Burkholderia cepacia: A Case Report from the University Hospital of Befelatanana Laboratory | InformativeBD

Zafindrasoa Domoina Rakotovao-Ravahatra, Rémy Narindra Milasoanjara , Benja Ramilitiana, Hoahy Rasoanandrasana , Mikkelsen Eliane Ranivoharisoa , Willy Franck Harilalaina Randriamarotia, and Andriamiadana Luc Rakotovao, from the institute of Madagascar. wrote a research article about, Burkholderia cepacia: A Case Report from the University Hospital of Befelatanana Laboratory. Entitled, Burkholderia cepacia: A case report in the laboratory of University Hospital of Befelatanana. This research paper published by the International journal of Microbiology and Mycology (IJMM). an open access scholarly research journal on Microbiology. under the affiliation of the International Network For Natural Sciences | INNSpub. an open access multidisciplinary research journal publisher. 

Abstract 

Burkholderia cepacia has rarely been reported in Antananarivo. We present a case of a 49-year-old male with chronic kidney disease, hemodialysis-dependent, who was admitted to the hospital because of dyspnoea, deterioration of the general state and fever. His past medical history includes chronic kidney disease, hypertension, diabetes and chronic global heart failure. Burkholderia cepacia was identified in blood culture. The Immuno-compromised state of the patient, the antimicrobial resistance of Burkholderia cepacia and the delay of positivity of blood cultures are discussed. 

 Read more : Isolation and Characterization of Probiotic Lactic Acid Bacteria from Human Saliva |InformativeBD

Introduction

Chronic renal failure is a public health problem worldwide. In 2015, more than 353 million people or 5% of the world's population suffer from chronic renal failure (Ramilitiana et al., 2016). The survival and quality of life of these patients depend on the continued good functioning of dialysis access sites. Bloodstream infection is the leading cause of hospitalization and the second most common cause of death among patients receiving regular hemodialysis. Controlling infection in these patients is a challenge for healthcare staff because hemodialysis is an invasive procedure with an inherent infection risk. Furthermore, catheters are often manipulated during hemodialysis sessions, and patients receiving hemodialysis are immunodeficient. Bloodstream infection is caused by the nosocomial infections in the majority of cases (Gauna et al, 2013). Among the germs involved, B. cepacia (B. cepacia) is an aerobic, glucose– non-fermenting, gram-negative bacillus that mainly affects immunocompromised and hospitalized patients as well as those with chronic affection diseases (Lee et al, 2015). Patients with cystic fibrosis and dialysis-dependent patients are particularly vulnerable. Clinical manifestations are varied and run the gamut from asymptomatic colonization to necrotizing pneumonia and sepsis (Zuckerman and Seder, 2007). It is often resistant to multiple antibiotics and has been shown to grow in penicillin medium. It is known to contaminate intravenous fluids, bronchoscopes and urinary catheters (Long et al, 2012). The isolation of the etiologic agent and determination of antimicrobial susceptibility profile are important for achieving better prognoses. The emergence of multiresistant bacteria is a wellrecognized problem. Therefore, surveillance studies are important for the monitoring of the emergence of these microorganisms, especially in immunocompromised patients, such as those undergoing hemodialysis (Gauna et al, 2013).

This study aims to demonstrate a case of B. cepacia sepsis in a dialysis-dependent patient who had endocarditis with past medical history of hypertension and diabetes.

Reference

Alvarez-Lerma F, Maull E, Terradas R, Segura C, Planells I, Coll P, Knobel H, Vázquez A. 2008. Moisturizing body milk as a reservoir of Burkholderia cepacia:outbreak of nosocomial infection in a multidisciplinary intensive care unit. Crit Care 12, R10.

Avgeri SG, Matthaiou DK, Dimopoulos G, Grammatikos AP Falagas ME. 2009. Therapeutic options for Burkholderia cepacia infections beyond co-trimoxazole: a systematic review of the clinical evidence. Int J Antimicrob Agents 33, 394-404.

Baul SN, De R, Mandal PK, Roy S, Dolai TK., Chakrabarti P. 2018. Outbreak of Burkholderia cepacia infection: a systematic study in a hematolo-oncology unit of a tertiary care hospital from eastern India. Mediterr J Hematol Infect Dis 10, e201805.

Bayram M, Babalik M, Bakan ND, Dongel I. 2011. Community-acquired Burkholderia cepacia pneumonia: a report of two immunocompetent patients. Tuberk Toraks 59, 380-383.

Comité de l’antibiogramme de la Société Française de microbiologie : recommendations CA-SFM. 2013. Accessed 15 March 2019 on the website http://www.sfm-microbiologie.org/

Durham SH, Lee AE, Assanasen C. 2012. Burkholderia cepacia septicemia in a pediatric oncology patient: a pharmacotherapy challenge. Ann Pharmacother 46, e16.

Gauna TT, Oshiro E, Luzio YC, Paniago AMM, Cury Pontes ERJ, Chang MR. 2013. Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil. Revista da Socieda de Brasileira de Medicina Tropical 46, 426-432.

Ki HK, Kim SH, Han SW, Cheong HS. 2011. A case of native valve endocarditis caused by Burkholderia cepacia without predisposing factors. BMC Infectious Diseases 11, 114.

Lee KW, Lee ST, Cho H. 2015. Burkholderia Cepacia Causing Nosocomial Urinary Tract Infection in Children. Child Kidney Dis 19, 143-147.

Long S, Pickering L, Prober C. 2012. Principles and Practice of Pediatric Infectious Diseases 4, 1744p.

Martin M, Winterfeld I, Kramme E, Ewert I, Sedemund-Adib B, Mattner F. 2012. Outbreak of Burkholderia cepacia complex caused by contaminated alcohol-free Mouthwash. Anaesthesist 61, 25-29.

Mérens A, Janvier F, Vu-Thien H, Cavallo J-D, Jeannot K. 2012. Phenotypes of antibiotic resistance of Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cepacia. RFL 42(445), 59-74.

Ramilitiana B, Ranivoharisoa EM, Dodo M, Razafimandimby E and Randriamarotia WF. 2016. A retrospective study on the incidence of chronic renal failure in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo (the capital city of Madagascar). Pan Afr Med J 23, 141.

Rose H, Baldwin A, Dowson CG, Mahenthiralingam E. 2009. Biocide susceptibility of the Burkholderia cepacia complex. J Antimicrob Chemother 63, 502-510.

Souza AV, Moreira CR, Pasternak J, Hirata ML, Saltini DA, Caetano VC, Ciosak S, Azevedo FM, Severino P, Vandamme P, Magalhaes VD. 2004. Characterizing uncommon Burkholderia cepacia complex isolates from an outbreak in a haemodialysis unit. J Med Microbiol 53, 999-1005.

Zhou J, Chen Y, Tabibi S, Alba L, Garber E, Saiman L. 2007. Antimicrobial susceptibility and synergy studies of Burkholderia cepacia complex isolated from patients with cystic fibrosis. Antimicrob Agents Chemother 51, 1085-1088.

Zuckerman JB, Seder DB. 2007. Infection control practice in cystic fibrosis centers. Clin Chest Med 28, 381-404.

Source : Burkholderia cepacia: A case report in the laboratory of University Hospital of Befelatanana