Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy
AbstractBurkholderia cepacia complex (Bcc) is a bacterial group with ‘natural’ multi-antimicrobial resistance. This complex has generated epidemic outbreaks across the world. In people with cystic fibrosis (CF), Bcc can cause severe lung infections that lead to accelerated lung damage, which can be...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Annals of Medicine |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2024.2307503 |
| _version_ | 1827375943290716160 |
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| author | Juan Carlos Gutiérrez Santana Victor Rafael Coria Jiménez |
| author_facet | Juan Carlos Gutiérrez Santana Victor Rafael Coria Jiménez |
| author_sort | Juan Carlos Gutiérrez Santana |
| collection | DOAJ |
| description | AbstractBurkholderia cepacia complex (Bcc) is a bacterial group with ‘natural’ multi-antimicrobial resistance. This complex has generated epidemic outbreaks across the world. In people with cystic fibrosis (CF), Bcc can cause severe lung infections that lead to accelerated lung damage, which can be complicated by necrotizing pneumonia accompanied by high fevers, leucocytosis, and bacteraemia, which commonly causes fatal outcomes. Specifically, infection by Burkholderia cenocepacia is considered an exclusion criterion for lung transplantation. The species of Bcc exhibit both genetic and phenotypic hypervariability that complicate their accurate microbiological identification. Automated methods such as MALDI-TOF can err in the determination of species. Their slow growth even in selective agars and the absence of international consensuses on the optimal conditions for their isolation make early diagnosis a difficult challenge to overcome. The absence of correlations between antibiograms and clinical results has resulted in the absence of standardized cut-off values of antimicrobial susceptibility, a fact that brings a latent risk since incorrect antibiotic therapy can induce the selection of more aggressive variants that worsen the clinical picture of the host, added to the absence of a clear therapeutic guide for the eradication of pulmonary infections by Bcc in patients with CF, resulting in frequently ineffective treatments. There is an urgent need to standardize methods and diagnostic tools that would allow an early and accurate diagnosis, as well as to perform clinical studies of the effectiveness of available antibiotics to eradicate Bcc infections, which would allow us to establish standardized therapeutic schemes for Bcc-infected patients. |
| first_indexed | 2024-03-08T12:01:41Z |
| format | Article |
| id | doaj.art-828517eac1644175b28f5e54487a049f |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-03-08T12:01:41Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-828517eac1644175b28f5e54487a049f2024-01-23T18:36:46ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602024-12-0156110.1080/07853890.2024.2307503Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapyJuan Carlos Gutiérrez Santana0Victor Rafael Coria Jiménez1Laboratory of Experimental Bacteriology, National Institute of Pediatrics, Mexico City, MexicoLaboratory of Experimental Bacteriology, National Institute of Pediatrics, Mexico City, MexicoAbstractBurkholderia cepacia complex (Bcc) is a bacterial group with ‘natural’ multi-antimicrobial resistance. This complex has generated epidemic outbreaks across the world. In people with cystic fibrosis (CF), Bcc can cause severe lung infections that lead to accelerated lung damage, which can be complicated by necrotizing pneumonia accompanied by high fevers, leucocytosis, and bacteraemia, which commonly causes fatal outcomes. Specifically, infection by Burkholderia cenocepacia is considered an exclusion criterion for lung transplantation. The species of Bcc exhibit both genetic and phenotypic hypervariability that complicate their accurate microbiological identification. Automated methods such as MALDI-TOF can err in the determination of species. Their slow growth even in selective agars and the absence of international consensuses on the optimal conditions for their isolation make early diagnosis a difficult challenge to overcome. The absence of correlations between antibiograms and clinical results has resulted in the absence of standardized cut-off values of antimicrobial susceptibility, a fact that brings a latent risk since incorrect antibiotic therapy can induce the selection of more aggressive variants that worsen the clinical picture of the host, added to the absence of a clear therapeutic guide for the eradication of pulmonary infections by Bcc in patients with CF, resulting in frequently ineffective treatments. There is an urgent need to standardize methods and diagnostic tools that would allow an early and accurate diagnosis, as well as to perform clinical studies of the effectiveness of available antibiotics to eradicate Bcc infections, which would allow us to establish standardized therapeutic schemes for Bcc-infected patients.https://www.tandfonline.com/doi/10.1080/07853890.2024.2307503Burkholderia cepacia complexcystic fibrosisantimicrobial stewardshipearly diagnosisantibacterial agents |
| spellingShingle | Juan Carlos Gutiérrez Santana Victor Rafael Coria Jiménez Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy Annals of Medicine Burkholderia cepacia complex cystic fibrosis antimicrobial stewardship early diagnosis antibacterial agents |
| title | Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy |
| title_full | Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy |
| title_fullStr | Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy |
| title_full_unstemmed | Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy |
| title_short | Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy |
| title_sort | burkholderia cepacia complex in cystic fibrosis critical gaps in diagnosis and therapy |
| topic | Burkholderia cepacia complex cystic fibrosis antimicrobial stewardship early diagnosis antibacterial agents |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2024.2307503 |
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