Burkholderia cepacia complex: Beyond pseudomonas and acinetobacter

Abstract

Burkholderia cepacia complex (BCC) is an important nosocomial pathogen in hospitalised patients, particularly those with prior broad-spectrum antibacterial therapy. BCC causes infections that include bacteraemia, urinary tract infection, septic arthritis, peritonitis and respiratory tract infection. Due to high intrinsic resistance and being one of the most antimicrobial-resistant organisms encountered in the clinical laboratory, these infections can prove very difficult to treat and, in some cases, result in death. Patients with cystic fibrosis (CF) and those with chronic granulomatous disease are predisposed to infection by BCC bacteria. BCC survives and multiplies in aqueous hospital environments, including disinfectant agents and intravenous fluids, where it may persist for long periods. Outbreaks and pseudo-outbreaks of BCC septicaemia have been documented in intensive care units, oncology units and renal failure patients. BCC is phenotypically unremarkable, and the complex exhibits an extensive diversity of genotypes. BCC is of increasing importance for agriculture and bioremediation because of their antinematodal and antifungal properties as well as their capability to degrade a wide range of toxic compounds. It has always been a tedious task for a routine microbiological laboratory to identify the nonfermenting gram-negative bacilli, and poor laboratory proficiency in identification of this nonfermenter worldwide still prevails. In India, there are no precise reports of the prevalence of BCC infection, and in most cases, these bacteria have been ambiguously reported as nonfermenting gram-negative bacilli or simply Pseudomonas spp. The International Burkholderia cepacia Working Group is open to clinicians and scientists interested in advancing knowledge of BCC infection/colonisation in persons with CF through the collegial exchange of information and promotion of coordinated approaches to research.

Burkholderia cepacia—An Uncommon Cause of Exit-Site Infection in a Peritoneal Dialysis Patient

“…B. cepacia infection usually occurs in cystic fibrosis patients and immunocompromised hosts (1). Nosocomial outbreaks of Burkholderia bacteremia have also been reported in intensive care and dialysis units due to contaminated medical devices (2)(3)(4) …”

Pseudo-outbreak of Burkholderia cepacia blood stream infections in intensive care units of a super-speciality hospital: A cross-sectional study

“…It is classified as 10 serovars, collectively termed as B. cepacia complex (BCC). [1,2] BCC species have often been reported from outbreaks in both immunocompetent and immunocompromised patients admitted in hospitals. Nosocomial infections caused by BCC include blood stream infections (BSI), pneumonia, surgical wound infections, and genitourinary tract infections.…”

Existence of Burkholderia cepacia at Burn and Intensive Care Units in Alexandria Main University Hospital, Egypt

“…This also explains the lack of reports about the prevalence of B. cepacia infections in Egypt and many countries. (7)(8)(9) In routine clinical laboratories, the identification of putative Bcc isolates is generally performed using a combination of selective media, conventional biochemical analysis and/or commercial systems. Several different media have been developed for the selective isolation of Bcc isolates from different specimens (10)(11)(12) such as B. cepacia selective agar (BCSA), Pseudomonas cepacia (PC) agar, or oxidation-fermentation polymyxin-bacitracin lactose (OFPBL) agar.…”

“…Thus giving extreme value to the proper identification of B. cepacia. (9)(10)(11)(12)(13)(14)(15)(16) The present study aimed to detect the isolation percentage of Bcc from the patients were admitted to burn units and ICUs of the Alexandria Main University Hospital throughout a period of 6 months (April to October 2015) and to determine their antibiotic susceptibility pattern.…”