Risk factors for Burkholderia cepacia complex colonization and infection among patients with cystic fibrosis

Abstract

Objectives: To determine risk factors for acquiring Burkholderia cepacia complex among patients with cystic fibrosis (CF). Study design: A case-control study was conducted with active surveillance for B cepacia complex colonization/infection among patients at 21 CF centers from April 1986 to March 1989 (study period). A case-patient was defined as any CF patient with B cepacia complex colonization for the first time during the study period. Control patients were patients with CF not B cepacia complex colonized during the study period. For each patient, a questionnaire was completed semiannually. Results: In multivariate analyses, hospitalization for pulmonary exacerbations, living with a B cepacia complex-positive person, attending a CF summer camp, and direct contact with a B cepacia complex-colonized CF person outside of camp and home were associated with B cepacia complex acquisition. Receiving antimicrobial aerosol therapy or cleaning and drying a home-used nebulizer between uses were associated with a decrease in B cepacia complex acquisition. Conclusions: Numerous factors inside and outside the health care setting are associated with person-to-person transmission of B cepacia complex among patients with CF. Prevention programs should reduce direct or indirect contact between noncolonized and B cepacia complex-colonized/infected patients with CF. (J Pediatr 2002;141:512-7)