Burkholderia cepacia from an Unidentified Organism to an Emerging Pathogen in a Tertiary Care Hospital- A Retrospective Study

Abstract

Introduction: Burkholderia is an important opportunistic pathogen in hospitalised and immunocompromised patients. It is responsible for approximately 0.6% of all Ventilator Associated Pneumonia (VAP). Burkholderia cepacia (B. cepacia) is a resilient organism, capable of survival in environments devoid of significant nutritional resources. Authors have come across many cases of B.cepacia in hospital for the last six years. Aim: To know the prevalence and microbiological profile of Burkholderia infection in tertiary care hospital, Srinagar, India. Materials and Methods: The present retrospective study was carried out in the Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India, from January 2013 to October 2018. The records of all patients diagnosed with B.cepacia in Intensive Care Unit (ICU), wards, and Outpatient Department (OPD) were reviewed. Identification was done by Vitek 2. Descriptive analysis was done and data was presented as percentages. Results: The number of cases showed a steady rise from 2013 through 2016 and the peak number of cases occurred in the year 2016. Then, again the numbers started to decline. Surgical ICU was the most common location (n=490) where the cases were detected. Most of the isolates were sensitive to cotrimoxazole, ceftazidime, tigecycline and levofloxacin and moderately sensitive to minocycline and meropenem. Conclusion: Burkholderia is no longer restricted to patients with Cystic Fibrosis (CF) and can affect patients in ICU setting and that the mortality from the infection remains high in our part of the world. Further studies are needed to be carried out to address this issue.

Keywords

• emergence
• nosocomial infection
• sepsis
• surveillance
• ventilator associated pneumonia