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Previous Volume 331:981-987 October 13, 1994 Number 15 Next

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ABSTRACT

Background In patients with cystic fibrosis, infection with Pseudomonas cepacia is associated with poor outcomes. However, the extent of person-to-person transmission and the source of P. cepacia infection after lung transplantation are not well defined. Using DNA-based typing systems, we sought to determine the genetic relatedness of P. cepacia infection at one cystic fibrosis center.

Methods We analyzed 65 P. cepacia isolates gathered over a period of eight years at a single cystic fibrosis center from 17 clinic patients and from 5 patients who underwent double-lung transplantation. The isolates were analyzed by ribotyping and chromosomal fingerprinting based on pulsed-field gel electrophoresis.

Results Analyses of serial isolates revealed that each clinic patient and transplant recipient harbored a different P. cepacia clone that was persistent. In the transplant recipients, the preoperative and postoperative isolates were identical. In the two patients with disseminated infection after lung transplantation, isolates from multiple sites were identical and indicated clonal expansion of the previous respiratory P. cepacia strain. Pulsed-field gel electrophoresis proved both more discriminative and more practical than ribotyping as a means of defining the genetic relatedness of the P. cepacia isolates.

Conclusions Our serial analyses in patients with cystic fibrosis at one center found distinct strains of P. cepacia persistently infecting each patient and no evidence of person-to-person transmission of this organism. P. cepacia infection after lung transplantation was due to the persistence of the strain present before transplantation.

Source Information

From the Department of Pediatrics (S.S.) and the Section of Molecular Genetics, Maxwell Finland Laboratory for Infectious Diseases (L.S., R.-Z.J., R.G.), Boston University School of Medicine and Boston City Hospital, Boston; and the Cystic Fibrosis Center (P.F.), Clinical Microbiology Laboratory (P.G.), and Division of Cardiothoracic Surgery (T.M.E.), University of North Carolina School of Medicine and Hospitals, Chapel Hill.

Address reprint requests to Dr. Goldstein at the Section of Molecular Genetics, Maxwell Finland Laboratory for Infectious Diseases, 774 Albany St., Boston, MA 02118.

Full Text of this Article

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