An Epidemic of Burkholderia cepacia Transmitted between Patients with and without Cystic Fibrosis
Burkholderia cepacia is an important pathogen in cystic fibrosis (CF) and an infrequent cause of nosocomial infection in non-CF patients. This report describes a large hospital outbreak that appeared to involve both patient groups, a previously unrecognized phenomenon. Ribotype restriction fragment...
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| Veröffentlicht in: | The Journal of infectious diseases 1999-05, Vol.179 (5), p.1197-1205 |
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| creator | Holmes, Alison Nolan, Rathel Taylor, Rebecca Finley, Richard Riley, Margaret Jiang, Ru-zhang Steinbach, Suzanne Goldstein, Richard |
| description | Burkholderia cepacia is an important pathogen in cystic fibrosis (CF) and an infrequent cause of nosocomial infection in non-CF patients. This report describes a large hospital outbreak that appeared to involve both patient groups, a previously unrecognized phenomenon. Ribotype restriction fragment length polymorphism (RFLP) profiles and pulsed-field gel electrophoresis-resolved macrochromosomal RFLPs were analyzed, a ribotype-based phylogenic tree was constructed, and case-control and cohort studies were performed. A single dominant clone was found in both CF and non-CF groups. Phylogenic analysis suggests that it has evolved independently and that such highly transmissible strains can emerge rapidly and randomly. Acquisition risk in the CF patients was linked to hospitalization (odds ratio = 5.47, P = .0158, confidence interval = 1.28-26.86) and was associated with significantly increased mortality rates. Infection control policies must now consider this threat of transmission between non-CF and CF patients. |
| doi_str_mv | 10.1086/314699 |
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This report describes a large hospital outbreak that appeared to involve both patient groups, a previously unrecognized phenomenon. Ribotype restriction fragment length polymorphism (RFLP) profiles and pulsed-field gel electrophoresis-resolved macrochromosomal RFLPs were analyzed, a ribotype-based phylogenic tree was constructed, and case-control and cohort studies were performed. A single dominant clone was found in both CF and non-CF groups. Phylogenic analysis suggests that it has evolved independently and that such highly transmissible strains can emerge rapidly and randomly. Acquisition risk in the CF patients was linked to hospitalization (odds ratio = 5.47, P = .0158, confidence interval = 1.28-26.86) and was associated with significantly increased mortality rates. Infection control policies must now consider this threat of transmission between non-CF and CF patients.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1086/314699</identifier><identifier>PMID: 10191223</identifier><identifier>CODEN: JIDIAQ</identifier><language>eng</language><publisher>Chicago, IL: University of Chicago Press</publisher><subject>Adolescent ; Adult ; Bacteriology ; Biological and medical sciences ; Burkholderia cepacia ; Burkholderia cepacia - genetics ; Burkholderia cepacia - isolation & purification ; Burkholderia Infections - epidemiology ; Burkholderia Infections - microbiology ; Burkholderia Infections - transmission ; Case-Control Studies ; Cohort Studies ; Cross Infection - microbiology ; Cystic fibrosis ; Cystic Fibrosis - microbiology ; Disease Outbreaks ; Disease transmission ; DNA, Bacterial - analysis ; Electrophoresis, Gel, Pulsed-Field ; Epidemics ; Epidemiology ; Female ; Fundamental and applied biological sciences. Psychology ; Hospital admissions ; Hospitalization ; Humans ; Infections ; Intensive care units ; Major Articles ; Male ; Microbiology ; Mississippi - epidemiology ; Molecular Epidemiology ; Mortality ; Phylogeny ; Polymorphism, Restriction Fragment Length ; Restriction Mapping ; Ribotyping ; Risk Factors</subject><ispartof>The Journal of infectious diseases, 1999-05, Vol.179 (5), p.1197-1205</ispartof><rights>Copyright 1999 Infectious Diseases Society of America</rights><rights>1999 INIST-CNRS</rights><rights>1999 by the Infectious Diseases Society of America. All rights reserved. 1999</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-a747043eeff27c805e009875439abc155bbce708a051e0c245c82dfd533dafca3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/30111858$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/30111858$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,777,781,800,882,27905,27906,57998,58231</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1784974$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10191223$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holmes, Alison</creatorcontrib><creatorcontrib>Nolan, Rathel</creatorcontrib><creatorcontrib>Taylor, Rebecca</creatorcontrib><creatorcontrib>Finley, Richard</creatorcontrib><creatorcontrib>Riley, Margaret</creatorcontrib><creatorcontrib>Jiang, Ru-zhang</creatorcontrib><creatorcontrib>Steinbach, Suzanne</creatorcontrib><creatorcontrib>Goldstein, Richard</creatorcontrib><title>An Epidemic of Burkholderia cepacia Transmitted between Patients with and without Cystic Fibrosis</title><title>The Journal of infectious diseases</title><addtitle>J Infect Dis</addtitle><description>Burkholderia cepacia is an important pathogen in cystic fibrosis (CF) and an infrequent cause of nosocomial infection in non-CF patients. This report describes a large hospital outbreak that appeared to involve both patient groups, a previously unrecognized phenomenon. Ribotype restriction fragment length polymorphism (RFLP) profiles and pulsed-field gel electrophoresis-resolved macrochromosomal RFLPs were analyzed, a ribotype-based phylogenic tree was constructed, and case-control and cohort studies were performed. A single dominant clone was found in both CF and non-CF groups. Phylogenic analysis suggests that it has evolved independently and that such highly transmissible strains can emerge rapidly and randomly. Acquisition risk in the CF patients was linked to hospitalization (odds ratio = 5.47, P = .0158, confidence interval = 1.28-26.86) and was associated with significantly increased mortality rates. Infection control policies must now consider this threat of transmission between non-CF and CF patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Bacteriology</subject><subject>Biological and medical sciences</subject><subject>Burkholderia cepacia</subject><subject>Burkholderia cepacia - genetics</subject><subject>Burkholderia cepacia - isolation & purification</subject><subject>Burkholderia Infections - epidemiology</subject><subject>Burkholderia Infections - microbiology</subject><subject>Burkholderia Infections - transmission</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>Cross Infection - microbiology</subject><subject>Cystic fibrosis</subject><subject>Cystic Fibrosis - microbiology</subject><subject>Disease Outbreaks</subject><subject>Disease transmission</subject><subject>DNA, Bacterial - analysis</subject><subject>Electrophoresis, Gel, Pulsed-Field</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hospital admissions</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Infections</subject><subject>Intensive care units</subject><subject>Major Articles</subject><subject>Male</subject><subject>Microbiology</subject><subject>Mississippi - epidemiology</subject><subject>Molecular Epidemiology</subject><subject>Mortality</subject><subject>Phylogeny</subject><subject>Polymorphism, Restriction Fragment Length</subject><subject>Restriction Mapping</subject><subject>Ribotyping</subject><subject>Risk Factors</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS0EokOBfwDyArEL9TO2N0hl1AdSpbIoa8txbhiXJB5sp1X_PS4zasuqq3Ol8-no6B6E3lPyhRLdHnEqWmNeoBWVXDVtS_lLtCKEsYZqYw7Qm5yvCSGCt-o1OqCEGsoYXyF3POOTbehhCh7HAX9b0u9NHHtIwWEPW-erXiU35ymUAj3uoNwCzPiHKwHmkvFtKBvs5v7fEZeC13e51LDT0KWYQ36LXg1uzPBur4fo5-nJ1fq8ubg8-74-vmi8ELQ0TglV6wEMA1NeEwmEGK2k4MZ1nkrZdR4U0Y5ICsQzIb1m_dBLzns3eMcP0ddd7nbpJuh9LZfcaLcpTC7d2eiC_d-Zw8b-ijeWcyaZVjXg8z4gxT8L5GKnkD2Mo5shLtm2ptVEi-dBqnhrFOWPoK-fyAmGhzaU2PvZ7G62Cn582v0JttupAp_2gMvejUMdxIf8yCktjBIV-7DDrnOJ6cHmhFKqpeZ_AV6XqcA</recordid><startdate>19990501</startdate><enddate>19990501</enddate><creator>Holmes, Alison</creator><creator>Nolan, Rathel</creator><creator>Taylor, Rebecca</creator><creator>Finley, Richard</creator><creator>Riley, Margaret</creator><creator>Jiang, Ru-zhang</creator><creator>Steinbach, Suzanne</creator><creator>Goldstein, Richard</creator><general>University of Chicago Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19990501</creationdate><title>An Epidemic of Burkholderia cepacia Transmitted between Patients with and without Cystic Fibrosis</title><author>Holmes, Alison ; Nolan, Rathel ; Taylor, Rebecca ; Finley, Richard ; Riley, Margaret ; Jiang, Ru-zhang ; Steinbach, Suzanne ; Goldstein, Richard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-a747043eeff27c805e009875439abc155bbce708a051e0c245c82dfd533dafca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Bacteriology</topic><topic>Biological and medical sciences</topic><topic>Burkholderia cepacia</topic><topic>Burkholderia cepacia - genetics</topic><topic>Burkholderia cepacia - isolation & purification</topic><topic>Burkholderia Infections - epidemiology</topic><topic>Burkholderia Infections - microbiology</topic><topic>Burkholderia Infections - transmission</topic><topic>Case-Control Studies</topic><topic>Cohort Studies</topic><topic>Cross Infection - microbiology</topic><topic>Cystic fibrosis</topic><topic>Cystic Fibrosis - microbiology</topic><topic>Disease Outbreaks</topic><topic>Disease transmission</topic><topic>DNA, Bacterial - analysis</topic><topic>Electrophoresis, Gel, Pulsed-Field</topic><topic>Epidemics</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Hospital admissions</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Infections</topic><topic>Intensive care units</topic><topic>Major Articles</topic><topic>Male</topic><topic>Microbiology</topic><topic>Mississippi - epidemiology</topic><topic>Molecular Epidemiology</topic><topic>Mortality</topic><topic>Phylogeny</topic><topic>Polymorphism, Restriction Fragment Length</topic><topic>Restriction Mapping</topic><topic>Ribotyping</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holmes, Alison</creatorcontrib><creatorcontrib>Nolan, Rathel</creatorcontrib><creatorcontrib>Taylor, Rebecca</creatorcontrib><creatorcontrib>Finley, Richard</creatorcontrib><creatorcontrib>Riley, Margaret</creatorcontrib><creatorcontrib>Jiang, Ru-zhang</creatorcontrib><creatorcontrib>Steinbach, Suzanne</creatorcontrib><creatorcontrib>Goldstein, Richard</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holmes, Alison</au><au>Nolan, Rathel</au><au>Taylor, Rebecca</au><au>Finley, Richard</au><au>Riley, Margaret</au><au>Jiang, Ru-zhang</au><au>Steinbach, Suzanne</au><au>Goldstein, Richard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An Epidemic of Burkholderia cepacia Transmitted between Patients with and without Cystic Fibrosis</atitle><jtitle>The Journal of infectious diseases</jtitle><addtitle>J Infect Dis</addtitle><date>1999-05-01</date><risdate>1999</risdate><volume>179</volume><issue>5</issue><spage>1197</spage><epage>1205</epage><pages>1197-1205</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><coden>JIDIAQ</coden><abstract>Burkholderia cepacia is an important pathogen in cystic fibrosis (CF) and an infrequent cause of nosocomial infection in non-CF patients. This report describes a large hospital outbreak that appeared to involve both patient groups, a previously unrecognized phenomenon. Ribotype restriction fragment length polymorphism (RFLP) profiles and pulsed-field gel electrophoresis-resolved macrochromosomal RFLPs were analyzed, a ribotype-based phylogenic tree was constructed, and case-control and cohort studies were performed. A single dominant clone was found in both CF and non-CF groups. Phylogenic analysis suggests that it has evolved independently and that such highly transmissible strains can emerge rapidly and randomly. Acquisition risk in the CF patients was linked to hospitalization (odds ratio = 5.47, P = .0158, confidence interval = 1.28-26.86) and was associated with significantly increased mortality rates. Infection control policies must now consider this threat of transmission between non-CF and CF patients.</abstract><cop>Chicago, IL</cop><pub>University of Chicago Press</pub><pmid>10191223</pmid><doi>10.1086/314699</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adolescent Adult Bacteriology Biological and medical sciences Burkholderia cepacia Burkholderia cepacia - genetics Burkholderia cepacia - isolation & purification Burkholderia Infections - epidemiology Burkholderia Infections - microbiology Burkholderia Infections - transmission Case-Control Studies Cohort Studies Cross Infection - microbiology Cystic fibrosis Cystic Fibrosis - microbiology Disease Outbreaks Disease transmission DNA, Bacterial - analysis Electrophoresis, Gel, Pulsed-Field Epidemics Epidemiology Female Fundamental and applied biological sciences. Psychology Hospital admissions Hospitalization Humans Infections Intensive care units Major Articles Male Microbiology Mississippi - epidemiology Molecular Epidemiology Mortality Phylogeny Polymorphism, Restriction Fragment Length Restriction Mapping Ribotyping Risk Factors |
| title | An Epidemic of Burkholderia cepacia Transmitted between Patients with and without Cystic Fibrosis |
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