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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

An international, multicentre evaluation and description of Burkholderia pseudomallei infection in cystic fibrosis

Zeitschrift:
BMC Pulmonary Medicine > Ausgabe 1/2015
Autoren:
James B. Geake, David W. Reid, Bart J. Currie, Scott C. Bell, MelioidCF Investigators
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12890-015-0109-9) contains supplementary material, which is available to authorized users.

Competing interests

All authors declare they have no competing interests.

Authors’ contributions

JBG participated in design of the study, collated clinical data, and drafted the manuscript. DWR participated in the design of the study and edited the manuscript. BJC participated in design of the study, provided clinical data on study subjects, and edited the final manuscript. SCB conceived the study, participated in design of the study, and edited the final manuscript. The Melioid CF Group provided clinical data on study subjects and edited the final manuscript. All authors read and approved the final manuscript.

Authors' information

Not applicable

Availability of data and materials

Not applicable

Abstract

Background

Several cases of Burkholderia pseudomallei infection in CF have been previously reported. We aimed to identify all cases globally, risk factors for acquisition, clinical consequences, and optimal treatment strategies.

Methods

We performed a literature search to identify all published cases of B. pseudomallei infection in CF. In addition we hand-searched respiratory journals, and contacted experts in infectious diseases and CF around the world. Supervising clinicians for identified cases were contacted and contemporaneous clinical data was requested.

Results

25 culture-confirmed cases were identified. The median age at acquisition was 21 years, mean FEV1 % predicted was 60 %, and mean BMI was 19.5 kg/m2. The location of acquisition was northern Australia or south-east Asia for most. 19 patients (76 %) developed chronic infection, which was usually associated with clinical decline. Successful eradication strategies included a minimum of two weeks of intravenous ceftazidime, followed by a consolidation phase with trimethoprim/sulfamethoxazole, and this resulted in a higher chance of success when instituted early. Three cases of lung transplantation have been recorded in the setting of chronic B. pseudomallei infection.

Conclusion

Chronic carriage of B. pseudomallei in patients with CF appears common after infection, in contrast to the non-CF population. This is often associated with an accelerated clinical decline. Lung transplantation has been performed in select cases of chronic B. pseudomallei infection.
Zusatzmaterial
Additional file 1: online search strategy. (DOC 23 kb)
12890_2015_109_MOESM1_ESM.doc
Additional file 2: clinical data entry sheet. (DOC 77 kb)
12890_2015_109_MOESM2_ESM.doc
Literatur
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