Abstract

Chronic bacterial lung infections in cystic fibrosis (CF) are the leading cause of morbidity and mortality. While a range of bacteria are known to be capable of establishing residence in the CF lung, only a small number have a clearly established link to deteriorating clinical status. The two bacteria with the clearest roles in CF lung disease are Pseudomonas aeruginosa and bacteria belonging to the Burkholderia cepacia complex (BCC). A number of common adaptations by P. aeruginosa strains to chronic lung infection in CF have been well described. Typically, initial isolates of P. aeruginosa are nonmucoid and display a range of putative virulence determinants. Upon establishment of chronic infection, subsequent isolates ultimately show a reduction in putative virulence determinants, including swimming motility, along with an acquisition of the mucoid phenotype and increased levels of antimicrobial resistance. Infections by BCC are marked by an unpredictable, but typically worse, clinical outcome. However, in contrast to P. aeruginosa infections in CF, studies describing adaptive changes in BCC bacterial phenotype during chronic lung infections are far more limited. To further enhance our understanding of chronic lung infections by BCC bacteria in CF, we assessed the swimming motility phenotype in 551 isolates of BCC bacteria from cystic fibrosis (CF) lung infections between 1981 and 2007. These data suggest that swimming motility is not typically lost by BCC during chronic infection, unlike as seen in P. aeruginosa infections. Furthermore, while we observed a statistically significant link between mucoidy and motility, we did not detect any link between motility phenotype and clinical outcome. These studies highlight the need for further work to understand the adaptive changes of BCC bacteria during chronic infection in the CF lung.

Highlights

  • People with cystic fibrosis (CF) experience chronic lung infections, lasting years and sometimes decades

  • B. cenocepacia is traditionally considered the most virulent of the Burkholderia cepacia complex (BCC) species, so it is notable that a larger percentage - 38% - of B. cenocepacia isolates examined were nonmotile as opposed to 14% of B. multivorans (Table 1)

  • We assessed the extent of motility displayed by these isolates, in terms of the diameter of the resultant colony when B. cenocepacia and B. multivorans were grown on swimming motility agar

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Summary

Introduction

People with cystic fibrosis (CF) experience chronic lung infections, lasting years and sometimes decades. These lung infections are the main cause of morbidity and mortality in CF, leading to either lung transplantation or death through cumulative damage to the lungs. A number of bacterial species are associated with chronic infection in the CF endobronchial space [1,2]. The BCC comprises at least 18 distinct species of bacteria and all, except for B. ubonensis, have been isolated from the lungs of people with CF [5,6]. The epidemiology of BCC bacteria in CF appears to be changing, with B. multivorans becoming the most common cause of new BCC infection in CF in number of studies [1,7]

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