Clinical outcome after acquisition of Burkholderia cepacia in patients with cystic fibrosis

Background Respiratory disease is the major cause of morbidity and mortalit y in cystic fibrosis (CF). The significance of Burkholderia cepacia (B. cep acia) in the pathogenesis of lung disease in CF is debated, but its exact r ole remains unclear. Aim To assess the impact of respiratory tract colonisation with B. cepacia in patients with CF by measuring changes in pulmonary function and body mas s index (BMI). Methods Three groups of patients were defined based on sputum culture isola tes: Group 1 were B. cepacia and Pseudomonas aeruginosa (P. aeruginosa) pos itive patients; Group 2 were P. aeruginosa positive; and Group 3 were colon ised with neither organism. Forced expiratory volume (FEV) and BMI were mea sured annually from 1987 to 1995 and the year of acquisition of Fl aerugino sa or B. cepacia was recorded. Results The mean annual decrease in FEV, was significantly different in all three groups: Group 1, -5.4 (5.1)%; Group 2, -3.9 (6.5)%; and Group 3, -1. 6 (1.0)%, (p <0.05). The mean percentage decrease in FEV of a sub-group of Group 1 patients where the B. cepacia acquisition date was known was 6.1% p er year versus 1.55% in Group 2 patients (p <0.05). Conclusions Acquisition of B. cepacia may be a cause of, rather than a mark er for, a decrease in pulmonary function.