Burkholderia cepacia in cystic fibrosis: Novel Australian cluster strain without accelerated respiratory deterioration

Objective: To determine whether 4 years of colonization with a novel Austra lian cluster strain (The 'Hunter' strain) of Burkholderia cepacia (B, cepac ia) in cystic fibrosis (CF) patients was associated with more rapid decline in nutritional status and pulmonary function than in non-colonized contemp oraries from the same CF clinic. Methodology: A retrospective review of respiratory function and nutritional data from a single multidisciplinary paediatric CF clinic over 4 years (19 93-97). Results: Paired spirometry data for 1993 and 1997 were available in 47 pati ents without (n = 31) and with B, cepacia (n = 16) colonization (mean (+/- SD) ages in 1993: 12.1 years Ir 4.0 vs 12.6 years +/- 6.5; P = 0.83). Their percentage predicted forced expiratory volume in 1 s (FEV1) (94.2% +/- 16. 7 vs 85.9% +/- 21.2; P = 0.19) were not significantly different. The averag ed annual fall in FEV1 over 4 years was also not significantly different (3 .8% +/- 3.8 vs 3.6% +/- 3.7; P = 0.82). Weight percentile (Wt%), height per centile (Ht%) and percentage age weight for height (%WFH) were not signific antly different between groups in 1993. By 1997, Wt% (36.7% +/- 25.1 vs 22. 3% +/- 19.6: P = 0.04) and Ht% (42.5% +/- 29.6 vs 17.6% +/- 19.4; P = 0.002 ) but not %WFH (102% +/- 10.0 vs 106% +/- 11.2: P > 0.10) were lower in sub jects with B, cepacia. Conclusions: in adolescent CF patients, colonization with the Hunter strain of B. cepacia was associated with a deterioration in some nutritional para meters but not with an accelerated decline in FEV1 over 4 years. As varying pathogenicity of B. cepacia strains may account for differing rates of pul monary decline, further assessment of the consequences of colonization with certain strains of B. cepacia in CF is needed.