The Involvement of the Low-Oxygen-Activated Locus of Burkholderia Cenocepacia in Adaptation During Cystic Fibrosis Infection

Chronic infection is a hallmark of cystic fibrosis (CF) related lung disease. Several opportunistic pathogens, such as Pseudomonas aeruginosa and Burkholderia cepacia complex (Bcc) colonise the airways of CF patients impacting significantly on the quality of life and mortality of people with CF. Bcc is a group of 22 genetically distinct, highly antibiotic resistant bacterial species1,2,3,4 associated with a more dramatic decline than P. aeruginosa5,6. About 20% of Bcc colonised patients experience bacteraemia and “cepacia syndrome”, characterised by a sometimes fatal, necrotising pneumonia7. B. cenocepacia is the most virulent Bcc species and although most frequently associated with bacteraemia, this complication has also been linked to other Bcc species5,8,9,10