AIRBORNE DISSEMINATION OF BURKHOLDERIA (PSEUDOMONAS) CEPACIA FROM ADULT PATIENTS WITH CYSTIC-FIBROSIS

Background - Burkholderia (Pseudomonas) cepacia is an increasingly imp ortant pathogen in patients with cystic fibrosis but it is unclear how it spreads from patient to patient. A study was undertaken to determi ne whether B cepacia could be recovered from room air occupied by colo nised adult patients with cystic fibrosis. Methods - Air samples were obtained consecutively from an enclosed room or isolation cubicle befo re, during, and after occupation by six patients on nine occasions usi ng a surface air sampler incorporating contact plates with selective m edium. Settle plates were also used and sputum from five patients was cultured. Results - B cepacia was recovered from room air during occup ation by five of six patients, the number of bacteria ranging from 1 t o 158 cfu/m(3) (mean 32 cfu/m(3)). The number of bacteria isolated was greater when patients were coughing. B cepacia persisted in room air on four occasions after the patient left the room, on one occasion for up to 45 minutes. Conclusions - The isolation of B cepacia from the a ir of rooms occupied by colonised patients suggests that dissemination might occur by aerosol as well as by direct physical contact with pat ients or contaminated environmental sites.