2020, Number 4
<< Back Next >>
Rev Latin Infect Pediatr 2020; 33 (4)
Burkholderia cepacia, clinical course in a cystic fibrosis patient through the development of cepacia syndrome
Sánchez-Carrillo YH, Romero-López T, Ibanes-Gutiérrez C, González-Saldaña N
Language: Spanish
References: 17
Page: 210-214
PDF size: 230.37 Kb.
ABSTRACT
Burkholderia cepacia is an opportunistic pathogen in patients with cystic fibrosis. Its clinical impact is associated with increased morbidity and mortality, causing the so-called cepacia syndrome. We present the case of a five year-old female, that throughout the history of her disease presented with different clinical scenarios within the spectrum of the syndrome, from colonization by
B. cepacia to progressive deterioration of pulmonary function and finally the cepacia syndrome, which caused her death. The age of colonization and the isolated subspecies, in cystic fibrosis patients, have a direct impact on long term survival.
B. cepacia can be acquired in the hospital environment or through contact with carrier patients. Cepacia syndrome is characterized by generally being a fatal complication. The treatment is usually complex due to the microorganism´s resistance, with reports of up to three antimicrobials, with variable results in the different series.
REFERENCES
Jones AM, Dodd ME, Webb AK. Burkholderia cepacia: current clinical issues, environmental controversies and ethical dilemmas. Eur Respir J. 2001; 17 (2): 295-301.
Zahariadis G, Levy MH, Burns JL. Cepacia-Like syndrome caused by Burkholderia mutivorans. Can J Infect Dis. 2003; 14 (2): 123-125.
Jones A, Dodd M, Govan J, Barcus V, Doherty CJ, Morris J et al. Burkholderia cenocepacia and Burkholderia multivorans: influence on survival in cystic fibrosis. Thorax. 2004; 59 (11): 948-951.
Blackburn L, Brownlee K, Conway S, Denton M. “Cepacia syndrome” with Burkholderia multivorans, 9 years after initial colonization. Journal of Cystic Fibrosis. 2004; 3 (2): 133-134.
Coutinho CP, dos Santos SC, Madeira A, Mira NP, Moreira AS, Sá-Correia I. Long-term colonization of the cystic fibrosis lung by Burkholderia cepacia complex bacteria: epidemiology, clonal variation, and genome-wide expression alterations. Fron Cell Infect Microbiol. 2011; 1: 12.
Somayaji R, Yau Y, Tullis E, LiPuma JJ, Ratjen F, Waters V. Clinical outcomes associated with Burkholderia cepacia complex infection in patients with cystic fibrosis. Ann Am Thorac Soc. 2020; 10.1513/AnnalsATS.202003-204OC.
Manno G, Dalmastri C, Tabacchioni S, Vandamme P, Lorini R, Minicucci L, Bevivino A. Epidemiology and clinical course of Burkholderia cepacia complex infections, particularly those caused by different Burkholderia cenocepacia strains, among patients attending an Italian cystic fibrosis center. J Clin Microbiol. 2004; 42 (4): 1491-1497.
Hindo H, Sigley C, Karlson K. Cepacia syndrome in an adolescent with cystic fibrosis. Infectious Diseases in Clinical Practice. 2008; 16 (3): 198-200.
Millar-Jones L, Ryley HC, Paull A, Goodchild MC. Transmission and prevalence of Burkholderia cepacia in welsh cystic fibrosis patients. Respiratory Medicine. 1998; 92 (2): 178-183.
Aaron SD, Ferris W, Henry DA, Speert DP, MacDonald NE. Multiple combination bactericidal antibiotic testing for patients with cystic fibrosis infected with Burkholderia cepacia. Am J Respir Crit Care Med. 2000; 161 (4): 1206-1212.
Regan KH, Bhatt J. Eradication therapy for Burkholderia cepacia complex in people with cystic fibrosis. Cochrane Database Syst Rev. 2019; 4: CD009876.
Lord R, Jones AM, Horsley A. Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation. Cochrane Database Syst Rev. 2020; 4: CD009529.
Grimwood K, Kidd TJ, Tweed M. Successful treatment of cepacia syndrome. J Cyst Fibros. 2009; 8 (4): 291-293.
CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. CLSI Supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2020.
Gilchrist FJ, Webb AK, Bright-Thomas RJ, Jones AM. Successful treatment of cepacia syndrome with a combination of intravenous cyclosporin, antibiotics and oral corticosteroids. J Cyst Fibros. 2012; 11 (5): 458-460.
Kazachkov M, Lager J, LiPuma J, Barker PM. Survival following Burkholderia cepacia sepsis in a patient with cystic fibrosis treated with corticosteroids. Pediatr Pulmonol. 2001; 32 (4): 338-340.
Rupp ME, Karnatak R. Intravascular catheter-related bloodstream infections. Infect Dis Clin. 2018; 32 (4): 765-787.