Burkholderia cepacia

Updated: Oct 25, 2018
  • Author: Syed Faisal Mahmood, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Overview

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).

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Pathophysiology

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

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Epidemiology

Frequency

United States

B cepacia is ordinarily not a pathogen in the ambulatory setting, but it may colonize and/or infect the respiratory tract of patients with cystic fibrosis or bronchiectasis. B cepacia may also cause central venous catheter–related infections in patients with cancer and in those on hemodialysis. B cepacianosocomial pneumonia has rarely been reported, usually in patients treated with fluoroquinolones and ceftazidime. Skin and soft-tissue infections, surgical-wound infections, and genitourinary tract infections with B cepacia have also been reported.

According to the US Cystic Fibrosis Foundation’s 2016 National Patient Registry, 3% percent of all persons with cystic fibrosis were infected with B cepacia complex compared to 2.6% in 2012. [1]

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 or bronchiectasis.

Mortality/Morbidity

If an intravenous infusate contains high numbers of B cepacia, direct injection into the bloodstream may result in gram-negative bacteremia.

Mortality and morbidity is highest in those with impaired pulmonary function (eg, cystic fibrosis, bronchiectasis, chronic granulomatosis disease).

Disease severity (defined by the Simplified Acute Physiology Score II) and age are independent predictors of mortality. [2]

Malignancy and a higher SOFA score at onset of bacteremia are associated with high mortality rates. [3]

Race

Burkholderia has no racial predisposition.

Age

Burkholderia has no age predisposition.

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Prognosis

Signs and symptoms of B cepacia infections are related to the organ system involved and are indistinguishable from infections with other pathogens.

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