Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Division of Infectious Diseases, American University of Beirut Medical Center, Riad El Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon.
J Epidemiol Glob Health. 2022 Sep;12(3):274-280. doi: 10.1007/s44197-022-00048-2. Epub 2022 Jun 30.
The Burkholderia cepacia complex (Bcc), which was originally thought to be a single species, represents a group of 24 distinct species that are often resistant to multiple antibiotics, and usually known to cause life-threatening pulmonary infections in cystic fibrosis patients. Herein we describe a series of non-respiratory Bcc infections, the risk factors and epidemiologic factors, in addition to the clinical course.
This is a retrospective chart review of 44 patients with documented B. cepacia infections isolated from sites other than the respiratory tract admitted between June 2005 and February 2020 to the American University of Beirut Medical Center (AUBMC), a tertiary referral hospital for Lebanon and the Middle East region. The epidemiological background of these patients, their underlying risk factors, the used antibiotic regimens, and the sensitivities of the B. cepacia specimens were collected.
The majority of the Bcc infections (26/44, 59.1%) were hospital-acquired infections. The most common nationality of the patients was Iraqi (18/44, 40.9%), and the most common site of infection was bacteremia (17/44, 38.6%), followed by skin and soft tissues infections (16/44, 36.4%) and vertebral osteomyelitis (8/44, 18.2%). Most of the isolated B. cepacia were susceptible to ceftazidime, carbapenems, followed by TMP-SMX. Patients responded well to therapy with good overall outcome.
Bcc can cause infections outside the respiratory tract, mostly as hospital-acquired infections and in immunocompromised patients. Most patients were referred from countries inflicted by wars raising the possibility of a potential role of conflicts which need to be investigated in future studies. Directed therapy according to susceptibility results proved effective in most patients.
最初被认为是单一物种的伯克霍尔德氏菌复合群（Bcc）实际上代表了 24 个不同的物种，这些物种通常对多种抗生素具有耐药性，并且通常会导致囊性纤维化患者发生危及生命的肺部感染。在此，我们描述了一系列非呼吸道 Bcc 感染，包括危险因素和流行病学因素，以及临床过程。
这是对 2005 年 6 月至 2020 年 2 月期间在贝鲁特美国大学医学中心（AUBMC）住院的 44 例确诊为呼吸道以外部位分离的 B. cepacia 感染患者的回顾性图表分析。AUBMC 是黎巴嫩和中东地区的三级转诊医院。收集了这些患者的流行病学背景、潜在危险因素、使用的抗生素方案以及 B. cepacia 标本的敏感性。
大多数 Bcc 感染（26/44，59.1%）为医院获得性感染。患者中最常见的国籍是伊拉克（18/44，40.9%），最常见的感染部位是菌血症（17/44，38.6%），其次是皮肤和软组织感染（16/44，36.4%）和脊椎骨髓炎（8/44，18.2%）。大多数分离的 B. cepacia 对头孢他啶、碳青霉烯类敏感，其次是 TMP-SMX。患者对治疗反应良好，总体预后良好。
Bcc 可引起呼吸道以外的感染，主要为医院获得性感染和免疫功能低下的患者。大多数患者来自遭受战争的国家，这可能表明冲突发挥了潜在作用，这需要在未来的研究中进行调查。根据药敏结果进行靶向治疗对大多数患者有效。
