Burkholderia cepacia an emerging cause of septicaemia, in an intensive care unit from a tertiary care hospital, Nellore, India

Authors

  • Usham Gangaram Department of Medicine, Narayana Medical College, Nellore, Andhra Pradesh, India
  • Tupili Ramya Department of Microbiology, Narayana Medical College, Nellore, Andhra Pradesh, India
  • Kandati Jithendra Department of Microbiology, Narayana Medical College, Nellore, Andhra Pradesh, India
  • Desu Rama Mohan Department of Hospital Administration, Narayana Medical College, Nellore, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20200591

Keywords:

Burkholderia cepacia, Drug susceptibility, Intensive care unit, Septicaemia

Abstract

Background: Burkholderia cepacia is highly virulent and multidrug resistant organism to cause fatal and serious infections in ICUs leads to rise in mortality and morbidity. aim of present study was to know the prevalence of Burkholderia cepacia in blood stream infection in Intensive Care Unit and to know the drug susceptibility.

Methods: This is a prospective study was carried out in the Intensive Care Unit and Department of Microbiology, Narayana Medical College, Nellore, from February to March 2018. As a part of routine investigations Blood, urine, sputum or tracheal secretions sent for culture and sensitivity to the Microbiology laboratory. By conventional method, all the samples were cultured (except blood) onto Blood agar, Chocolate agar and MacConkey, s agar; incubated for 18-24 hours at 37⁰C. Blood cultures were performed in BACT/ Alert 3D (Biomeriux), only positives were subculture by conventional method. Further analysis was done in culture positive samples only.

Results: A total of 448 patients admitted in ICU were included in the study, from them 586 samples were collected. out of which we got 238 culture positives. Among them 19 patients were positive for Burkholderia cepacia, most of them isolated from blood (78.9%), followed by respiratory secretions (21.1%) and none of them were isolated from urine samples. Most of the isolates were sensitive to Meropenam and Tigecycline (89.4%) followed by minocycline (84.2%), ceftazidime (73.6%), levofloxacin (63.1%). While B. cepacia isolates showed high resistance to cefaperazone-sulbactam, ciprofloxacin, ticarcillin-clavulanic acid with (84.2%), (89.4%), (89.4%) respectively.

Conclusions: To conclude that, Burkholderia cepacia is one of the emerging causes of septicemia with multidrug resistance, cross contamination may be the root cause so it should be treated quickly and effectively.

References

Burkholder WH. Sour skin, a bacterial rot of onion bulbs. Phytopathology. 1950;40(1):115-7.

Govan JR, Brown AR, Jones AM. Evolving epidemiology of Pseudomonas aeruginosa and the Burkholderia cepacia complex in cystic fibrosis lung infection. Future Microbiol. 2007;2:153-64.

Greenberg DE, Goldberg JB, Stock F, Murray PR, Holland SM, LiPuma JJ. Recurrent Burkholderia infection in patients with chronic granulomatous disease: 11-year experience at a large referral center. Clin Infec Dis. 2009 Jun 1;48(11):1577-9.

Mahenthiralingam E, Urban TA, Goldberg JB. The multifarious, multireplicon Burkholderia cepacia complex. Nature Rev Microbiol. 2005 Feb;3(2):144-56.

Donlan RM, Costerton JW. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002 Apr 1;15(2):167-93.

LiPuma JJ. Update on the Burkholderia cepacia complex. Curr Opin Pulm Med. 2005 Nov 1;11(6):528-33.

Matthaiou DK, Chasou E, Atmatzidis S, Tsolkas P. A case of bacteremia due to Burkholderia cepacia in a patient without cystic fibrosis. Resp Med CME. 2011 Jan 1;4(3):144-5.

Mangram A, Jarvis WR. Nosocomial Burkholderia cepacia outbreaks and pseudo-outbreaks. Infec Control Hospital Epidemiol. 1996 Nov;17(11):718-20.

LiPuma JJ, Currie BJ, Peacock SJ, Vandamme PA. Burkholderia, Stenotrophomonas, Ralstonia, Cupriavidus, Pandoraea, Brevundimonas, Comamonas, Delftia, and Acidovorax. Manual Clin Microbiol. 2011 Jan 1;10:692-713.

Levy, Itzhak, Leibovici, Lenard, Moshie D, Samra. A prospective study of gram negative bacteremia in children. Paediatr Infec Dis J. Feb 1996; 15:117-22.

Mandell GL, Bennett JE, Dolin R. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 5th ed. Philadelphia: Churchill Livingstone; 2000.

Mac Faddin JF. Biochemical tests for identification of medical bacteria. 3rd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2000:411-480.

McMenamin JD, Zaccone TM, Coenye T, Vandamme P, LiPuma JJ. Misidentification of Burkholderia cepacia in US cystic fibrosis treatment centers. Chest. 2000 Jun 1;117(6):1661-5.

Bhise SM, Rahangdale VA, Qazi MS. Burkholderia Cepacia an emerging cause of septicemia-an outbreak in a neonatal Intensive Care Unit from a tertiary care hospital of central India. IOSR J Dent Med Sci. 2013;10:41-3.

Gales AC, Jones RN, Andrade SS, Sader HS. Antimicrobial susceptibility patterns of unusual nonfermentative gram-negative bacilli isolated from Latin America: report from the SENTRY Antimicrobial Surveillance Program (1997-2002). Memórias do Instituto Oswaldo Cruz. 2005 Oct;100(6):571-7.

Omar N, El Raouf HA, Okasha H, Nabil N. Microbiological assessment of Burkholderia cepacia complex (BCC) isolates in Alexandria Main University Hospital. Alexand J Med. 2015;51(1):41-6.

Kady HE, Mohamed ONE, Abaza AF, Zidan YHM, Burkholderia Cepacia Complex Among Intensive Care Unit Patients in Two Private Hospitals In Alexandria. Inter J Sci Technol Research Jan 2018;7(1):102-9.

CLSI. Statistical Quality Control for Quantitative Measurement Procedures: Principles and Definitions. 4th ed. CLSI guideline C24. Wayne, PA: Clinical and Laboratory Standards Institute; 2016.

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Published

2020-02-24

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Original Research Articles