Burkholderia cepacia complex
From IDWiki
Background
- Gram-negative bacillus
- Classified into nine genomovars (phenotypically similar but genotypically distinct)
- Burkholderia cenocepacia (genomovar III)
- Burkholderia multivorans (genomovar II)
- Burkholderia dolosa (genomovar VI)
- Environmental organism
- Multiple mechanisms of resistance:
- β-lactamases
- RND efflux pumps
- Altered LPS conferring polymixin resistance
- Gyrase mutations conferring fluoroquinolone resistance
Clinical Manifestations
- Opportunistic lung infections, primarily of cystic fibrosis and lung transplant patients
- Colonizes the lungs of patients with cystic fibrosis and portends a poor prognosis
- Occasionally causes nosocomial outbreaks traced back to aqueous pharmaceutical products
Management
- Should be guided by antimicrobial susceptibility testing
- Antibiotic options include:
- TMP-SMX (preferred, if susceptible)
- Ceftazidime and ceftazidime-avibactam
- Meropenem and imipenem
- Minocycline
