Diagnostic Considerations

B cepacia recovered from blood cultures may represent infection, pseudo infection, or actual infection from contaminated intravenous fluids (infusate-related).

Regard the recovery of B cepacia from the respiratory secretions or urine of catheterized patients as colonization until proven otherwise.

B cepacia is a common cause of catheter-associated bacteriuria in hospitalized patients. B cepacia commonly colonizes the urine and is potentially pathogenic only in individuals with impaired host defenses (eg, patients on steroids or those with diabetes, systemic lupus erythematosus [SLE], multiple myeloma, cirrhosis, or chronic granulomatous disease).

B cepacia is an extremely rare cause of nosocomial pneumonia. In ventilated patients with presumed nosocomial pneumonia who have fever, pulmonary infiltrates, and leukocytosis, B cepacia cultured from respiratory secretions generally represents colonization rather than infection.

Nosocomial infections caused by B cepacia include the following:

Catheter-associated bacteriuria - Indwelling urinary catheters
Central line-associated bloodstream infection - Central venous catheters (CVCs)
Urinary tract infection - following urinary tract instrumentation
Secondary bacteremia - Arterial monitoring devices
Pseudobacteremia - Contamination of blood during collection and/or processing of blood cultures

There also have been reports of B cepacia as a cause of endocarditis in individuals with drug addiction or prosthetic heart valves, endophthalmitis and subdural empyema, brain abscesses, and meningitis.^{[5, 6, 7, 8, 9, 10, 11]}

Workup

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Author

Sara Ahmed, MBBS, MRCP(UK), FCPS Faculty, Infectious Diseases, Aga Khan University Hospital , Pakistan

Sara Ahmed, MBBS, MRCP(UK), FCPS is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Syed Faisal Mahmood, MBBS Associate Professor of Infectious Diseases, Program Director, Infectious Diseases Fellowship Program, Department of Medicine, Aga Khan University Hospital, Pakistan

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

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, Massachusetts Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

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, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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, Medical Society of the District of Columbia

Disclosure: Nothing to disclose.

Sections Burkholderia cepacia
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