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Burkholderia gladioli

Question
Hello!

The last throat culture test that our ten years old son underwent showed the presence of Burkholderia gladioli. The outpatient department told us that it was a harmless species, I should not google since Burkholderia was not harmless generally speaking. He should be treated i.v. immediately if possible and might not go to the University respectively to the physiotherapy unless a test showed negative evidence twice. However, this does not sound harmless at all! How is this germ to be evaluated and is there no other way of treatment? While googleling (of course I did) there was information about i.m. administration of Ceftadizim and oral administration of Cotrimoxazole.

Furthermore, I found some comments regarding orchids; I have some orchids in the kitchen and living room.

Thank you very much for your help. [part with telephone number removed]

Best regards
Heike Klug
Answer
Dear questioner,

It is not easy, indeed, to answer your questions since there is pretty little information about this germ in CF. Although this germ bears the name component "Burkholderia" it is clinically considered far away from the "Burkholderia Cepacia" complex and the sorrows connected to it. The name derives from "Pseudomonas gladioli". Since the first evidence in CF patients (1989) only reports with a small number of patients have been published. The most recent report (Kennedy et al. JCF, 2007;6:267-273) describes a long-term observation of 35 (33 with CF) patients; all patients had this germ verifiably somewhen. All patients had different strains which argues against infection among one another. The majority (>60%) did not have a chronic colonization but got rid of the germ again. Based on this study it is not possible to make a trusted statement about the influence on the clinical progression after chronical colonization. An initial intravenous therapy did not lead to resistence problems in the majority of the patients. In those cases where a chronic infection was established there were mostly resistences against more than two of the usual antibiotics, however.
In conclusion we do not know much about that germ, we can even not make a reliable statment on the influence of that germ on the course of the illness. Therefore, as one wants to be on the safe side, you are probably told not to go to university and the physiotherapy unless the germ is treated. The way of treatment depends on the resistance of the germ to antibiotics which is investigated with a so-called "antibiogramm", often only the i.v. route is the only possibility to have a secure eradication.
To make a comment on the "orchids": those plants can suffer from an illness caused by B. gladioli. It is not known if the patient can aquire the germ by that route - therefore if there is any doubt it is probably better to give the orchids away.
I hope to have been helpful with this information.

Best regards
M. Ballmann
28.04.2008