Prevalence of Burkholderia cepacia recovered from clinical specimens in the Zainoel Abidin general hospital, Banda Aceh, Indonesia
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Abstract
Background and Objectives: Burkholderia cepacia is one of the multiple intrinsic resistant bacteria causing opportunistic infections. The study aimed to determine the distribution of B. cepacia isolates based on types of clinical specimen, hospital wards, and the patient's gender-age and to evaluate their antibiotic susceptibility.
Materials and Methods: This study involved isolating, identifying, and testing antibiotic susceptibility of B. cepacia isolates recovered from clinical specimens of Dr. Zainoel Abidin general hospital (RSUDZA) Banda Aceh Indonesia during March 2019-March 2022.
Results: In total, there were 3,622 Gram-negative bacterial isolates of 10,192 clinical specimens obtained during the study period and B. cepacia was positively detected in 127 isolates (1.24%). Most of the 127 isolates of B. cepacia were found in blood and sterile body fluid samples (55.11%) followed by urine and pus samples accounting for 23.62% and 13.37%, respectively. The internal medicine wards had the highest number of detected B. cepacia isolates at 28.3%. B. cepacia infections were more common in men (59.05%) and people over 45 years old (41.73%). The bacteria were highly sensitive to the antibiotic ceftazidime (92.7%).
Conclusion: Culture examination of clinical specimens is not required for confirmed infections, despite being essential for appropriate antibiotic treatment. Implementing surveillance programs and judicious use of antibiotics can prevent bacterial transmission.
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2. Bach E, Sant'Anna FH, Magrich Dos Passos JF, Balsanelli E, De Baura VA, Pedrosa FO, et al. Detection of misidentifications of species from the Burkholderia cepacia complex and description of a new member, the soil bacterium Burkholderia catarinensis sp. nov. Pathog Dis 2017; 75: 10.1093/femspd/ftx076.
3. Marrs ECL, Perry A, Perry JD. Evaluation of three culture media for isolation of Burkholderia cepacia complex from respiratory samples of patients with cystic fibrosis. Microorganisms 2021; 9: 2604.
4. Zurita J, Mejia L, Zapata S, Trueba G, Vargas AC, Aguirre S, et al. Healthcare-associated respiratory tract infection and colonization in an intensive care unit caused by Burkholderia cepacia isolated in mouthwash. Int J Infect Dis 2014; 29: 96-99.
5. Magalhães M, Doherty C, Govan JRW, Vandamme P. Polyclonal outbreak of Burkholderia cepacia complex bacteraemia in haemodialysis patients. J Hosp Infect 2003; 54: 120-123.
6. Song JE, Kwak YG, Um TH, Cho CR, Kim S, Park IS, et al. Outbreak of Burkholderia cepacia pseudobacteraemia caused by intrinsically contaminated commercial 0.5% chlorhexidine solution in neonatal intensive care units. J Hosp Infect 2018; 98: 295-299.
7. Torbeck L, Raccasi D, Guilfoyle DE, Friedman RL, Hussong D. Burkholderia cepacia: this decision is overdue. PDA J Pharm Sci Technol 2011; 65: 535-543.
8. Scoffone VC, Chiarelli LR, Trespidi G, Mentasti M, Riccardi G, Buroni S. Burkholderia cenocepacia infections in cystic fibrosis patients: Drug resistance and therapeutic approaches. Front Microbiol 2017; 8: 1592.
9. Saran S, Azim A, Gurjar M. Multidrug-resistant Burkholderia cepacia bacteremia in an immunocompetent adult diagnosed with dengue and scrub coinfection: A rare case report. Int J Crit Illn Inj Sci 2018; 8: 173-175.
10. Hisano M, Sugawara K, Tatsuzawa O, Kitagawa M, Murashima A, Yamaguchi K. Bacteria-associated haemophagocytic syndrome and septic pulmonary embolism caused by Burkholderia cepacia complex in a woman with chronic granulomatous disease. J Med Microbiol 2007; 56: 702-705.
11. Rhodes KA, Schweizer HP. Antibiotic resistance in Burkholderia species. Drug Resist Updat 2016; 28: 82-90.
12. Coenye T. Social interactions in the Burkholderia cepacia complex: biofilms and quorum sensing. Future Microbiol 2010; 5: 1087-1099.
13. Duan J, Kang J, Han T, Ma Y, Guo Q, Song Y, et al. Report-Prevalence of hospital acquired Burkholderia cepacia infection and its antimicrobial susceptibility in a Chinese hospital. Pak J Pharm Sci 2017; 30: 551-553.
14. Dizbay M, Tunccan OG, Sezer BE, Aktas F, Arman D. Nosocomial Burkholderia cepacia infections in a Turkish university hospital: a five-year surveillance. J Infect Dev Ctries 2009; 3: 273-277.
15. Kwayess R, Al Hariri HE, Hindy J-R, Youssef N, Haddad SF, Kanj SS. Burkholderia cepacia infections at sites other than the respiratory tract: A large case series from a tertiary referral hospital in Lebanon. J Epidemiol Glob Health 2022; 12: 274-280.
16. Srinivasan S, Arora NC, Sahai K. Report on the newly emerging nosocomial Burkholderia cepacia in a tertiary hospital. Med J Armed Forces India 2016; 72 (Suppl 1): S50-S53.
17. Siddiqui T, Sahu C, Patel SS, Ghoshal U. Clinical and microbiological profile of patients with bloodstream infections caused by Burkholderia cepacia complex. J Lab Physicians 2022; 14: 312-316.
18. Lee Y-M, Park KH, Moon C, Kim DY, Lee MS, Kim T, et al. Management and outcomes of Burkholderia cepacia complex bacteremia in patients without cystic fibrosis: a retrospective observational study. Eur J Clin Microbiol Infect Dis 2020; 39: 2057-2064.
19. Mamishi S, Shalchi Z, Mahmoudi S, Hosseinpour Sadeghi R, Haghi Ashtiani MT, Pourakbari B. Antimicrobial resistance and genotyping of bacteria isolated from urinary tract infection in children in an Iranian referral hospital. Infect Drug Resist 2020; 13: 3317-3323.
20. Dellalana LE, Byrge KC, Gandelman JS, Lines T, Aronoff DM, Person AK. A unique case of Burkholderia cepacia prosthetic mitral valve endocarditis and literature review. Infect Dis Clin Pract (Baltim Md) 2019; 27: 123-125.
21. Somayaji R, Yau YCW, Tullis E, LiPuma JJ, Ratjen F, Waters V. Clinical outcomes associated with Burkholderia cepacia complex infection in patients with cystic fibrosis. Ann Am Thorac Soc 2020; 17: 1542-1548.
22. Correa-Martínez CL, Schuler F, Kampmeier S. Sex differences in vancomycin-resistant enterococci bloodstream infections-a systematic review and meta-analysis. Biol Sex Differ 2021; 12: 36.
23. Bressler AM, Kaye KS, LiPuma JJ, Alexander BD, Moore CM, Reller LB, et al. Risk Factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: A case-control study. Infect Control Hosp Epidemiol 2007; 28: 951-958.
24. Giefing-Kröll C, Berger P, Lepperdinger G, Grubeck-Loebenstein B. How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell 2015; 14: 309-321.
25. Shukla R, Bilolikar A, Udayasri B, Rani P. Antibiotic susceptibility pattern of Burkholderia cepacia complex from various clinical samples in a tertiary care center: A one year prospective study. J Med Sci Res 2018; 6: 1-5.
26. Oslan SNH, Yusoff AH, Mazlan M, Lim SJ, Khoo JJ, Oslan SN, et al. Comprehensive approaches for the detection of Burkholderia pseudomallei and diagnosis of melioidosis in human and environmental samples. Microb Pathog 2022; 169: 105637.
27. Nuryastuti T, Umaroh N, Asdie RH, Sari IP, Musthafa A. Pan-drug-resistant and biofilm-producing strain of Burkholderia pseudomallei: first report of melioidosis from a diabetic patient in Yogyakarta, Indonesia. Int Med Case Rep J 2018; 11: 319-323.
2. Bach E, Sant'Anna FH, Magrich Dos Passos JF, Balsanelli E, De Baura VA, Pedrosa FO, et al. Detection of misidentifications of species from the Burkholderia cepacia complex and description of a new member, the soil bacterium Burkholderia catarinensis sp. nov. Pathog Dis 2017; 75: 10.1093/femspd/ftx076.
3. Marrs ECL, Perry A, Perry JD. Evaluation of three culture media for isolation of Burkholderia cepacia complex from respiratory samples of patients with cystic fibrosis. Microorganisms 2021; 9: 2604.
4. Zurita J, Mejia L, Zapata S, Trueba G, Vargas AC, Aguirre S, et al. Healthcare-associated respiratory tract infection and colonization in an intensive care unit caused by Burkholderia cepacia isolated in mouthwash. Int J Infect Dis 2014; 29: 96-99.
5. Magalhães M, Doherty C, Govan JRW, Vandamme P. Polyclonal outbreak of Burkholderia cepacia complex bacteraemia in haemodialysis patients. J Hosp Infect 2003; 54: 120-123.
6. Song JE, Kwak YG, Um TH, Cho CR, Kim S, Park IS, et al. Outbreak of Burkholderia cepacia pseudobacteraemia caused by intrinsically contaminated commercial 0.5% chlorhexidine solution in neonatal intensive care units. J Hosp Infect 2018; 98: 295-299.
7. Torbeck L, Raccasi D, Guilfoyle DE, Friedman RL, Hussong D. Burkholderia cepacia: this decision is overdue. PDA J Pharm Sci Technol 2011; 65: 535-543.
8. Scoffone VC, Chiarelli LR, Trespidi G, Mentasti M, Riccardi G, Buroni S. Burkholderia cenocepacia infections in cystic fibrosis patients: Drug resistance and therapeutic approaches. Front Microbiol 2017; 8: 1592.
9. Saran S, Azim A, Gurjar M. Multidrug-resistant Burkholderia cepacia bacteremia in an immunocompetent adult diagnosed with dengue and scrub coinfection: A rare case report. Int J Crit Illn Inj Sci 2018; 8: 173-175.
10. Hisano M, Sugawara K, Tatsuzawa O, Kitagawa M, Murashima A, Yamaguchi K. Bacteria-associated haemophagocytic syndrome and septic pulmonary embolism caused by Burkholderia cepacia complex in a woman with chronic granulomatous disease. J Med Microbiol 2007; 56: 702-705.
11. Rhodes KA, Schweizer HP. Antibiotic resistance in Burkholderia species. Drug Resist Updat 2016; 28: 82-90.
12. Coenye T. Social interactions in the Burkholderia cepacia complex: biofilms and quorum sensing. Future Microbiol 2010; 5: 1087-1099.
13. Duan J, Kang J, Han T, Ma Y, Guo Q, Song Y, et al. Report-Prevalence of hospital acquired Burkholderia cepacia infection and its antimicrobial susceptibility in a Chinese hospital. Pak J Pharm Sci 2017; 30: 551-553.
14. Dizbay M, Tunccan OG, Sezer BE, Aktas F, Arman D. Nosocomial Burkholderia cepacia infections in a Turkish university hospital: a five-year surveillance. J Infect Dev Ctries 2009; 3: 273-277.
15. Kwayess R, Al Hariri HE, Hindy J-R, Youssef N, Haddad SF, Kanj SS. Burkholderia cepacia infections at sites other than the respiratory tract: A large case series from a tertiary referral hospital in Lebanon. J Epidemiol Glob Health 2022; 12: 274-280.
16. Srinivasan S, Arora NC, Sahai K. Report on the newly emerging nosocomial Burkholderia cepacia in a tertiary hospital. Med J Armed Forces India 2016; 72 (Suppl 1): S50-S53.
17. Siddiqui T, Sahu C, Patel SS, Ghoshal U. Clinical and microbiological profile of patients with bloodstream infections caused by Burkholderia cepacia complex. J Lab Physicians 2022; 14: 312-316.
18. Lee Y-M, Park KH, Moon C, Kim DY, Lee MS, Kim T, et al. Management and outcomes of Burkholderia cepacia complex bacteremia in patients without cystic fibrosis: a retrospective observational study. Eur J Clin Microbiol Infect Dis 2020; 39: 2057-2064.
19. Mamishi S, Shalchi Z, Mahmoudi S, Hosseinpour Sadeghi R, Haghi Ashtiani MT, Pourakbari B. Antimicrobial resistance and genotyping of bacteria isolated from urinary tract infection in children in an Iranian referral hospital. Infect Drug Resist 2020; 13: 3317-3323.
20. Dellalana LE, Byrge KC, Gandelman JS, Lines T, Aronoff DM, Person AK. A unique case of Burkholderia cepacia prosthetic mitral valve endocarditis and literature review. Infect Dis Clin Pract (Baltim Md) 2019; 27: 123-125.
21. Somayaji R, Yau YCW, Tullis E, LiPuma JJ, Ratjen F, Waters V. Clinical outcomes associated with Burkholderia cepacia complex infection in patients with cystic fibrosis. Ann Am Thorac Soc 2020; 17: 1542-1548.
22. Correa-Martínez CL, Schuler F, Kampmeier S. Sex differences in vancomycin-resistant enterococci bloodstream infections-a systematic review and meta-analysis. Biol Sex Differ 2021; 12: 36.
23. Bressler AM, Kaye KS, LiPuma JJ, Alexander BD, Moore CM, Reller LB, et al. Risk Factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: A case-control study. Infect Control Hosp Epidemiol 2007; 28: 951-958.
24. Giefing-Kröll C, Berger P, Lepperdinger G, Grubeck-Loebenstein B. How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell 2015; 14: 309-321.
25. Shukla R, Bilolikar A, Udayasri B, Rani P. Antibiotic susceptibility pattern of Burkholderia cepacia complex from various clinical samples in a tertiary care center: A one year prospective study. J Med Sci Res 2018; 6: 1-5.
26. Oslan SNH, Yusoff AH, Mazlan M, Lim SJ, Khoo JJ, Oslan SN, et al. Comprehensive approaches for the detection of Burkholderia pseudomallei and diagnosis of melioidosis in human and environmental samples. Microb Pathog 2022; 169: 105637.
27. Nuryastuti T, Umaroh N, Asdie RH, Sari IP, Musthafa A. Pan-drug-resistant and biofilm-producing strain of Burkholderia pseudomallei: first report of melioidosis from a diabetic patient in Yogyakarta, Indonesia. Int Med Case Rep J 2018; 11: 319-323.
| Files | ||
| Issue | Vol 15 No 1 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v15i1.11916 | |
| Keywords | ||
| Antimicrobial resistance; Burkholderia cepacia; Prevalence | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Suhartono S, Mahdani W, Muzayanna N. Prevalence of Burkholderia cepacia recovered from clinical specimens in the Zainoel Abidin general hospital, Banda Aceh, Indonesia. Iran J Microbiol. 2023;15(1):38-44.
