Cross infection between cystic fibrosis patients colonised with Burkholderia cepacia

Whilst patient to patient spread of the respiratory pathogen Burkholderia cepacia is well recognised between patients with cystic fibrosis, prompting a strict segregation policy, cross colonisation between cystic fibrosis patients already infected with B cepacia has not been described and surveys show a very low incidence of patients with more than one strain. Five adult cystic fibrosis patients with B cepacia are presented who became cross colonised with a second B cepacia (UK epidemic) strain, four of whom then died, three from the cepacia syndrome. These cases show that, amongst segregated patients, cross colonisation with different B cepacia strains is possible, and even in these patients the acquisition of the UK epidemic strain may have a fatal outcome. In future it may be necessary to segregate cystic fibrosis patients colonised with the UK epidemic strain from all other patients with cystic fibrosis.