M020: COLONISATION AND TRANSMISSION WITH BURKHOLDERIA CEPACIA
IN A FRENCH CYSTIC FIBROSIS (CF) CENTRE
Carrère J.*, Mathieu L.*, Segonds C.**, Godard C.***,
Bingen E.****, Galabert C.*, Chazalette J.P*. Observatoire du
P. Cepacia AFLM Paris - France. * Hopital Renee Sabran - Giens
- 83406 Hyeres France. ** Laboratoire Bacteriologie, C.H.U. Rangueil
- Toulouse - France, *** Laboratoire Bacteriologie C.H.U. J. Mintz
- Besanson - France. **** Laboratoire Bacteriologie Hopital R.
Debre Paris- France.
Infection with Burkholderia Cepacia (Bc) is regarded as a major risk for CF patients, with important cross-colonisation, multidrug-resistances and is associated in some cases with a high mortality
We investigated the incidence of lung infection by Bc in our centre. Bc was found in 17 (9 males and 8 females) of the 330 CF patients (5,1 %). Colonisation by this bacteria occurred at an average age of 15 years (8-32 years), the onset of which appeared 5 years or later, after the first colonisation with Pseudomonas aeruginosa (Pa). All 17 patients had severely deteriorated lung disease, a Shwachman-Kulczycki score of 64 (54-77).
PCR ribotyping, AP-PCR ribotyping, restriction fragment length polymorphism (RFLP), plasmidic profile were used to confirm the identity of strains.
Most Bc isolates were intrinsically resistant to antimicrobial agents. Preliminary results only indicates that:
- 7 types of Bc were found
- CF patients colonised by the same epidemic strain of Bc showed variable clinical responses.
Bc was never found in the environment.
In conclusion: this study confirms that there is person to person transmission of Bc, and gives rise to the question of its preferential colonisation in patients chronically infected with Pa and compromised pulmonary function.