Several cases of Burkholderia pseudomallei ( B. pseudomallei ) infection in cystic fibrosis have been previously reported. The aim of a study was to identify all cases globally, risk factors for acquisition, clinical consequences, and optimal treatment strategies.
Researchers performed a literature search to identify all published cases of Burkholderia pseudomallei infection in cystic fibrosis. In addition they contacted experts in infectious diseases and cystic fibrosis around the world, and clinical data was requested.
25 culture-confirmed cases were identified. The median age at acquisition was 21 years, mean FEV1 percent predicted was 60%, and mean BMI ( body mass index ) 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.
In conclusion, chronic carriage of Burkholderia pseudomallei in patients with cystic fibrosis appears common after infection, in contrast to the non-cystic fibrosis population. This is often associated with an accelerated clinical decline.
Lung transplantation has been performed in select cases of chronic Burkholderia pseudomallei infection. ( Xagena )
Geake JB et al, BMC Pulm Med 2015;15:116