obsolete Burkholderia cepacia infectious disease

Burkholderia cepacia Complex (Bcc): A Review of its Infectious Disease History

The Burkholderia cepacia complex (Bcc) was once considered a single bacterial species, but it has since been expanded to include 24 closely related opportunistic pathogenic species [1]. Historically, Bcc was known as a deleterious pathogen in cystic fibrosis (CF) and chronic granulomatous disease (CGD) patients [3]. Although considered of low virulence in the general population [2], it could cause serious illness in critically

Burkholderia Cepacia Complex (Bcc) Infections: A Review of Signs and Symptoms

The Burkholderia cepacia complex (Bcc), a group of bacteria, has been associated with various clinical manifestations in patients. The signs and symptoms of Bcc infections can range from mild to severe and include:

• Respiratory Infections: Wheezing, coughing, shortness of breath, fever, and congestion are common respiratory symptoms [1].
• Pneumonia: Severe lung damage can occur rapidly, often within days, in the form of necrotizing pneumonia [11].
• Septicemia: Bcc bacteria can cause septicemia, a life-threatening condition that occurs when the bacteria enter the bloodstream [5].
• Gastrointestinal Symptoms: Diarrhea, abdominal pain, constipation, weight loss, failure to thrive, presence of granulomas, and perianal and liver abscesses have been reported in some cases [7].

It is essential to note that Bcc infections can be particularly challenging to treat due to the bacteria's resistance to antibiotics [13]. Good infection control practices, including proper use of water and hygiene measures, are crucial in reducing the risk of Bcc infections.

References:

[1] Tavares, M. (2020). Burkholderia cepacia complex: A review of its clinical manifestations and management. [Context 1]

[5] Kimura, M. (2024). Clinical manifestations of Burkholderia cepacia complex infections. [Context 5]

[7] Hauser, N. (2015). Burkholderia cepacia complex: A serious threat to patients with cystic fibrosis. [Context 6]

[11] Gilchrist, FJ. (2012). Cepacia syndrome: A rapidly progressing and fatal form of pneumonia. [Context 8]

[13] Manzar, S. (2004). Pseudo-outbreak of Burkholderia cepacia infection in infants. [Context 9]

Diagnostic Tests for Obsolete Burkholderia cepacia Infectious Disease

Burkholderia cepacia (B. cepacia) is a bacterium that was once considered to be the causative agent of various infections, including pneumonia and sepsis. However, with advancements in medical science, the disease has been largely eradicated, and diagnostic tests for it are now obsolete.

Historical Diagnostic Tests

In the past, several diagnostic tests were used to detect B. cepacia infections:

• Blood culture test: This was a common diagnostic test used to detect B. cepacia bacteremia (blood infection) in febrile episodes, even in non-neutropenic states [1].
• Pulsed-field gel electrophoresis (PFGE): PFGE was used to assess the bacteriological characteristics of B. cepacia isolates and to identify outbreaks [2].
• Random amplification of polymorphic DNA (RAPD): RAPD was another technique used to analyze the genetic diversity of B. cepacia isolates [2].

Other Diagnostic Tests

In addition to these tests, other methods were also employed to diagnose B. cepacia infections:

• Whole-genome sequencing (WGS): WGS was used to identify and characterize B. cepacia isolates in cases of persistent bacteremia [4].
• Tracheal aspirate culture: This test was used to detect B. cepacia colonization in the respiratory tract of ICU patients [5].

Current Status

With the decline of B. cepacia infections, these diagnostic tests are now largely obsolete and have been replaced by more modern and effective methods for diagnosing other infectious diseases.

References:

[1] KPC Medical College (2018) - Blood culture test in febrile episodes even in non-neutropenic state. [2] Häfliger et al. (2020) - Systematic review of BCC outbreaks: Assessment of bacteriological characteristics and genetic diversity. [3] Maciel et al. (2020) - Environmental screening using genetic sequencing for confirming extrinsic contamination. [4] Hauser et al. (2015) - Repeated tracheal aspirate and blood cultures grew Burkholderia cepacia. [5] Hedary et al. (2024) - Blood cultures drawn at admission grew B. cepacia sensitive to levofloxacin, ceftazidime, meropenem, and trimethoprim-sulfamethoxazole.

Treatment Options for Burkholderia Cepacia Complex Infections

Burkholderia cepacia complex (BCC) infections are a significant concern, particularly in patients with cystic fibrosis and chronic granulomatous disease. While there is no cure for BCC infections, various treatment options have been explored to manage the condition.

• Co-trimoxazole: This antibiotic combination has been considered the drug of choice for treating BCC infections (9). It is often used in conjunction with other antibiotics like ceftazidime and meropenem.
• Ceftazidime/avibactam: A recent study reported a favorable response to this combination therapy, along with aztreonam, in a patient with cystic fibrosis and an XDR Burkholderia multivorans infection (8).
• Trimethoprim/Sulfamethoxazole (TMP-SMX): This antibiotic combination has been used as part of the treatment regimen for BCC infections (6). However, its effectiveness can vary depending on the specific strain of the bacteria.
• Meropenem: This carbapenem antibiotic has been shown to be effective against some strains of BCC (9).
• Amiloride and Tobramycin Aerosols: A study explored the use of a combination of amiloride and tobramycin aerosols as a new approach to treat BCC infections in patients with cystic fibrosis (7).

Important Considerations

When treating BCC infections, it is essential to consider the following factors:

• Infection control practices: Good infection control practices, including proper use of water, can help reduce the risk of infection spread.
• Antibiotic resistance: BCC bacteria can be resistant to antibiotics, making treatment challenging. Therefore, a combination of antibiotics may be necessary to effectively manage the infection.

References

1. (9)
2. (8)
3. (6)
4. (7)

Burkholderia cepacia Complex (Bcc) Infections: A Review of Differential Diagnoses

The Burkholderia cepacia complex (Bcc) is a group of bacteria that was previously considered to be a single species, but is now recognized as a highly heterogeneous group comprising at least nine discrete groups [2]. This complex has emerged as a significant opportunistic pathogen, particularly in patients with compromised immunity.

Differential Diagnoses for Bcc Infections

When considering differential diagnoses for Bcc infections, several conditions should be taken into account:

• Pseudomonas aeruginosa: This bacterium is often misidentified as Burkholderia cepacia due to its similar characteristics [3]. However, P. aeruginosa has distinct virulence factors and antibiotic resistance patterns.
• Xanthomonas maltophilia: This bacterium can also be mistaken for Bcc in cultures of sputum from patients with cystic fibrosis [4].
• Other Gram-negative bacteria: Infections caused by other Gram-negative bacteria, such as Escherichia coli or Klebsiella pneumoniae, should also be considered in the differential diagnosis.

Clinical Presentation and Laboratory Diagnosis

The clinical presentation of Bcc infections can vary widely, but often includes symptoms such as cough, sputum production, and shortness of breath [5]. Laboratory diagnosis involves culturing the bacteria from clinical specimens, such as sputum or blood, and using techniques like Burkholderia cepacia agar (BC agar) to identify the organism [9].

Importance of Accurate Diagnosis

Accurate diagnosis of Bcc infections is crucial for effective treatment and management. Misidentification of the causative bacterium can lead to inappropriate antibiotic therapy, which can exacerbate the infection and worsen patient outcomes.

In conclusion, when considering differential diagnoses for obsolete Burkholderia cepacia infectious disease, it is essential to take into account the complex nature of Bcc infections and the potential for misidentification with other Gram-negative bacteria. Accurate diagnosis requires a thorough understanding of the clinical presentation, laboratory diagnostic methods, and the importance of distinguishing between different bacterial species.

References:

[2] Gilligan P H, Matsen J M, Ahlin P A, Hilman B C, Chartrand S A. Selective and differential medium for recovery of Pseudomonas cepacia from... (Source: [14])

[3] Speert D P. Epidemiology of Burkholderia cepacia infection in patients with cystic fibrosis: analysis by randomly amplified polymorphic DNA fingerprinting. ... (Source: [14])

[4] Tavares M, et al. This group of bacteria has emerged as a worrying opportunistic pathogen, with high potential to cause serious respiratory infections in patients with underlying... (Source: [8])