Burkholderia cenocepacia and Burkholderia multivorans: influence on survival in cystic fibrosis

Thorax. 2004 Nov;59(11):948-51. doi: 10.1136/thx.2003.017210.


Introduction: Burkholderia cepacia infection has been associated with a poor prognosis for patients with cystic fibrosis (CF). It is now recognised that organisms classified as B cepacia comprise a number of distinct genomic species each known as a genomovar of the B cepacia complex (BCC). The outcome of infection for CF patients with individual genomovars is unknown. The clinical outcome of infection with the two most commonly isolated genomovars (B cenocepacia and B multivorans) was studied at a specialist CF centre between 1982 and 2003.

Methods: The numbers of patients who progressed from initial to chronic infection were assessed. Control groups were created by matching patients with chronic BCC infection by percentage forced expiratory volume in 1 second with patients with Pseudomonas aeruginosa infection. Outcome measures were survival time, deaths from "cepacia syndrome", rate of decline in spirometry and body mass index (BMI), and treatment requirements.

Results: Forty nine patients had an initial infection with either B multivorans (n = 16) or B cenocepacia (n = 33); 8/16 and 31/33, respectively, developed chronic infection (p<0.001). Deaths from "cepacia syndrome" occurred in both BCC groups. Patients with B cenocepacia infection had a shorter survival than patients with P aeruginosa infection (p = 0.01). There was no difference in survival between CF patients infected with B multivorans and P aeruginosa. There were no observed differences in changes in spirometry and BMI or treatment requirements between the BCC groups and respective controls.

Conclusion: In CF, the genomovar status of BCC may influence both the likelihood of progression from initial to chronic infection and the overall survival of the patients.

MeSH terms

  • Adult
  • Burkholderia Infections / complications*
  • Burkholderia Infections / physiopathology
  • Burkholderia cepacia
  • Burkholderia cepacia complex*
  • Cystic Fibrosis / microbiology*
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Male
  • Prognosis
  • Survival Analysis
  • Vital Capacity / physiology