Exceptionally high representation of Burkholderia cepacia among B. cepacia complex isolates recovered from the major Portuguese cystic fibrosis center

Abstract

Burkholderia cepacia, a species found infrequently in cystic fibrosis (CF), was isolated from 85% of patients infected with bacteria of the B. cepacia complex that visited the major Portuguese CF center, in Lisbon, during 2003 to 2005. A detailed molecular analysis revealed that this was mainly due to two B. cepacia clones. These clones were indistinguishable from two strains isolated from intrinsically contaminated nonsterile saline solutions for nasal application, detected during routine market surveillance by the Portuguese Medicines and Health Products Authority.

FIG. 1.

Ribopatterns (⋄, R2; □, R5; ▿, R12; ▪, R17; •, R19; ▵, R24) of the B. cepacia isolates obtained from CF patients visiting the HSM CF center between January 1995 and March 2006. Clinical B. cepacia strains identical to strains isolated from the contaminated saline solutions, with ribopatterns 17 and 19, are represented by solid symbols. The arrows indicate the date of detection of contaminated saline solutions. Patients G, O, AB, and AF also harbored B. cenocepacia isolates. This representation is based on results in Table 1 and on previous results (6).

FIG. 2.

(A) Ribopatterns generated by B. cepacia isolates from contaminated saline solutions or from CF patients. Lanes: 1, λ/HindIII molecular size standard; 2, ribotype 17; 3, ribotype 20; 4, ribotype 18; 5, ribotype 19. Ribotypes 19 and 17 are common to isolates from saline solutions and CF patients. (B) RFLP-PFGE profile II, generated by seven B. cepacia isolates that gave rise to ribopattern 19, isolated from contaminated saline solutions or from CF patients. Lanes: 1, bacteriophage lambda concatemer molecular size standards; 2, saline solution isolate; 3, IST4173 (CF); 4, IST4162 (CF); 5, IST4152 (CF); 6, IST4171 (CF); 7, IST4199 (CF); 8, IST4202 (CF).