Burkholderia cepacia sepsis among neonates.

T1 - Histopathologic features of Burkholderia cepacia pneumonia in patients without cystic fibrosis

Burkholderia urinary tract infection after renal transplantation.

Technique
Take a routine respiratory sample from the patient e.g. sputa, deep pharyngeal swabs or bronchial washings. Dilute the sample, if necessary, in Ringer’s solution to give a 1:2 dilution. Streak onto Burkholderia cepacia Medium and incubate at 37°C for 48 to 72 hours.
Examine after 48 hours for sage green colonies and the medium turning from straw-green to bright pink. All colonies should be further identified and confirmed. Re-incubate for a further 24 hours if necessary.
Typical colonies of Burkholderia cepacia are circular, and entire. Colour formation is based on natural pigment expression and colonies vary from grey to sage green, with the medium changing from orange to bright pink.

4. Nelson JW, Butler SL, Krieg D, Govan JR. Virulence factors of Burkholderia cepacia.  ;8:-

Burkholderia cepacia in Healthcare Settings | HAI | CDC

The slower growing Burkholderia cepacia can be missed on conventional media such as blood or MacConkey Agar due to overgrowth caused by other faster growing organisms found in the respiratory tract of CF patients such as mucoid Klebsiella species, Pseudomonas aeruginosa and Staphylococcus species. This may lead to the infection being missed or wrongly diagnosed.

Originally isolated from onions, Burkholderia cepacia can survive for long periods and multiply in hostile environments such as antiseptic and disinfectant solutions, distilled water, whirlpool baths, nebulizers and commercially packaged urinary catheter kits3. An outbreak in Arizona in 1998 due to contaminated alcohol-free mouthwash, was investigated by the Food and Drug Administration (FDA), who suggested an association with the deionisation procedure of the water used to prepare the product4. The organism may be present in low numbers in many non-sterile products used in hospitals. It has been isolated from various water sources and can grow in distilled water with a nitrogen source due to its ability to fix carbon dioxide from air5. Suction catheters rinsed in acetic acid solution have reduced incidence of transmission of Burkholderia cepacia and other pseudomonads.


The Burkholderia cepacia complex (B

Burkholderia cepacia Selective Agar (BCSA) was developed by Henry, Campbell, LiPuma and Speert for the selective isolation of () .(2) is commonly isolated from cystic fibrosis patients. Correct identification of the organism is critical to patient care.(2) It was found that BCSA had a lower false-positivity rate than either Oxidation-Fermentation-Polymyxin-Bacitracin-Lactose (OFBPL) Agar or PC () Agar. This finding was confirmed later by Henry, Campbell, McGimpsey, Clarke, Louden, Burns, Roe, Vandamme and Speert.(1)

Burkholderia Cepacia in People With Cystic Fibrosis

Welcome to the new website of the International Burkholderia cepacia Working Group. This site’s goal is to foster sharing of information and resources relevant to Burkholderia cepacia complex researchers. If you are a researcher working with B. cepacia complex bacteria and are interested in contributing to this site, please register and become a member.

Burkholderia cepacia complex - Wikipedia

AB - We present the histopathologic features of fatal Burkholderia cepacia pneumonia in three adults (one man [age 44 years] and two women [aged 40 and 43 years]). In all patients, the pulmonary infiltrates initially were localized (right middle lobe, left upper lobe, and right middle lobe) but rapidly progressed. Two open-lung biopsies and one pneumonectomy specimen showed necrotizing granulomatous inflammation merging with areas of more conventional necrotizing bronchopneumonia. In one patient, a mediastinal lymph node also showed stellate necrotizing granulomas. Vasculitis was absent. B. cepacia was cultured from the open-lung biopsies and bronchial wash specimens in two patients and from postmortem cultures of lung, subcarinal lymph nodes, and blood in the third. The histopathology in these patients resembles that of melioidosis, which is caused by a related organism, Burkholderia pseudomallei. B. cepacia needs to be considered in the differential diagnosis of necrotizing granulomatous inflammation. In addition, given the rarity with which B. cepacia is identified as a cause of pneumonia in the immunocompetent host, isolation of B. cepacia should trigger a workup for underlying immunodeficiency or lead to an investigation to exclude the possibility of a nosocomial infection.

FDA updates on 2017 Burkholderia cepacia contamination

N2 - We present the histopathologic features of fatal Burkholderia cepacia pneumonia in three adults (one man [age 44 years] and two women [aged 40 and 43 years]). In all patients, the pulmonary infiltrates initially were localized (right middle lobe, left upper lobe, and right middle lobe) but rapidly progressed. Two open-lung biopsies and one pneumonectomy specimen showed necrotizing granulomatous inflammation merging with areas of more conventional necrotizing bronchopneumonia. In one patient, a mediastinal lymph node also showed stellate necrotizing granulomas. Vasculitis was absent. B. cepacia was cultured from the open-lung biopsies and bronchial wash specimens in two patients and from postmortem cultures of lung, subcarinal lymph nodes, and blood in the third. The histopathology in these patients resembles that of melioidosis, which is caused by a related organism, Burkholderia pseudomallei. B. cepacia needs to be considered in the differential diagnosis of necrotizing granulomatous inflammation. In addition, given the rarity with which B. cepacia is identified as a cause of pneumonia in the immunocompetent host, isolation of B. cepacia should trigger a workup for underlying immunodeficiency or lead to an investigation to exclude the possibility of a nosocomial infection.