Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant

Abstract

Burkholderia cepacia causes sepsis in neonates who are immunocompromised or exposed via nosocomial transmission. We report a case of B. cepacia sepsis in a previously healthy 5-week-old male originally treated for bacterial pneumonia per chest X-ray findings and 3 days of fevers. Regardless of appropriate antibiotics and an initial negative blood culture, he developed severe hypoglycemia, circulatory collapse with disseminated intravascular coagulopathy, and expired. A second blood culture taken following transfer to the intensive care unit resulted positive for B. cepacia postmortem. Review of the newborn screen and family history was otherwise normal. Subsequent postmortem autopsy showed multifocal bilateral pneumonia with necrotizing granulomatous and suppurative portions of lung tissue. Additionally, there was a prominent cavitary lesion 2.5 cm in the right lower lobe with branching and septate fungal hyphae. Stellate microabscesses with granulomas were present in the liver and spleen. These findings plus B. cepacia bacteremia are highly suggestive of an immunocompromised status. Review of the literature shows that its presence has been associated with chronic granulomatous disease. Therefore, in a persistently febrile infant not responding to antibiotics for common microbes causing community-acquired pneumonia, immunodeficiency workup should ensue in addition to respective testing for chronic granulomatous disease especially if B. cepacia culture-positive as it is strongly associated with neutrophil dysfunction.

Characterisation of Mid-Gestation Amniotic Fluid Cytokine and Bacterial DNA Profiles in Relation to Pregnancy Outcome in a Small Australian Cohort

“…Burkholderia cepacia , a potential pathogen, was identified in one term sample (relative abundance 50.6%) and two preterm samples (relative abundances of 11.3% and 1.04%). This species has previously been reported as a cause of neonatal sepsis in a full term infant [ 39 ], while other species of the genus have been reported to cause intra-amniotic infection and preterm labour [ 40 , 41 ]. The results of our study therefore highlight the potential to detect preterm-birth-associated pathogens in amniotic fluid samples taken early in pregnancy.…”

Burkholderia cepacia Complex Infections in Urgently Referred Neonates from Syrian Border Regions to a Hospital in Turkey: A Cross-Border Cluster

“…In a systematic review of healthcare-associated BCC outbreaks, medical products are found to be the most frequent source of the outbreaks, representing over half of the identified sources, with 12% of the outbreaks caused by disinfectant products [ 16 ]. Maternal risk factors such as poor intrapartum and postnatal infection control practices also play a role in developing neonatal infections [ 3 , 17 ].…”

Neonatal bloodstream infections

“…The majority of these organisms are E. coli or Klebsiella isolates; however, other gram-negatives have emerged as multidrug-resistant threats. These multidrug-resistant GNB run the gamut from common pathogens such as Salmonella and Serratia all the way to Ewingella, Elizabethkingia, Pantoea, and Chryseobacterium spp [30][31][32][33][34][35][36][37][38][39][40]. Perhaps the most concerning trend in gram-negative neonatal infections has been the arrival of carbapenem-resistant organisms [41].…”