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Burkholderia cenocepacia ET12 transmission in adults with cystic fibrosis
  1. Ana C Blanchard1,
  2. Lin Tang2,
  3. Manal Tadros3,
  4. Matthew Muller4,
  5. Theodore Spilker5,
  6. Valerie J Waters1,
  7. John J LiPuma5,
  8. Elizabeth Tullis6
  1. 1Pediatrics, Infectious Diseases, Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2Infection Prevention and Control, St Michael’s Hospital, Toronto, Ontario, Canada
  3. 3Laboratory Medicine, St Michael’s Hospital, Toronto, Ontario, Canada
  4. 4Internal Medicine, Infectious Diseases/Infection Prevention and Control, St Michael’s Hospital, Toronto, Ontario, Canada
  5. 5Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, USA
  6. 6Internal Medicine, Respirology, St Michael’s Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Ana C Blanchard, Pediatrics, Infectious Diseases, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; ana.blanchard{at}


This report describes transmission of a Burkholderia cenocepacia ET12 strain (ET12-Bc) at the Toronto Adult Cystic Fibrosis (CF) Centre occurring from 2008 to 2017. Epidemiological and genomic data from 11 patients with CF were evaluated. Isolates were analysed using whole genome sequencing (WGS). Epidemiological investigation and WGS analysis suggested nosocomial transmission, despite enhanced infection control precautions. This was associated with subsequent deaths in 10 patients. ET12-Bc positive patients are no longer cared for on the same unit as ET12-Bc negative patients.

  • cystic fibrosis
  • infection control
  • bacterial infection
  • clinical epidemiology
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  • Contributors ET, VJW and ACB planned the study. ACB performed a chart review to collect clinical data and obtained information regarding the epidemiological investigation from LT and MM. TS and JJL who had performed whole genome sequencing analyses, provided scientific interpretations of the results. ACB wrote the manuscript. LT, MT, MM, TS, JJL, VJW and ET reviewed the manuscript and provided feedback. ACB and ET are the guarantors of the overall content of this study.

  • Funding JJL is supported by a grant (LIPUMA 17AB00) from the Cystic Fibrosis Foundation.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Approved by the St Michael’s Research Ethics Board (REB#18-100).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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