Presentación de poster: EVALUATION OF CYSTIC FIBROSIS PATIENTS? CLINICAL OUTCOME CHRONICLY COLONYZED BY BURKHOLDERIA CONTAMINANS

DANIELA CASCO; CLAUDIA PRIETO; BETTIOL, MARISA; FERNANDO RENTERÍA; DALESSANDRO, VIRGINIA; ALEJANDRA BOSCH; BELTINA LEÓN; MARIANA LEGUIZAMÓN; CECILA FIGOLI

Denver

Conferencia; 32th annual North American Cystic Fibrosis Conference (NACFC); 2018

North American Cystic Fibrosis Society

Introduction. B. contaminans represents a highly problematic pathogen for patients with cystic fibrosis (CF) due to multiple reasons including: high antibiotic resistance, transmissibility among patients, and highly unpredictable clinical outcome ranging from asymptomatic infections to a devastating and fatal pneumonia similar to a ?cepacia syndrome?. The aim of this work was to evaluate the clinical status of patients colonized by B. contaminans and to analyze whether it is associated to the genetic characteristics of the isolates recovered along their chronic infections.Methods. This study was carried out with 17 patients colonized by B. contaminans attended at the children hospital ?Sor María Ludovica?, La Plata, Argentina, in the period 2005-2017. Among them, 14 patients were chronically infected, while 3 presented transient infections. For each patient, the first isolate which was believed to have initiated the infection and the last isolate available of the chronic infection were analyzed by multilocus sequence typing, (MLST). For all the isolates the antibiotic sensibilities against the main antibiotics recommended by the Clinical and Laboratory Standards Institute (CLSI) Guidelines were determined. Patients? clinical status was assessed through nutritional parameters, such as Z score BMI and BMI percentile together with respiratory symptoms, including persistent cough, shortness of breath and lung exacerbation frequency.Results. The MLST analysis revealed a low genetic diversity among isolates: only the ST 102 and ST 872 were found. Although the ST 872 was the prevalent linage from 2005 to 2015 it was completely substituted by ST 102 in the last 3 years. Among the 10 patients colonized by ST 872 two different scenarios were found. Half of them evolved slowly, and showed a stable clinical outcome for many years, while the other half evolved rapidly to an adverse outcome. Remarkably, for the 4 patients colonized with ST 102, the nutritional and respiratory outcomes worsened in less than 3 years of the chronic infection.As regards the antibiotic sensitivity it was observed that along the chronic infection 80 % of the isolates belonging to the ST 872 linage developed resistance to at least three of the antibiotics tested, while in the case of the isolates belonging to the ST 102 linage are still sensitive to some of the antibiotics used in clinical treatments. Conclusions. Through this investigation we could find for the first time, a direct association between the B. contaminans linage that is colonizing the respiratory tract of cystic fibrosis patients, with their nutritional and respiratory outcome. Our results also showed that for patients colonized by the ST 102 linage, different treatments for early eradication of B. contaminans might be implement to eradicate the infection and improve the clinical outcomes of the patients.