Correa-Ruiz Ana, Girón Rosa, Buendía Buenaventura, Medina-Pascual M José, Valenzuela Claudia, López-Brea Manuel, Sáez-Nieto Juan Antonio
Servicio de Microbiología, Instituto de Investigación Sanitaria, Hospital de La Princesa, Madrid, Spain.
Enferm Infecc Microbiol Clin. 2013 Dec;31(10):649-54. doi: 10.1016/j.eimc.2012.12.001. Epub 2013 Mar 23.
Burkholderia cepacia complex have emerged as significant pathogens in cystic fibrosis (CF) patients due to the risk of cepacia syndrome and the innate multi-resistance of the microorganisms to antibiotics. The aim of this study was to describe the antimicrobial susceptibility profiles, the genotypes and subtypes of BCC, and the clinical evolution of CF patients with BCC.
The lung function and Brasfield and Shwachman score were assessed in 12 patients. BCC were identified and susceptibility was studied by MicroScan (Siemens). Species and genospecies of BCC were confirmed by molecular methods in a Reference Centre (Majadahonda).
BCC were identified in 12 of 70 patients (17.1%) over a ten year period. The mean age to colonization by BCC was 24.4 years (SD: 7.71). B. cenocepacia was isolated in 4 patients (33.3%), B. contaminans was isolated in 3 patients (25%), both B. vietnamiensis and B. stabilis were isolated in 2 patients (16.7%), and B. cepacia, B. multivorans and B. late were isolated in one patient (8.3%). Among the B. cenocepacia, subtype IIIa was identified in two strains, and subtype IIIb was identified in the other two strains. There was susceptibility to meropenem in 90% of BCC, 80% to cotrimoxazole, 60% to minocycline, 50% to ceftazidime, and 40% to levofloxacin.
B. cenocepacia was the most prevalent species among the BCC isolated in CF adult patients, and subtypes IIIa and IIIb were identified in the 50% of the strains. Meropenem and cotrimoxazole showed the best activity.
由于洋葱伯克霍尔德菌复合体（BCC）有引发洋葱伯克霍尔德菌综合征的风险且该微生物对多种抗生素具有天然耐药性，其已成为囊性纤维化（CF）患者的重要病原体。本研究旨在描述BCC的抗菌药物敏感性概况、基因型和亚型，以及CF合并BCC患者的临床病程。
对12例患者的肺功能以及布拉斯菲尔德和施瓦克曼评分进行评估。通过MicroScan（西门子公司）鉴定BCC并研究其药敏情况。在一个参考中心（马亚达翁达）采用分子方法确认BCC的种和基因型种。
在10年期间，70例患者中有12例（17.1%）鉴定出BCC。BCC定植的平均年龄为24.4岁（标准差：7.71）。4例患者（33.3%）分离出洋葱伯克霍尔德菌，3例患者（25%）分离出污染伯克霍尔德菌，2例患者（16.7%）分别分离出越南伯克霍尔德菌和稳定伯克霍尔德菌，1例患者（8.3%）分别分离出洋葱伯克霍尔德菌、多食伯克霍尔德菌和迟缓伯克霍尔德菌。在洋葱伯克霍尔德菌中，2株鉴定为IIIa亚型，另外2株鉴定为IIIb亚型。90%的BCC对美罗培南敏感，80%对复方新诺明敏感，60%对米诺环素敏感，50%对头孢他啶敏感，40%对左氧氟沙星敏感。
在CF成年患者分离出的BCC中，洋葱伯克霍尔德菌是最常见的菌种，50%的菌株鉴定为IIIa和IIIb亚型。美罗培南和复方新诺明显示出最佳活性。
