Pandoraea Sputorum Colonization in a Patient With Cystic Fibrosis

• Published in: Archivos de bronconeumología (English ed.) 2011-11, Vol.47 (11), p.571-574
• Main Authors: Martínez-Lamas, Lucía, Rabade Castedo, Carlos, Martín Romero Domínguez, Miguel, Barbeito Castiñeiras, Gema, Palacios Bartolomé, Ana, Pérez del Molino Bernal, María Luisa
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Bronchiectasis - etiology; Bronchiectasis - microbiology; Burkholderia cepacia complex - drug effects; Burkholderia cepacia complex - isolation & purification; Burkholderia cepacia complex - pathogenicity; Burkholderia Infections - drug therapy; Burkholderia Infections - etiology; Burkholderia Infections - microbiology; Child; Cystic fibrosis; Cystic Fibrosis - complications; Cystic Fibrosis - microbiology; Cytokines - secretion; Drug Resistance, Multiple, Bacterial; Female; Fibrosis quística; Follow-Up Studies; Humans; Imipenem - therapeutic use; Internal Medicine; MALDITOF-MS; Pandoraea; Pneumonia, Bacterial - drug therapy; Pneumonia, Bacterial - etiology; Pneumonia, Bacterial - microbiology; Pseudomonas Infections - drug therapy; Pseudomonas Infections - etiology; Pseudomonas Infections - microbiology; Pulmonary/Respiratory; Sputum - microbiology; Superinfection; Virulence
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/j.arbr.2011.06.014

Abstract Cystic fibrosis (CF) is a disease produced by a defect in the transmembrane conductance regulator protein, CFTR. Currently, the morbidity and mortality associated with CF are fundamentally related with the lung affectation that is a consequence of this defect. With the progression of the disease, there is an increase in the isolation of non-fermenting gram-negative bacilli colonizing these patients. The genus Pandoraea arises from a reclassification of species included within the “ Burkholderia cepacia complex”. It is made up of 9 species susceptible only to tetracycline, imipenem and cotrimoxazole. We report the first clinical case in Spain of colonization by Pandoraea sputorum in a patient diagnosed with CF at the age of eleven. After several previous colonizations by different Pseudomonas species in September 2005, a gram-negative bacillus was isolated in sputum, which was identified by sequencing and mass spectrometry (MALDITOF-MS) as P. sputorum, only sensitive to piperacillin-tazobactam, cotrimoxazole and imipenem. From 2005 to 2008, chronic colonization by this microorganism was associated with deterioration in lung function that was recuperated after treatment with piperacillin-tazobactam and imipenem. In 2010, this microorganism was once again isolated and treated with imipenem, to which the patient responded favorably. Currently, it is not known whether this microorganism is a chronic colonizer, whether it produces a transitory infection or it constitutes an important problem in CF patients, but given its special characteristics of sensitivity to anti-microbial drugs, the correct identification of this genus is essential. Mass spectrometry seems to be a valid technique that is faster than sequencing methods for identifying these species.