Prevalence and clonality of Burkholderia cepacia complex genomovars in UK patients with cystic fibrosis referred for lung transplantation

Background: It has previously been reported that patients infected with Burkholderia cenocepacia (genomovar III) before lung transplantation have a poorer outcome than those with other B cepacia complex infections. Methods: An extensive study was conducted to determine the prevalence and clonality of B cepacia complex genomovars isolated from patients referred for transplant assessment between 1989 to the present and, where appropriate, whether strain type was related to transplant outcome. Results: Isolates from 29 patients were identified as B cepacia complex organisms by molecular analysis. Thirteen patients (45%) were infected with the highly transmissible ET-12 strain of B cenocepacia recA lineage III-A, while all remaining patients were infected with genetically unique B cenocepacia, B multivorans, and B vietnamiensis strains. All previously reported deaths following transplantation were associated with ET-12 infection. Conclusions: The ET-12 strain is the predominant cause of B cenocepacia infections in patients with cystic fibrosis referred to our pulmonary transplant centre and is associated with poor transplant outcomes using standard treatment regimens.