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Garcia BA, Carden JL, Goodwin DL, Smith TA, Gaggar A, Leon K, Antony VB, Rowe SM, Solomon GM. Implementation of a successful eradication protocol for Burkholderia Cepacia complex in cystic fibrosis patients. BMC Pulm Med 2018; 18:35. [PMID: 29444656 PMCID: PMC5813405 DOI: 10.1186/s12890-018-0594-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 01/24/2018] [Indexed: 12/05/2022] Open
Abstract
Background Infection with Burkholderia cepacia complex (Bcc) results in a heterogeneous clinical course ranging from asymptomatic colonization of the airways to fulminant respiratory failure in patients with cystic fibrosis (CF). Early eradication of Pseudomonas aeruginosa improves clinical outcomes. The efficacy and clinical outcomes following implementation of an eradication protocol for Bcc are less well understood. Methods We developed and implemented a single center Bcc eradication protocol that included an intensive combination of intravenous, inhaled, and oral antibiotic therapies based on in vitro sensitivities. We conducted a retrospective cohort analysis of clinical outcomes compared to patients with chronic Bcc infection. Results Six patients were identified as having a newly acquired Bcc colonization and were placed on the eradication protocol. Sequential sputum samples after completion of the protocol demonstrated sustained clearance of Bcc in all patients. Lung function and nutritional status remained stable in the year following eradication. Conclusion Clearance of Bcc from sputum cultures using a standardized protocol was successful at one year and was associated with clinical stability.
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Affiliation(s)
- Bryan A Garcia
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA
| | - Jacque L Carden
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA
| | - Dana L Goodwin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA
| | - Tim A Smith
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA
| | - Amit Gaggar
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA.,Gregory Fleming James Cystic Fibrosis Research Center, Birmingham, AL, USA
| | - Kevin Leon
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA.,Gregory Fleming James Cystic Fibrosis Research Center, Birmingham, AL, USA
| | - Veena B Antony
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA.,Gregory Fleming James Cystic Fibrosis Research Center, Birmingham, AL, USA
| | - Steven M Rowe
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA.,Gregory Fleming James Cystic Fibrosis Research Center, Birmingham, AL, USA
| | - George M Solomon
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA. .,Gregory Fleming James Cystic Fibrosis Research Center, Birmingham, AL, USA.
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