40-year single center experience of Burkholderia cystic fibrosis airway infections

OBJECTIVES: To resolve the epidemiology of airway infections with Burkholderia cepacia complex (Bcc) in people with cystic fibrosis (pwCF) over 40 years at a single treatment center. METHODS: All Bcc and Burkholderia gladioli airway isolates were collected from pwCF who presented at the CF outpatient and the lung transplantation clinics from 1983 to 2022. RESULTS: The collection of 1205 strains is dominated by B. multivorans (56 %) followed by B. cenocepacia (16 %), B. stabilis (10 %) and B. orbicola (9%). Twenty-seven pwCF experienced a single self-limiting episode of airway infection with Bcc. Thirteen pwCF were harboring Bcc for 1.7 to 13.6 years and 15 pwCF were persistently infected with Bcc. Sixteen Bcc-positive CF patients received a lung transplant. Fatal post-transplant sepsis happened in one B. multivorans-, two B. cenocepacia- and two B. orbicola-positive patients. CONCLUSIONS: After the first acquisition of Bcc, transient carriage was 2.7 times more frequent than persistent colonization. Infections with B. cenocepacia or B. orbicola confer a higher risk for post-transplant sepsis than an infection with B. multivorans.

• Tümmler, B.
• Ulrich, J.
• Sedlacek, L.