An outbreak of Burkholderia cepacia bacteremia in hospitalized hematology patients selectively affecting those with acute myeloid leukemia

Vardi, Anna; Sirigou, Antonia; Lalayanni, Chrysavgi; Kachrimanidou, Melina; Kaloyannidis, Panayiotis; Anagnostopoulos, Achilles; Sotiropoulos, Damianos

doi:10.1016/j.ajic.2012.04.325

Cited by 12 publications

(9 citation statements)

References 30 publications

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“…Though other studies showed sensitivity to ceftazidime, 11 , 18 but our study showed resistance to this antibiotic including many other cephalosporins as shown in figure 3 . As shown in the study by Vardi et al 12 , the organisms had shown resistance to polymyxin B, Imipenem, and aminoglycosides; our study also showed a similar type of resistance to the antibiotics except for imipenem (including all other carbapenems) which had shown excellent sensitivity. All the patients received empirical antibiotics with Cefoperazone-Sulbactum or Piperacillin-Tazobactum and became afebrile within three days of intravenous antibiotic therapy.…”

Section: Discussionsupporting

confidence: 85%

“…Its intrinsic resistance to many disinfectants, antiseptic solutions, and antibiotics makes infection control particularly problematic. 12 Though many reports of Bcc outbreaks are there in intensive care units, hemodialysis clinic, and also oncology departments, but reports regarding hematology patients are few. 8 , 12 , 13 The very pertinent issues regarding these organisms is that the virulence of sepsis is no different from other gram-negative organism and considering the prolonged hospital stay of our patients the organism may become multi-antibiotic resistant.…”

Section: Discussionmentioning

confidence: 99%

“… 12 Though many reports of Bcc outbreaks are there in intensive care units, hemodialysis clinic, and also oncology departments, but reports regarding hematology patients are few. 8 , 12 , 13 The very pertinent issues regarding these organisms is that the virulence of sepsis is no different from other gram-negative organism and considering the prolonged hospital stay of our patients the organism may become multi-antibiotic resistant. 14 Moreover Burkholderia outbreak can occur due to the growth of the organism in saline, antiseptic solutions as established by others.…”

Section: Discussionmentioning

confidence: 99%

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Outbreak of Burkholderia Cepacia Infection: A Systematic Study in a Hematology-Oncology Unit of a Tertiary Care Hospital From Eastern India.

Baul

Mandal

et al. 2018

Mediterr J Hematol Infect Dis

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BackgroundBurkholderia cepacia, an aerobic gram-negative bacillus, is a frequent colonizer of fluids used in the hospital ward. It poses little risk of infection to healthy people; however it is a known important opportunistic pathogen causing morbidity and mortality due to its intrinsic resistance to most of the antibiotics in hospitalized patients. Small hospital outbreaks are frequent. B. cepacia may occur as an opportunistic infection in hemato-oncology patients. Here we present an outbreak of Burkholderia cepacia infection in hematology ward of our institute.MethodsFebrile episodes as defined by IDSA guideline, 2010 were followed, and blood for culture and sensitivity was sent in all the events. The culture was done by an automated method using Bactalert 3d Biomeriux & sensitivity pattern by Microscan Siemens method and subsequently detected by PCR based method.ResultsDuring September 2016 to February 2017 (six months), a total of 498 blood cultures were sent during febrile episodes. Out of which 60 (12%) came out to be positive for different microorganisms. Out of all positive cultures, Burkholderia cepacia was detected in 29 (48%) patients, which reduced drastically following the change in antibiotic administration practice. All isolates showed sensitivity to pipercillin+tazobactum, cefoperazone+sulbactum, fluoroquinolones, cotrimoxazole and carbapenems and resistance to polymyxin B and colistin. With timely intervention by appropriate intravenous antibiotics as per culture sensitivity result and change in antibiotic preparation practice, overall mortality was low 1 (4%) out of 29 culture positive episodes.ConclusionChange of antibiotic preparation practice was the key to control this outbreak, and overall mortality was low.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outbreak of Burkholderia Cepacia Infection: A Systematic Study in a Hematology-Oncology Unit of a Tertiary Care Hospital From Eastern India.

Baul

Mandal

et al. 2018

Mediterr J Hematol Infect Dis

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“…Moreover, Bcc contamination of pharmaceutical formulations, medical devices, and disinfectants has led to a number of outbreaks among both CF and non-CF populations (22). Bcc is also an emerging pathogen in nosocomial infections among chemotherapy patients and other immunosuppressed individuals (23,24). The high level of antibiotic resistance combined with the continued acquisition of Bcc bacteria from the environment suggests that prevention of infection with a prophylactic vaccine may be a better approach than eradication of existing infections.…”

mentioning

confidence: 99%

Linocin and OmpW Are Involved in Attachment of the Cystic Fibrosis-Associated Pathogen Burkholderia cepacia Complex to Lung Epithelial Cells and Protect Mice against Infection

McClean¹,

Healy

Collins³

et al. 2016

Infect Immun

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Members of the Burkholderia cepacia complex (Bcc) cause chronic opportunistic lung infections in people with cystic fibrosis (CF), resulting in a gradual lung function decline and, ultimately, patient death. The Bcc is a complex of 20 species and is rarely eradicated once a patient is colonized; therefore, vaccination may represent a better therapeutic option. We developed a new proteomics approach to identify bacterial proteins that are involved in the attachment of Bcc bacteria to lung epithelial cells. Fourteen proteins were reproducibly identified by two-dimensional gel electrophoresis from four Bcc strains representative of two Bcc species: Burkholderia cenocepacia, the most virulent, and B. multivorans, the most frequently acquired. Seven proteins were identified in both species, but only two were common to all four strains, linocin and OmpW. Both proteins were selected based on previously reported data on these proteins in other species. Escherichia coli strains expressing recombinant linocin and OmpW showed enhanced attachment (4.2-and 3.9-fold) to lung cells compared to the control, confirming that both proteins are involved in host cell attachment. Immunoproteomic analysis using serum from Bcc-colonized CF patients confirmed that both proteins elicit potent humoral responses in vivo. Mice immunized with either recombinant linocin or OmpW were protected from B. cenocepacia and B. multivorans challenge. Both antigens induced potent antigen-specific antibody responses and stimulated strong cytokine responses. In conclusion, our approach identified adhesins that induced excellent protection against two Bcc species and are promising vaccine candidates for a multisubunit vaccine. Furthermore, this study highlights the potential of our proteomics approach to identify potent antigens against other difficult pathogens.

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“…Acute myeloid leukemia was the main risk factor, and the duration of infection was associated with neutropenia. 6 …”

Section: Discussionmentioning

confidence: 99%

Burkholderia cepacia septicemia in a patient with acute myeloid leukemia in postchemotherapy bone marrow aplasia

Mihăilă¹,

Blaga²

2013

Pak J Med Sci

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The patients with hematologic malignancies are predisposed to develop infections with unusual bacteria, like Burkholderia cepacia, which is frequently resistant to many antibiotics and antiseptics. We present the case of a female patient with acute myeloid leukemia type 2 on the background of myelodysplastic syndrome, from whom Burkholderia cepacia was isolated in blood culture, after the 2nd cycle of induction. She was sensitive to ceftazidime, but its eradication was not easy. Five other patients were contaminated with this bacteria, but all of them had favourable evolution. The case is discussed in the context of those similar in literature.

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An outbreak of Burkholderia cepacia bacteremia in hospitalized hematology patients selectively affecting those with acute myeloid leukemia

Cited by 12 publications

References 30 publications

Outbreak of Burkholderia Cepacia Infection: A Systematic Study in a Hematology-Oncology Unit of a Tertiary Care Hospital From Eastern India.

Outbreak of Burkholderia Cepacia Infection: A Systematic Study in a Hematology-Oncology Unit of a Tertiary Care Hospital From Eastern India.

Linocin and OmpW Are Involved in Attachment of the Cystic Fibrosis-Associated Pathogen Burkholderia cepacia Complex to Lung Epithelial Cells and Protect Mice against Infection

Burkholderia cepacia septicemia in a patient with acute myeloid leukemia in postchemotherapy bone marrow aplasia

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