Two case reports of the successful eradication of new isolates of Burkholderia cepacia complex in children with cystic fibrosis

BMC Pharmacol Toxicol. 2016 Mar 28;17:14. doi: 10.1186/s40360-016-0054-0.

Abstract

Background: Chronic infection with Burkholderia cepacia complex (BCC) has a detrimental effect on morbidity and mortality for patients with cystic fibrosis (CF). It is therefore logical to attempt to eradicate new isolates however there is a paucity of information to guide treatment. We report the successful eradication of new isolates of BCC in two children with CF.

Case presentation: Burkholderia cepacia was successfully eradicated in a 14 year old boy with CF and Burkholderia gladioli was successfully eradicated in a six year old girl with CF. In both children two weeks of intravenous (IV) tobramycin, ceftazidime and temocillin were used followed by three months of inhaled tobramycin. Bronchoalveolar lavage samples taken during flexible bronchoscopy were used prior to treatment to exclude spontaneous clearance as well as after treatment to confirm eradication.

Conclusions: New isolates of BCC can be successfully eradicated in children with CF. More research is urgently required in this area to identify the best treatment regimen for BCC eradication.

Keywords: Burkholderia cepacia complex; Cystic fibrosis; Eradication; Paediatrics.

Publication types

  • Case Reports

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Bronchoalveolar Lavage Fluid / microbiology
  • Burkholderia Infections / complications
  • Burkholderia Infections / drug therapy*
  • Burkholderia cepacia complex / drug effects*
  • Burkholderia cepacia complex / growth & development
  • Burkholderia cepacia complex / isolation & purification
  • Ceftazidime / administration & dosage
  • Ceftazidime / pharmacology
  • Ceftazidime / therapeutic use*
  • Child
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Drug Therapy, Combination
  • England
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Microbial Sensitivity Tests
  • Penicillins / administration & dosage
  • Penicillins / pharmacology
  • Penicillins / therapeutic use*
  • Tobramycin / administration & dosage
  • Tobramycin / pharmacology
  • Tobramycin / therapeutic use*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Penicillins
  • temocillin
  • Ceftazidime
  • Tobramycin