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      Use of selective medium for Burkholderia cepacia isolation in respiratory samples from cystic fibrosis patients Translated title: Uso de meio seletivo para identificação de cepas de Burkholderia cepacia em amostras de trato respiratório de pacientes portadores de fibrose cística

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          Abstract

          Burkholderia cepacia colonizes cystic fibrosis (CF) patients. We evaluated the impact of the use of a selective medium in the rate of B. cepacia recovery from respiratory samples of CF patients. During a 6-month period, respiratory samples were collected from 106 CF patients and cultivated on selective media including a B. cepacia selective medium. Confirmation of the identity of B. cepacia isolates was carried out by species specific PCR and determination of genomovar status performed by a sequential PCR approach. Results of B. cepacia isolation during this period were compared to the preceding two years, when the sample processing was identical except for the lack of the B. cepacia selective medium. B. cepacia was isolated in 11/257 (4.2%) of the samples using the selective medium, in contrast with the preceding two years, when it was isolated in 6/1029 samples (0.58%), p < 0.0001. Identity of all 11 isolates was confirmed by PCR and genomovar determination was accomplished in all but one isolate. These results suggest that the use of a selective medium increases recovery rate of B. cepacia from respiratory samples.

          Translated abstract

          A Burkholderia cepacia coloniza os pacientes portadores de fibrose cística (FC). Avaliamos o impacto do uso de um meio seletivo no isolamento de B. cepacia em amostras de secreção respiratória de pacientes portadores de FC. Durante um período de 6 meses, amostras de trato respiratório foram colhidas de 106 pacientes com FC e cultivadas em meios seletivos incluindo um meio para isolamento de B. cepacia. A identidade das cepas de B. cepacia foi confirmada através de PCR espécie específica e a determinação do genomovar ou subespécie realizada através de reações seqüenciais de PCR. Os resultados de isolamento de B. cepacia durante este período foram comparados com os dois anos precedentes, quando o processamento das amostras era idêntico, exceto pela utilização do meio seletivo para B. cepacia. B. cepacia foi isolada em 11/257 (4,2%) amostras usando o meio seletivo, e em apenas 6/1029 (0,58%) nos dois anos precedentes (p < 0,0001). A identidade destas 11 cepas foi confirmada e a determinação do genomovar obtida em 10/11. Estes resultados sugerem que o uso do meio seletivo aumenta a freqüência de isolamento de B. cepacia em amostras de trato respiratório de pacientes portadores de FC.

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          Pseudomonas cepacia infection in cystic fibrosis: an emerging problem.

          The prevalence of Pseudomonas cepacia infection increased from 10% in 1971 to 18% by 1981 in a population of approximately 500 patients with cystic fibrosis. Carriage of P. aeruginosa has remained unchanged at 70% to 80% over the same period. Patients infected with P. cepacia have greater impairment of pulmonary function than those with P. aeruginosa. A syndrome characterized by high fever, severe progressive respiratory failure, leukocytosis, and elevated erythrocyte sedimentation rate has occurred in eight patients over the past 3 years, with a 62% fatality rate. Because P. cepacia strains are uniformly resistant to ticarcillin, piperacillin, and aminoglycosides, and because ceftazidime is ineffective despite in vitro activity, treatment of these infections is very difficult. Prevention of acquisition and effective treatment of P. cepacia in patients with cystic fibrosis are now major clinical problems in our clinic.
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            Occurrence of multiple genomovars of Burkholderia cepacia in cystic fibrosis patients and proposal of Burkholderia multivorans sp. nov.

            We performed an integrated genotypic and phenotypic analysis of 128 strains of the genera Burkholderia, Ralstonia, and Pseudomonas in order to study the taxonomic structure of Burkholderia cepacia and its relationships with other Burkholderia species. Our data show that presumed B. cepacia strains isolated from cystic fibrosis patients belong to at least five distinct genomic species, one of which was identified as Burkholderia vietnamiensis. This group of five phenotypically similar species is referred to as the B. cepacia complex. The name Burkholderia multivorans is proposed for one of these genomic species, which was formerly referred to as B. cepacia genomovar II; the remaining B. cepacia groups are referred to as genomovars I, III, and IV, pending additional differential phenotypic tests. The role and pathogenic potential of each of these taxa, particularly in view of the potentially fatal infections in cystic fibrosis patients, need further evaluation. The data presented also demonstrate that Pseudomonas glathei and Pseudomonas pyrrocinia should be reclassified as Burkholderia species.
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              Taxonomy and identification of the Burkholderia cepacia complex.

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                Author and article information

                Journal
                rimtsp
                Revista do Instituto de Medicina Tropical de São Paulo
                Rev. Inst. Med. trop. S. Paulo
                Instituto de Medicina Tropical (São Paulo, SP, Brazil )
                1678-9946
                July 2002
                : 44
                : 4
                : 203-208
                Affiliations
                [01] orgnameUniversity of São Paulo orgdiv1Medical School orgdiv2Hospital das Clínicas
                [03] orgnameUniversity of São Paulo orgdiv1Medical School orgdiv2Instituto de Medicina Tropical de São Paulo
                [02] São Paulo orgnameUniversity of São Paulo orgdiv1Medical School orgdiv2Hospital das Clínicas Brazil
                Article
                S0036-46652002000400004 S0036-4665(02)04400404
                10.1590/S0036-46652002000400004
                4ee73492-218c-49bb-8d3f-c389f46d31f5

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 14 March 2002
                : 13 June 2002
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 6
                Product

                SciELO Brazil

                Categories
                Technical report

                Genomovars,Burkholderia cepacia,Cystic fibrosis,Selective medium,Sputum

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