A 17-Year Nationwide Study of Burkholderia cepacia Complex Bloodstream Infections Among Patients in the United States Veterans Health Administration

Chakhtoura, Nadim G. El; Saade, Elie; Wilson, Brigid; Pérez, Federico; Papp-Wallace, Krisztina M.

doi:10.1093/cid/cix559

Cited by 34 publications

(30 citation statements)

References 32 publications

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“…B, Chest X-ray taken hospital discharge day highly resistant or highly virulent bacteria" is included as a relative contraindication, thereby giving individual centers the ability to dictate practice. Moreover, high mortality has also been reported in a large cohort of non-CF patients with BCC bloodstream infections 7. To our knowledge, ours is the first reported case of pan-resistant BCC bacteraemic pneumonia.…”

supporting

confidence: 59%

“…Consequently, although the current guidelines do not list BCC infection as an absolute contraindication to lung transplantation, “colonization with highly resistant or highly virulent bacteria” is included as a relative contraindication, thereby giving individual centers the ability to dictate practice. Moreover, high mortality has also been reported in a large cohort of non‐CF patients with BCC bloodstream infections …”

Section: Discussionmentioning

confidence: 99%

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A case of pan‐resistant Burkholderia cepacia complex bacteremic pneumonia, after lung transplantation treated with a targeted combination therapy

Cantón-Bulnes

Martínez

López-Cerero

et al. 2019

Transplant Infectious Dis

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We describe a case of one patient with cystic fibrosis who developed a pan‐resistant Burkholderia cepacia complex rapidly progressive bacteraemic pneunonia, following bilateral lung transplantation. The patient was treated with a targeted combination antibiotic therapy (meropenem plus ceftazidime/avibactam plus high doses of nebulized colistimethate sodium). Evolution of the disease was complicated by multiple organ system dysfunction. Finally, clinical improvement and microbiological cure was achieved.

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supporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

A case of pan‐resistant Burkholderia cepacia complex bacteremic pneumonia, after lung transplantation treated with a targeted combination therapy

Cantón-Bulnes

Martínez

López-Cerero

et al. 2019

Transplant Infectious Dis

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“…Furthermore, in vitro data suggest potential synergy between beta-lactam or carbapenem antibiotics (meropenem or ceftazidime) and fluoroquinolones in the treatment of B. cepacia 15 . In a recent study describing the treatment and outcomes of 248 patients over a 17 year period with B. cepacia bacteremia, combination therapy was utilized in 29% of cases, most commonly with fluoroquinolone containing regimens (59%) 16 . While B. cepacia was the most likely primary pathogen responsible for PVE, this patient's high-risk situation with second valve placement, as well as the gram positive cocci seen on aortic thrombus tissue Gram stain, resulted in the use of vancomycin to cover methicillin-resistant S. epidermidis, Bacillus spp., and S. viridans.…”

Section: Report Of a Casementioning

confidence: 99%

A Unique Case of Burkholderia cepacia Prosthetic Mitral Valve Endocarditis and Literature Review

Dellalana

Byrge

Gandelman

et al. 2019

Infect Dis Clin Pract

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Burkholderia cepacia prosthetic valve endocarditis (PVE) is extremely rare, with few cases in the literature. A report of a patient with PVE is described, followed by a literature review on B. cepacia PVE. A 38 year old man with poor dentition and a history of intravenous drug use (IVDU) and mitral valve replacement was found to have a mitral valve vegetation. Five sets of blood cultures on different days grew B. cepacia. Individual sets of blood cultures on different dates also isolated S. viridans (outside hospital culture), methicillin-resistant S. epidermidis (hospital day 1), and Bacillus spp. (hospital day 6). He was successfully treated with ceftazidime and levofloxacin as dual therapy for B. cepacia PVE, in addition to vancomycin for gram positive coverage. This case report and review highlights the possibility of B. cepacia PVE in immunocompetent patients with poor dentition, with the potential for a successful outcome following combination antimicrobial therapy.

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“…S. maltophilia was among the 10 most common bacterial pathogens causing pneumonia in hospitalized patients from Europe, China, and the United States (15). The B. cepacia complex is a serious problem for cystic fibrosis patients and is increasingly occurring in hospital outbreaks in intensive care settings (5,(16)(17)(18).…”

mentioning

confidence: 99%

In Vitro Activity of Minocycline against U.S. Isolates of Acinetobacter baumannii-Acinetobacter calcoaceticus Species Complex, Stenotrophomonas maltophilia, and Burkholderia cepacia Complex: Results from the SENTRY Antimicrobial Surveillance Program, 2014 to 2018

Flamm

Shortridge

Castanheira

et al. 2019

Antimicrob Agents Chemother

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We evaluated the activity of minocycline and comparator agents against a large number of Stenotrophomonas maltophilia (n = 1,289), Acinetobacter baumannii-Acinetobacter calcoaceticus species complex (n = 1,081), and Burkholderia cepacia complex (n = 101) isolates collected from 2014 to 2018 from 87 U.S. medical centers spanning all 9 census divisions. The isolates were collected primarily from hospitalized patients with pneumonia (1,632 isolates; 66.0% overall), skin and skin structure infections (354 isolates; 14.3% overall), bloodstream infections (266 isolates; 10.8% overall), urinary tract infections (126 isolates; 5.1% overall), intra-abdominal infections (61 isolates; 2.5% overall), and other infections (32 isolates; 1.3% overall). Against the A. baumannii-A. calcoaceticus species complex, colistin was the most active agent, exhibiting MIC50/90 values at ≤0.5/2 μg/ml and 92.4% susceptibility. Minocycline ranked second in activity, with MIC50/90 values at 0.25/8 μg/ml and susceptibility at 85.7%. Activity for these two agents was reduced against extensively drug-resistant and multidrug-resistant isolates of the Acinetobacter baumannii-Acinetobacter calcoaceticus species complex. Only two agents showed high levels of activity (susceptibility, >90%) against S. maltophilia, minocycline (MIC50/90, 0.5/2 μg/ml; 99.5% susceptible) and trimethoprim-sulfamethoxazole (MIC50/90, ≤0.5/1 μg/ml; 94.6% susceptible). Minocycline was active against 92.8% (MIC90, 4 μg/ml) of trimethoprim-sulfamethoxazole-resistant S. maltophilia isolates. Various agents exhibited susceptibility rates of nearly 90% against the B. cepacia complex isolates; these were trimethoprim-sulfamethoxazole (MIC50/90, ≤0.5/2 μg/ml; 93.1% susceptible), ceftazidime (MIC50/90, 2/8 μg/ml; 91.0% susceptible), meropenem (MIC50/90, 2/8 μg/ml; 89.1% susceptible), and minocycline (MIC50/90, 2/8 μg/ml; 88.1% susceptible). These results indicate that minocycline is among the most active agents for these three problematic potential pathogen groups when tested against U.S. isolates.

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A 17-Year Nationwide Study of Burkholderia cepacia Complex Bloodstream Infections Among Patients in the United States Veterans Health Administration

Cited by 34 publications

References 32 publications

A case of pan‐resistant Burkholderia cepacia complex bacteremic pneumonia, after lung transplantation treated with a targeted combination therapy

A case of pan‐resistant Burkholderia cepacia complex bacteremic pneumonia, after lung transplantation treated with a targeted combination therapy

A Unique Case of Burkholderia cepacia Prosthetic Mitral Valve Endocarditis and Literature Review

In Vitro Activity of Minocycline against U.S. Isolates of Acinetobacter baumannii-Acinetobacter calcoaceticus Species Complex, Stenotrophomonas maltophilia, and Burkholderia cepacia Complex: Results from the SENTRY Antimicrobial Surveillance Program, 2014 to 2018

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