Burkholderia cepacia complex: Difference between revisions
From IDWiki
Burkholderia cepacia complex
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* Colonizes the lungs of patients with [[cystic fibrosis]] and portends a poor prognosis |
* Colonizes the lungs of patients with [[cystic fibrosis]] and portends a poor prognosis |
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* Occasionally causes nosocomial outbreaks traced back to aqueous pharmaceutical products |
* Occasionally causes nosocomial outbreaks traced back to aqueous pharmaceutical products |
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| + | * Also causes hospital- or ventilator-associated [[pneumonia]], [[bacteremia]] (possibly [[CLABSI]]), [[ecthyma gangrenosum]], [[burn infection]], wound infection, [[endophthalmitis]], and rarely [[endocarditis]] |
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== Management == |
== Management == |
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* Antibiotic options include: |
* Antibiotic options include: |
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** [[TMP-SMX]] (preferred, if susceptible) |
** [[TMP-SMX]] (preferred, if susceptible) |
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| − | ** [[Ceftazidime]] and [[ceftazidime-avibactam]] |
+ | ** [[Ceftazidime]] 2 g IV q8h and [[ceftazidime-avibactam]] 2.5 g IV q8h |
| − | ** [[Meropenem]] and [[imipenem]] |
+ | ** [[Meropenem]] 1-2 g IV q8h and [[imipenem]] 1 g IV q8h |
| − | ** [[Minocycline]] |
+ | ** [[Minocycline]] 100 mg p.o.IV q12h |
{{DISPLAYTITLE:''Burkholderia cepacia'' complex}} |
{{DISPLAYTITLE:''Burkholderia cepacia'' complex}} |
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Latest revision as of 12:48, 6 February 2023
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
- Also causes hospital- or ventilator-associated pneumonia, bacteremia (possibly CLABSI), ecthyma gangrenosum, burn infection, wound infection, endophthalmitis, and rarely endocarditis
Management
- Should be guided by antimicrobial susceptibility testing
- Antibiotic options include:
- TMP-SMX (preferred, if susceptible)
- Ceftazidime 2 g IV q8h and ceftazidime-avibactam 2.5 g IV q8h
- Meropenem 1-2 g IV q8h and imipenem 1 g IV q8h
- Minocycline 100 mg p.o.IV q12h
