of the plant-associated diazotrophic Burkholderia isolates analyzed.
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Affiliation(s)
- L Perin
- Universidade Federal Rural do Rio de Janeiro, km. 45, BR 465, CP 74505, Seropédica, Rio de Janeiro, Brazil
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Vonberg RP, Häußler S, Vandamme P, Steinmetz I. Identification of Burkholderia cepacia complex pathogens by rapid-cycle PCR with fluorescent hybridization probes. J Med Microbiol 2006; 55:721-727. [PMID: 16687590 DOI: 10.1099/jmm.0.46457-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Members of the Burkholderia cepacia complex are important bacterial pathogens in cystic fibrosis (CF) patients. The B. cepacia complex currently consists of nine genetic subgroups (genomovars) of different epidemiological relevance and possibly of different pathogenic potential in humans. In this study, a new approach was developed for the rapid identification of B. cepacia genomovar I, Burkholderia multivorans (genomovar II), Burkholderia cenocepacia (lineage III-A and III-B), Burkholderia stabilis (genomovar IV) and Burkholderia vietnamiensis (genomovar V), which cause the large majority of infections in CF patients. The method was based on the detection of differences in the recA gene sequence by using rapid-cycle PCR and genomovar-specific fluorescence resonance energy transfer (FRET) probes. The genomovar status of all 39 B. cepacia complex strains tested (genomovars I–V) was identified by melting-curve analysis. Each FRET probe produced a specific fluorescence signal only with the respective genomovar, and not with other B. cepacia complex strains and Burkholderia spp. The identification system was easy to handle and revealed B. cepacia complex genomovar I–V status from culture isolates within about 1 h.
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Affiliation(s)
- Ralf-Peter Vonberg
- Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Susanne Häußler
- Department of Cell Biology, German Research Center for Biotechnology, Braunschweig, Germany
- Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Peter Vandamme
- Laboratorium voor Mikrobiologie, Universiteit Gent, Belgium
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, Ernst Moritz Arndt University Greifswald, Germany
- Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
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46
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Pirone L, Chiarini L, Dalmastri C, Bevivino A, Tabacchioni S. Detection of cultured and uncultured Burkholderia cepacia complex bacteria naturally occurring in the maize rhizosphere. Environ Microbiol 2006; 7:1734-42. [PMID: 16232288 DOI: 10.1111/j.1462-2920.2005.00897.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The species composition of a Burkholderia cepacia complex population naturally occurring in the maize rhizosphere was investigated by using both culture-dependent and culture-independent methods. B. cepacia complex isolates were recovered from maize root slurry on the two selective media Pseudomonas cepacia azelaic acid tryptamine (PCAT) and trypan blue tetracycline (TB-T) and subjected to identification by a combination of restriction fragment length polymorphism (RFLP) analysis and species-specific polymerase chain reaction (PCR) tests of the recA gene. DNA extracted directly from root slurry was examined by means of nested PCR to amplify recA gene with species-specific B. cepacia complex primers and to obtain a library of PCR amplified recA genes. Using the culture-dependent method the species Burkholderia cepacia, Burkholderia cenocepacia, Burkholderia ambifaria and Burkholderia pyrrocinia were identified, whereas using the culture-independent method also the species Burkholderia vietnamiensis was detected. The latter method also allowed us to highlight a higher diversity within the B. cenocepacia species. In fact, by using the culture-independent method the species B. cenocepacia recA lineages IIIA and IIID besides B. cenocepacia recA lineage IIIB were detected. Moreover, higher heterogeneity of recA RFLP patterns was observed among clones assigned to the species B. cenocepacia than among B. cenocepacia isolates from selective media.
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Affiliation(s)
- Luisa Pirone
- ENEA (Ente Nazionale per le Nuove Tecnologie, l'Energia e l'Ambiente) C.R. Casaccia, UTS Biotecnologie - Protezione della Salute e degli Ecosistemi, Sezione Genetica e Genomica, Via Anguillarese 301, 00060 S. Maria di Galeria, Rome, Italy
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Levett PN, Morey RE, Galloway RL, Steigerwalt AG. Leptospira broomii sp. nov., isolated from humans with leptospirosis. Int J Syst Evol Microbiol 2006; 56:671-673. [PMID: 16514048 DOI: 10.1099/ijs.0.63783-0] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Isolates of Leptospira from two human cases of leptospirosis in Denmark and France were studied using DNA–DNA relatedness, G+C content, 16S rRNA gene sequence data and pulsed-field gel electrophoresis. These isolates differed from previously described species of Leptospira and are defined as Leptospira broomii sp. nov. The type strain is 5399T (=ATCC BAA-1107T=KIT 5399T).
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Affiliation(s)
- Paul N Levett
- Meningitis and Special Pathogens Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Roger E Morey
- Meningitis and Special Pathogens Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Renee L Galloway
- Meningitis and Special Pathogens Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Arnold G Steigerwalt
- Meningitis and Special Pathogens Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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48
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Kalish LA, Waltz DA, Dovey M, Potter-Bynoe G, McAdam AJ, Lipuma JJ, Gerard C, Goldmann D. Impact ofBurkholderia dolosaon Lung Function and Survival in Cystic Fibrosis. Am J Respir Crit Care Med 2006; 173:421-5. [PMID: 16272450 DOI: 10.1164/rccm.200503-344oc] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Chronic infection with Burkholderia cepacia complex bacteria in cystic fibrosis is associated with accelerated decline in pulmonary function and increased mortality. Clinical implications of the recently characterized genomovar VI, B. dolosa, are unknown. OBJECTIVES Characterization of impact of B. dolosa on pulmonary function and mortality in cystic fibrosis. METHODS We compared patients chronically infected with B. dolosa (n = 31) with unmatched patients with B. multivorans (n = 24) and with age- and sex-matched control subjects without Burkholderia species (n = 58). We analyzed rates of pulmonary function decline (% predicted FEV(1)) using a random effects model assuming segmented linear trends. All available FEV(1) measurements from 5 yr (median, 4.8) before until 2.5 yr (median, 1.5) after the first positive culture for Burkholderia (reference date) were analyzed. Survival was compared using the Kaplan-Meier method and proportional hazards model. MEASUREMENTS AND MAIN RESULTS Baseline FEV(1) and rate of decline were similar in the cohorts. Decline in FEV(1) after the reference date accelerated in patients with B. dolosa (-2.3 percentage points/yr pre vs. -7.1 post, p = 0.002), but was unchanged in the B. multivorans and control patients (-2.3 vs. -0.8 post, p = 0.38, and -2.1 pre vs. -0.5 post, p = 0.20, respectively). The probability of dying within 18 mo of the reference date was 13, 7, and 3% for B. dolosa, B. multivorans, and control patients, respectively (B. dolosa vs. control hazard ratio, 10.8; 95% confidence interval, 1.3-92.8; p = 0.03). CONCLUSIONS B. dolosa chronic infection in cystic fibrosis is associated with accelerated loss of lung function and decreased survival.
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Affiliation(s)
- Leslie A Kalish
- Infectious Diseases Division, Clinical Research Program; Division of Respiratory Diseases, Infection Control Program, Department of Laboratory Medicine, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
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49
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Campana S, Taccetti G, Ravenni N, Favari F, Cariani L, Sciacca A, Savoia D, Collura A, Fiscarelli E, De Intinis G, Busetti M, Cipolloni A, d'Aprile A, Provenzano E, Collebrusco I, Frontini P, Stassi G, Trancassini M, Tovagliari D, Lavitola A, Doherty CJ, Coenye T, Govan JRW, Vandamme P. Transmission of Burkholderia cepacia complex: evidence for new epidemic clones infecting cystic fibrosis patients in Italy. J Clin Microbiol 2005; 43:5136-42. [PMID: 16207975 PMCID: PMC1248445 DOI: 10.1128/jcm.43.10.5136-5142.2005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To analyze national prevalence, genomovar distribution, and epidemiology of the Burkholderia cepacia complex in Italy, 225 putative B. cepacia complex isolates were obtained from 225 cystic fibrosis (CF) patients attending 18 CF centers. The genomovar status of these isolates was determined by a polyphasic approach, which included whole-cell protein electrophoresis and recA restriction fragment length polymorphism (RFLP) analysis. Two approaches were used to genotype B. cepacia complex isolates: BOX-PCR fingerprinting and pulsed-field gel electrophoresis (PFGE) of genomic macrorestriction fragments. A total of 208 (92%) of 225 isolates belonged to the B. cepacia complex, with Burkholderia cenocepacia as the most prevalent species (61.1%). Clones delineated by PFGE were predominantly linked to a single center; in contrast, BOX-PCR clones were composed of isolates collected either from the same center or from different CF centers and comprised multiple PFGE clusters. Three BOX-PCR clones appeared of special interest. One clone was composed of 17 B. cenocepacia isolates belonging to recA RFLP type H. These isolates were collected from six centers and represented three PFGE clusters. The presence of insertion sequence IS 1363 in all isolates and the comparison with PHDC reference isolates identified this clone as PHDC, an epidemic clone prominent in North American CF patients. The second clone included 22 isolates from eight centers and belonged to recA RFLP type AT. The genomovar status of strains with the latter RFLP type is not known. Most of these isolates belonged to four different PFGE clusters. Finally, a third clone comprised nine B. pyrrocinia isolates belonging to recA RFLP type Se 13. They represented three PFGE clusters and were collected in three CF centers.
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Affiliation(s)
- S Campana
- Department of Pediatrics, Cystic Fibrosis Center, University of Florence, 50132 Florence, Italy.
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50
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Chiron R, Marchandin H, Counil F, Jumas-Bilak E, Freydière AM, Bellon G, Husson MO, Turck D, Brémont F, Chabanon G, Segonds C. Clinical and microbiological features of Inquilinus sp. isolates from five patients with cystic fibrosis. J Clin Microbiol 2005; 43:3938-43. [PMID: 16081934 PMCID: PMC1233925 DOI: 10.1128/jcm.43.8.3938-3943.2005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Patients with cystic fibrosis (CF) may be colonized with unusual gram-negative bacilli whose identification is difficult and clinical impact unclear. We describe the clinical and microbiological features of five colonizations with organisms belonging to the recently described genus Inquilinus in CF patients. Isolates were identified from Burkholderia cepacia selective medium by means of 16S rRNA analysis. All of them were resistant to colistin, penicillins, cephalosporins, and monobactams but exhibited a remarkable susceptibility to imipenem. One of the five patients was transiently colonized with a nonmucoid isolate, whereas the four other patients were persistently colonized over the period of follow-up (8 to 21 months) with mucoid isolates. Pulsed-field gel electrophoresis of SpeI-digested genomic DNA was powerful for strain genotyping and demonstrated the clonality of Inquilinus sp. colonization for the two patients tested. Clinical evolution after the onset of Inquilinus was heterogeneous, but for at least one patient the lung function worsened and eradication of Inquilinus sp. was unsuccessful despite several imipenem courses. Finally, Inquilinus spp. may represent a new threat for CF patients due to their mucoid characteristic, their multiresistant pattern to antibiotics, and their ability to persist in the respiratory tract.
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Affiliation(s)
- Raphaël Chiron
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Hélène Marchandin
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - François Counil
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Estelle Jumas-Bilak
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Anne-Marie Freydière
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Gabriel Bellon
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Marie-Odile Husson
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Dominique Turck
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - François Brémont
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Gérard Chabanon
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
| | - Christine Segonds
- Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier, Laboratoire de Bactériologie, CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CRCM, Hôpital Jeanne de Flandre, Lille, CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants, Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France
- Corresponding author. Mailing address: Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, TSA50032, 31059 Toulouse cedex 9, France. Phone: 33 5 61 32 21 55. Fax: 33 5 61 32 26 20. E-mail:
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