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An international, multicentre evaluation and description of Burkholderia pseudomallei infection in cystic fibrosis

Geake, James B., Reid, David W., Currie, Bart J., Bell, Scott C. and MelioidCF, Investigators (2015). An international, multicentre evaluation and description of Burkholderia pseudomallei infection in cystic fibrosis. BMC Pulmonary Medicine,15(Article No. 116).

Document type: Journal Article
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IRMA ID 11381xPUB183
Title An international, multicentre evaluation and description of Burkholderia pseudomallei infection in cystic fibrosis
Author Geake, James B.
Reid, David W.
Currie, Bart J.
Bell, Scott C.
MelioidCF, Investigators
Journal Name BMC Pulmonary Medicine
Publication Date 2015
Volume Number 15
Issue Number Article No. 116
ISSN 1471-2466   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84943279351
Total Pages 10
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Several cases of Burkholderia pseudomallei infection in CF have been previously reported. We aimed to identify all cases globally, risk factors for acquisition, clinical consequences, and optimal treatment strategies.

Methods
We performed a literature search to identify all published cases of B. pseudomallei infection in CF. In addition we hand-searched respiratory journals, and contacted experts in infectious diseases and CF around the world. Supervising clinicians for identified cases were contacted and contemporaneous clinical data was requested.

Results
25 culture-confirmed cases were identified. The median age at acquisition was 21 years, mean FEV1 % predicted was 60 %, and mean BMI was 19.5 kg/m2. The location of acquisition was northern Australia or south-east Asia for most. 19 patients (76 %) developed chronic infection, which was usually associated with clinical decline. Successful eradication strategies included a minimum of two weeks of intravenous ceftazidime, followed by a consolidation phase with trimethoprim/sulfamethoxazole, and this resulted in a higher chance of success when instituted early. Three cases of lung transplantation have been recorded in the setting of chronic B. pseudomallei infection.

Conclusion
Chronic carriage of B. pseudomallei in patients with CF appears common after infection, in contrast to the non-CF population. This is often associated with an accelerated clinical decline. Lung transplantation has been performed in select cases of chronic B. pseudomallei infection.
Keywords Burkholderia pseudomallei
Cystic fibrosis
Melioidosis
Patient outcome assessment
Therapeutics
DOI http://dx.doi.org/10.1186/s12890-015-0109-9   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au


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