Nishtha Singh¹, Sheetal Verma²*, Amber Azim³, Vimala Venkatesh⁴, Raj Kumar Kalyan⁴ and Prashant Gupta⁴

¹Department of Microbiology, Assistant Professor, T.S. Misra University, India
²Department of Microbiology, Additional Professor, King George Medical University, India
³Department of Microbiology, Senior Resident, King George Medical University, India
⁴Department of Microbiology, Professor, King George Medical University, India

*Corresponding Author: Sheetal Verma, Department of Microbiology, Additional Professor, King George Medical University, India.

Received: January 10, 2025; Published: February 21, 2025

Abstract

Introduction: Burkholderia spp. causes infections including bacteraemia, urinary tract infection, septic arthritis, peritonitis and respiratory tract infection in immunocompromised and competent individuals. Due to high intrinsic resistance and being one of the most antimicrobial-resistant organism encountered in the clinical laboratory, is responsible for increased mortality and morbidity.

Methods: Clinical samples were collected from patients admitted in intensive care units of a university hospital between January 16, 2023 to March 16, 2023. The samples were sub-cultured on 5% sheep blood agar and MacConkey agar. Plates were incubated at 37C for up to 72 hours. Isolates were identified using MALDI-TOF-MS. Antimicrobial susceptibility was evaluated as per latest CLSI guidelines.

Results: Total Burkholderia spp isolated were 154 from different clinical samples. Majority of isolates were Burkholderia cenocepia (74%), followed by Burkholderia cepacia (18.2%), Burkholderia contaminans (1.29%), Burkholderia vietnamiensis (1.29%), Burkholderia metallica, Burkholderia ambifaria and Burkholderia multivorans (0.64%) each. Burkholderia was mainly isolated from blood (87.6%) followed by pus (9.09%). Isolates resistant to ceftazidime and levofloxacin were 14% and to chloramphenicol 7.05% and minocycline 1.04%. Isolates demonstrated 100% sensitive to meropenem and sulfamethoxazole plus trimethoprim.

Conclusions: Burkholderia spp. appears to be an emerging cause of septicaemia in intensive care units. Meropenem, minocycline and sulfamethoxazole trimethoprim appear to promising therapeutic options. MALDI-TOF-MS is a reliable tool for prompt diagnosis and commencement of appropriate antibiotic therapy based on antimicrobial susceptibility testing.

Keywords: Burkholderia cepacia Complex (Bcc); Cystic Fibrosis (CF)

References

1. De Smet B., et al. “Burkholderia stagnalis nov. and Burkholderia territorii sp. nov. two novel Burkholderia cepacia complex species from environmental and human sources”. International Journal of Systematic and Evolutionary Microbiology 65 (2015): 2265-2271.
2. Burkholder W. “Sour skin a bacterial rot of onion bulbs”. Phytopathology 40 (1950): 115-118.
3. Parke JL and Sherman DG. “Diversity of the Burkholderia cepacia complex and implications for risk assessment of biological control strains”. Annual Review on Phytopathology 39 (2001): 255-258.
4. Gautam V., et al. “Identification of lysine positive non‐fermenting gram negative bacilli (Stenotrophomonas maltophilia and Burkholderia cepacia complex)”. Indian Journal of Medical Microbiology 27 (2009): 128-133.
5. Valvano MA., et al. “Survival and persistence of opportunistic Burkholderia species in host cells”. Current Opinion on Microbiology1 (2005): 99-105.
6. Kutty PK., et al. “Multistate outbreak of burkholderia cenocepacia colonization and infection associated with the use of intrinsically contaminated alcohol-free mouthwash”. Chest6 (2007): 1825-1831.
7. Mariana Tavares., et al. “Burkholderia cepaciaComplex Bacteria: a Feared Contamination Risk in Water-Based Pharmaceutical Products”. ASM Journals Clinical Microbiology Reviews3 (2015).
8. Dancer SJ and King MF. “Systematic Review on Use, Cost and Clinical Efficacy of Automated Decontamination Devices”. Antimicrobial Resistance and Infection Control 10 (2021): 34.
9. Mao N., et al. “Transmission Risk of Infectious Droplets in Physical Spreading Process at Different Times: A Review”.Building and Environment 185 (2020): 107307.
10. Jimenez L., et al. “Burkholderia cepacia: a problem that does not go away!” EC Microbiology 2 (2015): 205-210.
11. McDonnell G and Russell AD. “Antiseptics and disinfectants: activity, action, and resistance”. Clinical Microbiology Review 12 (1999): 147-179.
12. Croxatto A., et al. “Applications of MALDI-TOF mass spectrometry in clinical diagnostic microbiology”. FEMS Microbiology Review 36 (2012): 380-407.
13. Mangram A and Jarvis WR. “Nosocomial Burkholderiacepacia outbreaks and pseudo-outbreaks”. Infection Control and Hospital Epidemiology11 (1996): 718-720.
14. Yan JH. 2006-2007 Mohnarin report. Antibiotic Resistance of Non fermenting Gram Negative Bacilli (2008).
15. Attia MAM., et al. “A study on Burkholderia cepacia in susceptible pharmaceutical products: semi-nested PCR”. PDA Journal of Pharmaceutical Science and Technology (2016).
16. Coenye T., et al. “Taxonomy and Identification of the Burkholderia cepacia Complex”. Journal of Clinical Microbiology10 (2001): 3427-3436.
17. Henry DA., et al. “Phenotypic Methods for Determining Genomovar Status of the Burkholderia cepacia Complex”. Journal of Clinical Microbiology3 (2001): 1073-1078.
18. LiPuma JJ., et al. “Burkholderia, Stenotrophomonas, Ralstonia, Cupriavidus, Pandoraea, Brevundimonas, Comamonas, Delftia, and Acidovorax”. Manual Clinical Microbiology 10 (2011): 692-713.
19. De Smet B., et al. “Outbreak of Burkholderia cepacia bloodstream infections traced to the use of Ringer lactate solution as multiple-dose vial for catheter flushing, Phnom Penh, Cambodia”. Clinical Microbiology Infectious 19 (2013): 832-837.
20. Yang CJ., et al. “Nosocomial outbreak of two strains of Burkholderia cepacia caused by contaminated heparin”. Journal of Hospital Infection 69 (2008): 398-400.
21. Lee S., et al. “An outbreak of Burkholderia cenocepacia associated with contaminated chlorhexidine solutions prepared in the hospital”. American Journal of Infection Control 41 (2013): e93-96.
22. 22.   Matthew J., et al. “Outbreak of Burkholderia stabilis Infections Associated with Contaminated Nonsterile, Multiuse Ultrasound Gel — 10 States, May-September 2021”. MMWR 71.48 (2022): 1517-1521.
23. Akinboyo IC J., et al. “Multistate outbreak of an emerging Burkholderia cepaciacomplex strain associated with contaminated oral liquid docusate sodium”. Infection Control and Hospital Epidemiology 39 (2018): 237-239
24. Currie BJ J., et al. “The Epidemiology and Clinical Spectrum of Melioidosis: 540 Cases from the 20 Year Darwin Prospective Study”. PLOS Neglected Tropical Diseases 11 (2010): e900.
25. Tavares M J., et al. “Burkholderia cepacia complex bacteria: A feared contamination risk in water based pharmaceutical products”. Clinical Microbiology Review 33 (2020): 0139-119.
26. , et al. “A prospective study of gram negative bacteremia in children”. The Pediatric Infectious Disease Journal 15 (1996): 117-122.
27. Antony Beena., et al. “A sporadic outbreak ofBurkholderia cepacia complex bacteremia in pediatric intensive care unit of a tertiary care hospital in coastal Karnataka, South India”. Indian Journal of Pathology and Microbiology 2 (2016): 197-199.
28. Henry DA., et al. “Phenotypic Methods for Determining Genomovar Status of the Burkholderia cepacia Complex”. Journal of Clinical Microbiology3 (2001): 1073-1078.

Citation

Citation: Sheetal Verma., et al. “Characterization of Burkholderia Species from Various Clinical Specimens and their Antimicrobial Susceptibility Patterns".Acta Scientific Microbiology 8.3 (2025): 44-51.

Copyright

Copyright: © 2025 Sheetal Verma., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.