Impact of Clonally-related Burkholderia Contaminans Strains in Two Patients Attending an Italian Cystic Fibrosis Centre: a Case Report

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2019 Aug 30

PMID 31464603

Authors

Daniela Savi

Serena Quattrucci

Maria Trancassini

Claudia Dalmastri

Riccardo V De Biase

Marta Maggisano

Paolo Palange

Annamaria Bevivino

Affiliations

Soon will be listed here.

Abstract

Background: Burkholderia contaminans is one of the 20 closely related bacterial of the Burkholderia cepacia complex, a group of bacteria that are ubiquitous in the environment and capable of infecting people with cystic fibrosis (CF). This species is an emerging pathogen and it has been widely isolated from CF patients in Argentina, Spain, Portugal, Australia, Canada, USA with a low prevalence in Ireland, France, Russia, Switzerland, Czech Republic, and Italy. This is the first report of B. contaminans affecting two Italian CF patients attending the same CF Centre. We correlate B. contaminans colonisation with lung function decline and co-infection with other clinically relevant CF pathogens.

Case Presentation: B. contaminans was identified by Multi Locus Sequence Typing in routine sputum analysis of two Caucasian CF women homozygous for Phe508del CFTR mutation. Sequence Type 102 was detected in both strains. It is known that B. contaminans ST102 was isolated both from CF and non-CF patients, with an intercontinental spread across the world. Random Amplified Polymorphic DNA analysis revealed the genetic relatedness between the two strains. We examined their susceptibility to antimicrobial agents, comparing the latter with that recorded for other B. contaminans isolated from different countries. We also described key virulence factors possibly linked with a clinical outcome. Specifically, we attempted to correlate colonization with the incidence of acute exacerbation of symptoms and lung function decline.

Conclusions: This case presentation suggests that acquisition of B. contaminans ST102 is not directly associated with a lung function decline. We retain that the presence of other CF pathogens (i.e. MRSA and Trichosporon) along with B. contaminans ST102 might have contributed to the worsening of clinical conditions in our CF patients. The circumstances leading to the establishment of B. contaminans ST102 infections are still unknown. We highlight the importance to proper detect and typing bacteria implicated in CF infection by using molecular techniques.

References

Mahenthiralingam E, Coenye T, Chung J, Speert D, Govan J, Taylor P . Diagnostically and experimentally useful panel of strains from the Burkholderia cepacia complex. J Clin Microbiol. 2000; 38(2):910-3. PMC: 86244. DOI: 10.1128/JCM.38.2.910-913.2000. View

Berriatua E, Ziluaga I, Uribarren P, Juste R, Laevens S, Vandamme P . Outbreak of subclinical mastitis in a flock of dairy sheep associated with Burkholderia cepacia complex infection. J Clin Microbiol. 2001; 39(3):990-4. PMC: 87862. DOI: 10.1128/JCM.39.3.990-994.2001. View

Venter J, Remington K, Heidelberg J, Halpern A, Rusch D, Eisen J . Environmental genome shotgun sequencing of the Sargasso Sea. Science. 2004; 304(5667):66-74. DOI: 10.1126/science.1093857. View

Vermis K, Coenye T, LiPuma J, Mahenthiralingam E, Nelis H, Vandamme P . Proposal to accommodate Burkholderia cepacia genomovar VI as Burkholderia dolosa sp. nov. Int J Syst Evol Microbiol. 2004; 54(Pt 3):689-691. DOI: 10.1099/ijs.0.02888-0. View

Jolley K, Chan M, Maiden M . mlstdbNet - distributed multi-locus sequence typing (MLST) databases. BMC Bioinformatics. 2004; 5:86. PMC: 459212. DOI: 10.1186/1471-2105-5-86. View

Souza A, Moreira C, Pasternak J, Hirata M, Saltini D, Caetano V . Characterizing uncommon Burkholderia cepacia complex isolates from an outbreak in a haemodialysis unit. J Med Microbiol. 2004; 53(Pt 10):999-1005. DOI: 10.1099/jmm.0.45702-0. View

Courtney J, Dunbar K, McDowell A, Moore J, Warke T, Stevenson M . Clinical outcome of Burkholderia cepacia complex infection in cystic fibrosis adults. J Cyst Fibros. 2004; 3(2):93-8. DOI: 10.1016/j.jcf.2004.01.005. View

Blackburn L, Brownlee K, Conway S, Denton M . 'Cepacia syndrome' with Burkholderia multivorans, 9 years after initial colonization. J Cyst Fibros. 2004; 3(2):133-4. DOI: 10.1016/j.jcf.2004.03.007. View

Mahenthiralingam E, Urban T, Goldberg J . The multifarious, multireplicon Burkholderia cepacia complex. Nat Rev Microbiol. 2005; 3(2):144-56. DOI: 10.1038/nrmicro1085. View

10.

Vanlaere E, Coenye T, Samyn E, Van den Plas C, Govan J, De Baets F . A novel strategy for the isolation and identification of environmental Burkholderia cepacia complex bacteria. FEMS Microbiol Lett. 2005; 249(2):303-7. DOI: 10.1016/j.femsle.2005.06.026. View

11.

Baldwin A, Mahenthiralingam E, Thickett K, Honeybourne D, Maiden M, Govan J . Multilocus sequence typing scheme that provides both species and strain differentiation for the Burkholderia cepacia complex. J Clin Microbiol. 2005; 43(9):4665-73. PMC: 1234123. DOI: 10.1128/JCM.43.9.4665-4673.2005. View

12.

Campana S, Taccetti G, Ravenni N, Favari F, Cariani L, Sciacca A . Transmission of Burkholderia cepacia complex: evidence for new epidemic clones infecting cystic fibrosis patients in Italy. J Clin Microbiol. 2005; 43(10):5136-42. PMC: 1248445. DOI: 10.1128/JCM.43.10.5136-5142.2005. View

13.

Kalish L, Waltz D, Dovey M, Potter-Bynoe G, McAdam A, LiPuma J . Impact of Burkholderia dolosa on lung function and survival in cystic fibrosis. Am J Respir Crit Care Med. 2005; 173(4):421-5. DOI: 10.1164/rccm.200503-344OC. View

14.

Giovannetti L, VENTURA S, Bazzicalupo M, Fani R, Materassi R . DNA restriction fingerprint analysis of the soil bacterium Azospirillum. J Gen Microbiol. 1990; 136(6):1161-6. DOI: 10.1099/00221287-136-6-1161. View

15.

Mahenthiralingam E, Baldwin A, Drevinek P, Vanlaere E, Vandamme P, LiPuma J . Multilocus sequence typing breathes life into a microbial metagenome. PLoS One. 2006; 1:e17. PMC: 1762331. DOI: 10.1371/journal.pone.0000017. View

16.

Cunha M, Pinto-de-Oliveira A, Meirinhos-Soares L, Salgado M, Melo-Cristino J, Correia S . Exceptionally high representation of Burkholderia cepacia among B. cepacia complex isolates recovered from the major Portuguese cystic fibrosis center. J Clin Microbiol. 2007; 45(5):1628-33. PMC: 1865859. DOI: 10.1128/JCM.00234-07. View

17.

Zahariadis G, Levy M, Burns J . Cepacia-like syndrome caused by Burkholderia multivorans. Can J Infect Dis. 2007; 14(2):123-5. PMC: 2094916. DOI: 10.1155/2003/675159. View

18.

Mahenthiralingam E, Baldwin A, Dowson C . Burkholderia cepacia complex bacteria: opportunistic pathogens with important natural biology. J Appl Microbiol. 2008; 104(6):1539-51. DOI: 10.1111/j.1365-2672.2007.03706.x. View

19.

Vanlaere E, LiPuma J, Baldwin A, Henry D, De Brandt E, Mahenthiralingam E . Burkholderia latens sp. nov., Burkholderia diffusa sp. nov., Burkholderia arboris sp. nov., Burkholderia seminalis sp. nov. and Burkholderia metallica sp. nov., novel species within the Burkholderia cepacia complex. Int J Syst Evol Microbiol. 2008; 58(Pt 7):1580-90. DOI: 10.1099/ijs.0.65634-0. View

20.

Vanlaere E, Baldwin A, Gevers D, Henry D, De Brandt E, LiPuma J . Taxon K, a complex within the Burkholderia cepacia complex, comprises at least two novel species, Burkholderia contaminans sp. nov. and Burkholderia lata sp. nov. Int J Syst Evol Microbiol. 2009; 59(Pt 1):102-11. DOI: 10.1099/ijs.0.001123-0. View