Bernhardt Scott A, Spilker Theodore, Coffey Todd, LiPuma John J
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109-0646, USA.
Clin Infect Dis. 2003 Sep 15;37(6):780-5. doi: 10.1086/377541. Epub 2003 Aug 23.
Persons with cystic fibrosis (CF) are susceptible to chronic pulmonary infection due to certain Burkholderia species, but it is not clear whether this typically involves persistent infection with the same strain or sequential infection with distinct strains. We analyzed 1095 Burkholderia isolates recovered from serial sputum cultures from 379 patients with CF receiving care in 112 CF treatment centers in the United States. Genotyping was performed by random amplified polymorphic DNA typing or pulsed-field gel electrophoresis. Overall, a change in infecting strain was found in 24 (6.9%) of 347 patients infected with Burkholderia cepacia complex and in 3 (9%) of 32 patients infected with Burkholderia gladioli. Several patients were likely coinfected, at least transiently, with >1 B. cepacia complex strain. The potential for strain replacement during chronic infection may confound studies of the relationship between strain and clinical outcome and must be considered in designing effective infection-control practices.
患有囊性纤维化（CF）的人易因某些伯克霍尔德菌属菌种而发生慢性肺部感染，但尚不清楚这通常是涉及同一菌株的持续感染还是不同菌株的序贯感染。我们分析了从美国112个CF治疗中心接受治疗的379例CF患者的系列痰培养物中分离出的1095株伯克霍尔德菌。通过随机扩增多态性DNA分型或脉冲场凝胶电泳进行基因分型。总体而言，在347例感染洋葱伯克霍尔德菌复合群的患者中有24例（6.9%）以及在32例感染唐菖蒲伯克霍尔德菌的患者中有3例（9%）发现感染菌株发生了变化。有几名患者可能至少短暂地同时感染了>1种洋葱伯克霍尔德菌复合群菌株。慢性感染期间菌株替代的可能性可能会混淆关于菌株与临床结局之间关系的研究，并且在设计有效的感染控制措施时必须予以考虑。
