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Journal of Clinical Microbiology, August 2005, p. 3938-3943, Vol. 43, No. 8
0095-1137/05/$08.00+0 doi:10.1128/JCM.43.8.3938-3943.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Centre de Ressources et de Compétences pour la Mucoviscidose (CRCM), Service des Maladies Respiratoires,1 Laboratoire de Bactériologie,2 CRCM, Service de Pédiatrie, Hôpital Arnaud de Villeneuve,3 Laboratoire de Bactériologie-Virologie, Faculté de Pharmacie, Montpellier,4 Laboratoire de Bactériologie,5 CRCM, Service de Pédiatrie, Hôpital Debrousse, Lyon,6 Laboratoire de Bactériologie-Hygiène, Hôpital Calmette,7 CRCM, Hôpital Jeanne de Flandre, Lille,8 CRCM, Service de Pneumologie-Allergologie, Hôpital des Enfants,9 Observatoire Burkholderia cepacia, Laboratoire de Bactériologie-Hygiène, Hôpital Rangueil, Toulouse, France,10
Received 24 February 2005/ Returned for modification 10 April 2005/ Accepted 29 April 2005
Patients with cystic fibrosis (CF) may be colonized with unusual gram-negative bacilli whose identification is difficult and clinical impact unclear. We describe the clinical and microbiological features of five colonizations with organisms belonging to the recently described genus Inquilinus in CF patients. Isolates were identified from Burkholderia cepacia selective medium by means of 16S rRNA analysis. All of them were resistant to colistin, penicillins, cephalosporins, and monobactams but exhibited a remarkable susceptibility to imipenem. One of the five patients was transiently colonized with a nonmucoid isolate, whereas the four other patients were persistently colonized over the period of follow-up (8 to 21 months) with mucoid isolates. Pulsed-field gel electrophoresis of SpeI-digested genomic DNA was powerful for strain genotyping and demonstrated the clonality of Inquilinus sp. colonization for the two patients tested. Clinical evolution after the onset of Inquilinus was heterogeneous, but for at least one patient the lung function worsened and eradication of Inquilinus sp. was unsuccessful despite several imipenem courses. Finally, Inquilinus spp. may represent a new threat for CF patients due to their mucoid characteristic, their multiresistant pattern to antibiotics, and their ability to persist in the respiratory tract.
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