II. Pathophysiology

  1. Burkholderia Cepacia represents a group of at least 24 individual species (genomovars)
    1. Genomovars are grouped species, phenotypically similar, but genotypically distinct
    2. Burkholderia species were previously classified under the genus Pseudomonas
  2. Aerobic Gram Negative Rod
    1. Multi-drug resistance (including Topical Antiseptics) is common
    2. Causes opportunistic infections in susceptible hosts
    3. Identifying factors
      1. Oxidase positive
      2. Non-lactose fermenter
      3. Grows on selective media with colistin
  3. Sources
    1. Water (lakes, rivers, drinking water)
    2. Soil and crop plants (rhizosphere)
      1. Plant associated diseases include Onion Rot
    3. Water-based pharmaceuticals and personal care products
      1. Intravenous drugs and solutions
      2. Nasal sprays
      3. Mouthwash
      4. Preoperative skin solutions
      5. Hand sanitizers
      6. Benzalkonium chloride (BZK) solutions

III. Risk Factors

  1. Nosocomial Infection (e.g ICU)
    1. Burn Injury
    2. Mechanical Ventilation via endotrcheal tubes
    3. Urinary Catheters
    4. Hemodialysis
  2. Cystic Fibrosis (highest risk)
    1. Carrier state
    2. Bronchiectasis
    3. Pneumonia (rapid progression)
  3. Other risks
    1. Chronic Granulomatous Disease
    2. Immunocompromised patients
    3. Elderly

IV. Management: Antibiotics

  1. Variable Antibiotic susceptibility
  2. First-Line empiric therapy until cultures with susceptibility
    1. Trimethoprim Sulfamethoxazole
    2. Levofloxacin
  3. Alternative empiric therapy
    1. Minocycline
    2. Meropenem
    3. Ceftazidime

V. References

  1. Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 93
  2. Sanford Guide, accessed on IOS 2/2/2025
  3. Tavares (2020) Clin Microbiol Rev 33(3):e00139-19 +PMID: 32295766 [PubMed]

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