Epidemic spread of Pandoraea pulmonicola in a cystic fibrosis center

• Published in: BMC infectious diseases Vol. 15; no. 582; p. 583
• Main Authors: Degand, Nicolas, Lotte, Romain, Decondé Le Butor, Célia, Segonds, Christine, Thouverez, Michelle, Ferroni, Agnès, Vallier, Christine, Mély, Laurent, Carrère, Jacqueline
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.12.2015; BioMed Central
• Subjects: Adolescent; Adult; Analysis; Burkholderiaceae - drug effects; Burkholderiaceae - genetics; Burkholderiaceae - isolation & purification; Burkholderiaceae - physiology; Care and treatment; Complications and side effects; Cystic fibrosis; Cystic Fibrosis - complications; Cystic Fibrosis - microbiology; DNA, Bacterial - analysis; DNA, Bacterial - genetics; DNA, Bacterial - metabolism; Drug Resistance, Multiple, Bacterial; Electrophoresis, Gel, Pulsed-Field; Epidemics; Female; France; Gram-Negative Bacterial Infections - complications; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Gram-Negative Bacterial Infections - mortality; Gram-Negative Bacterial Infections - transmission; Humans; Infection Control; Infectious diseases; Life Sciences; Male; Microbiology and Parasitology; Middle Aged; Pseudomonas aeruginosa - genetics; Pseudomonas aeruginosa - isolation & purification; Pseudomonas aeruginosa - physiology; Restriction Mapping; RNA, Ribosomal, 16S - genetics; Sequence Analysis, DNA; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Trimethoprim, Sulfamethoxazole Drug Combination - pharmacology; Young Adult; France
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-015-1327-8

Pandoraea spp. are recently discovered bacteria, mainly recovered from cystic fibrosis (CF) patients, but their epidemiology and clinical significance are not well known. We describe an epidemic spread of Pandoraea pulmonicola from 2009 in our CF center, involving 6 out of 243 CF patients. Bacterial identification used amplified ribosomal DNA restriction analysis (ARDRA), MALDI-TOF mass spectrometry (MALDI-TOF MS) and 16S rDNA gene sequencing. The clonal link between strains was assessed with pulsed field gel electrophoresis (PFGE) using XbaI. Clinical data were gathered for all patients. The index case was chronically colonized since 2000. The main hypothesis for this bacterial spread was a droplet cross-transmission, due to preventive measures not being strictly followed. Antibiotic susceptibility testing revealed resistance to beta-lactams, ciprofloxacin and colistin. However, there was susceptibility to trimethoprim-sulfamethoxazole. All patients were chronically colonized with Pseudomonas aeruginosa, and the acquisition of P. pulmonicola resulted in chronic colonization in all patients. Three patients died, and two patients remained clinically stable, whereas one patient had a decline in lung function. This study, which is the first to describe an epidemic spread of P. pulmonicola, notes the potential transmissibility of this bacterial species and the need for infection control measures.