eMedicine Specialties > Infectious Diseases > Bacterial Infections

Burkholderia

Author: Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Contributor Information and Disclosures

Updated: Oct 14, 2008

Introduction

Background

Burkholderia cepacia is an aerobic gram-negative bacillus found in various aquatic environments. B cepacia is an organism of low virulence and is a frequent colonizer of fluids used in the hospital (eg, irrigation solutions, intravenous fluids). B cepacia rarely causes infection in healthy hosts. Based on phenotypic and genotypic analyses, B cepacia is divided into 9 genomovars that constitute the B cepacia complex (BCC).

Pathophysiology

B cepacia is almost always a colonizing bacterium rather than an infecting bacterium, but it is especially important when isolated from body fluids that are ordinarily sterile. The pathophysiology of B cepacia infection mirrors that of other nonfermentative aerobic bacilli.

Frequency

United States

B cepacia is generally not a pathogen in the ambulatory setting, but it may colonize and/or infect the respiratory tract of patients with cystic fibrosis. B cepacia may also cause catheter-related infections in patients with cancer and in those on hemodialysis. B cepacia nosocomial pneumonia has also been reported, especially in patients who have been treated with fluoroquinolones and ceftazidime antibiotics. Skin and soft-tissue infections, surgical-wound infections, and genitourinary tract infections with B cepacia have also been reported.

International

B cepacia is generally not a pathogen in the ambulatory setting, but it may colonize and/or infect the respiratory tract of patients with cystic fibrosis.

Mortality/Morbidity

  • If an intravenous infusate contains high numbers of B cepacia, direct injection into the bloodstream may induce the signs and symptoms associated with gram-negative bacteremia.
  • Gram-negative bacteremia may occur if urologic irrigation fluids that contain B cepacia are used during an invasive urologic procedure.

Clinical

History

  • A history of the use of irrigant solutions that may have contained B cepacia is epidemiologically important.

Physical

  • Physical examination is referable to the organ system involved.

Causes

  • B cepacia is a nonfermentative, aerobic, gram-negative bacillus formerly classified as Pseudomonas. Unlike Pseudomonas aeruginosa, B cepacia is an organism of low virulence with a limited ability to cause infection in humans.
  • B cepacia survives and multiplies in aqueous hospital environments, where it may persist for long periods.
  • Sources of B cepacia colonization include the following:
    • Personnel - Hands, antiseptic soaps, hand lotion1
    • Respiratory equipment and/or fluids - Respirator tubing condensate, ultrasonic nebulizers,2 inhalation medications
    • Intravenous lines and/or fluids - Intravenous solutions, central venous catheters
    • Pressure-monitoring devices - Pressure transducer fluids
    • Urine and/or fluids - Indwelling Foley catheters, urometers, irrigation solutions

More on Burkholderia

Overview: Burkholderia
Differential Diagnoses & Workup: Burkholderia
Treatment & Medication: Burkholderia
Follow-up: Burkholderia
References
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References

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Further Reading

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Keywords

Burkholderia infection , Burkholderia cepacia, B cepacia infection , B cepacia colonization, complex, Burkholderia cepacia complex , BCC, Burkholderia colonization, Burkholderia cepacia infection, Burkholderia cepacia colonization, nonaeruginosa pseudomonad, cystic fibrosis, Burkholderia pneumonia, Burkholderia bacteriuria, Burkholderia pseudobacteremia, Burkholderia cepacia pneumonia, B cepacia pneumonia

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Contributor Information and Disclosures

Author

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Medical Editor

Charles S Levy, MD, Associate Professor, Department of Medicine, Section of Infectious Disease, George Washington University School of Medicine
Charles S Levy, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, and Medical Society of the District of Columbia
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Richard B Brown, MD, FACP, Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine
Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD, Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center
Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

 
 
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