The emergence of a highly transmissible lineage of cbl+ Pseudomonas (Burkholderia) cepacia causing CF centre epidemics in North America and Britain

Nat Med. 1995 Jul;1(7):661-6. doi: 10.1038/nm0795-661.


The rapid increase in Pseudomonas (Burkholderia) cepacia infection in cystic fibrosis (CF) patients suggests epidemic transmission, but the degree of transmissibility remains controversial as conflicting conclusions have been drawn from studies at different CF centres. This report provides the first DNA sequence-based documentation of a divergent evolutionary lineage of P. cepacia associated with CF centre epidemics in North America (Toronto) and Europe (Edinburgh). The involved epidemic clone encoded and expressed novel cable (Cbl) pili that bind to CF mucin. The sequence of the cblA pilin subunit gene carried by the epidemic isolates proved to be invariant. Although it remains to be determined how many distinct, highly transmissible lineages exist, our results provide both a DNA sequence and chromosomal fingerprint that can be used to screen for one such particularly infectious, transatlantic clone.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Amino Acid Sequence
  • Bacterial Adhesion
  • Bacterial Outer Membrane Proteins / genetics
  • Burkholderia Infections / complications
  • Burkholderia Infections / epidemiology*
  • Burkholderia Infections / microbiology
  • Burkholderia Infections / transmission
  • Burkholderia cepacia / drug effects
  • Burkholderia cepacia / genetics
  • Burkholderia cepacia / isolation & purification*
  • Burkholderia cepacia / pathogenicity
  • Child
  • Cross Infection / complications
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cystic Fibrosis / complications*
  • DNA Fingerprinting
  • DNA, Bacterial / genetics
  • Disease Outbreaks*
  • Disease Susceptibility
  • Fimbriae Proteins
  • Fimbriae, Bacterial / physiology
  • Genetic Markers
  • Hospitals, Special
  • Humans
  • Molecular Sequence Data
  • North America / epidemiology
  • Phylogeny
  • Pneumonia, Bacterial / complications
  • Pneumonia, Bacterial / epidemiology*
  • Pneumonia, Bacterial / microbiology
  • Pneumonia, Bacterial / transmission
  • Polymorphism, Restriction Fragment Length
  • Scotland / epidemiology
  • Sequence Alignment
  • Sequence Homology, Nucleic Acid


  • Bacterial Outer Membrane Proteins
  • DNA, Bacterial
  • Genetic Markers
  • Fimbriae Proteins