Complexo Burkholderia cepacia: impacto clínico em pacientes com fibrose cística acompanhados no Rio de Janeiro

Abstract

Respiratory infections in cystic fibrosis (CF) are the main cause for morbidity and mortality. Prolonged survival and frequent use of antibiotics has led to knowledge of emergent pathogens in CF, Burkholderia cepacia complex (BCC), a group of 20 identified species. BCC colonization has been associated to poor prognosis and cross-infection in CF patients. The aim of this thesis was to investigate the clinical outcome of BCC colonization in CF patients chronically colonized with Pseudomonas aeruginosa, who were followed at two CF reference centers in Rio de Janeiro (Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira and Hospital Universitário Pedro Ernesto). CF patients chronically colonized with P. aeruginosa were divided into three groups: intermittent (I), chronic (II) and no colonization (III) with BCC. Body mass index (BMI) percentile and spirometric parameters were analyzed at three different times in each group. Fifty-six patients chronically colonized with P. aeruginosa were included. Of these, 27 also had evidence of BCC colonization (13 intermittent and 14 chronic). BMI percentile was significantly lower among patients chronically colonized by both P. aeruginosa and BCC. Mean values of FEV1% and FVC % were also significantly lower in these patients, both at the time of chronic BCC colonization and 24 months forward. Mean annual rate of decline of both FEV1% and FVC % was also higher for these patients. Chronic BCC colonization is associated with significant loss of lung function. Lower BMI might be a risk factor for chronic BCC colonization, preceding these events.