Burkholderia cepacia Brain Abscess in a Term Neonate

Pareek, Prince; Gupta, Bhavya; Chetan, Chinmay; Banait, Nishant; Deshpande, Sujata; Joshi, Prachi; Suryawanshi, Pradeep

doi:10.1007/s12098-019-03156-3

Cited by 5 publications

(6 citation statements)

References 3 publications

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“…It has been reported that B. cepacia causes various infections in children, including bacteremia, pneumonia, urinary tract infection, endocarditis, meningitis, and brain abscess . ( 22 , 27 , 28 ). According to Peng F et al's study, respiratory tract infections (15/16) were the most common, followed by blood infections (5/16) ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases

Shi

Chen²,

Chen

et al. 2023

Front. Pediatr.

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BackgroundBurkholderia cepacia (B. cepacia) is an emerging pathogen of nosocomial infection in pediatric patient carrying cystic fibrosis. The clinical diagnosis and treatment of B. cepacia infection remains poorly studied. This study outlined the risk factors, antimicrobial susceptibility, and clinical characteristics aiming to improve the treatment of B. cepacia infection.MethodsA retrospective study was conducted based on the 50 cases infection caused by B. cepacia in children without cystic fibrosis, which were diagnosed in the First Affiliated Hospital of Xiamen University, from January 1st, 2011 to December 31st, 2021.ResultsA total of 50 children were infected with B. cepacia, of whom 68% had an underlying health condition, such as cardiovascular disease (23.5%), respiratory disease (17.6%), nervous system disease (14.7%), and neoplastic disease (14.7%). At the onset of B. cepacia infection, 42 (84%) pediatric patients were in an intensive care unit (ICU), 33 (66%) underwent endotracheal intubation, and 32 (64%) had a central venous catheter (CVC). In addition, hospital-acquired cases were 46 (92%), and healthcare-acquired cases were 4 (12%). The most common infectious sites of B. cepacia were the respiratory tract (68%), followed by the blood (20%), and the urinary tract (12%). It indicated that B. cepacia was the most sensitive to ceftazidime (95.65%), followed by trimethoprim-sulfamethoxazole (88.68%), meropenem (82.98%), cefepime (77.78%), and levofloxacin (55.85%). The drug resistance rate of piperacillin-tazobactam, minocycline, aztreonam, cefoperazone-sulbactam and ceftriaxone was higher than 55%. 38 cases were cured or improved, eight had treatment terminated, and four died.ConclusionB. cepacia is an opportunistic pathogen normally found in immunocompromised pediatric patients and highly likely to lead to drug resistance. Nosocomial B. cepacia infections occurred mostly in patients in the ICU based on our observations. The surveillance of B. cepacia infections including changing epidemiology and increasing resistance of the microorganism is still very important. Treatment with effective antibiotics such as ceftazidime, meropenem, trimethoprim-sulfamethoxazole is associated with a favorable prognosis.

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Section: Discussionmentioning

confidence: 99%

Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases

Shi

Chen²,

Chen

et al. 2023

Front. Pediatr.

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“…Extrapulmonary infection caused by B. cepacia is a rare, life-threatening disease usually found in immunocompromised patients. 1,3 B. cepacia-induced infections are difficult to treat because the pathogen is resistant to multiple antibiotics inherently. 3 Several cases report that B. cepacia could cause abscesses in the brain, bilateral primary psoas, chest intra-abdominal, and even deep neck.…”

Section: Discussionmentioning

confidence: 99%

“…cepacia is a rare, life-threatening disease usually found in immunocompromised patients. 1 , 3 B . cepacia -induced infections are difficult to treat because the pathogen is resistant to multiple antibiotics inherently.…”

Section: Discussionmentioning

confidence: 99%

“…Burkholderia cepacia (B. cepacia), a Gram-negative aerobic bacillus, is a well-known opportunistic pathogen of immune-compromised patients including cystic fibrosis, chronic granulomatous disease, and lung transplantation patients. 1 Several cases report that B. cepacia could induce extrapulmonary-tissue abscesses, such as brain, bilateral psoas, chest intra-abdominal, and deep neck. [2][3][4][5][6][7][8] However, soft tissue infections with fractures caused by B. cepacia are extremely rare with no instances reported.…”

Section: Introductionmentioning

confidence: 99%

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Burkholderia cepacia Induced Occipital Subcutaneous Abscess and Fracture in a Brain-Dead Woman

Wu¹,

Liu²,

Chen³

et al. 2023

IDR

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Burkholderia cepacia is an aerobic opportunistic Gram-negative pathogen that mainly infects immunodeficiency patients. However, soft tissue infections with fractures due to Burkholderia cepacia are rare with no cases reported. Here, we report a rare case of 3 years of brain death in a 43-year-old woman with Burkholderia cepacia resulting in an occipital subcutaneous abscess and fracture. Through the second-generation sequencing of the whole genome of this strain, it was found that there were no high virulence genes and virulence factors. The patient received targeted antibiotic therapy and showed improvement in clinical symptoms and radiological signs. Bone destruction because of Burkholderia cepacia is easily overlooked due to the lack of characteristic symptoms and limited clinical examination. This case reminds us that Burkholderia cepacia without major virulence factors could damage the bone in immune-compromised patients.

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“…The clinical symptoms of brain abscess vary due to different virulence of pathogenic bacteria and the body's response to different conditions, which may easily lead to misdiagnosis, thus resulting in poor prognosis and an increased risk of mortality in children. Even if they survive, there will be permanent neurological impairment [3][4][5][6][7][8][9][10][11] . Therefore, in addition to the prevention of brain abscess, diagnosing and treating it early are essential.…”

Section: Literature Reviewmentioning

confidence: 99%

Neonatal Brain Abscess: Case Report of 12 Cases and Literature Review

Peng

Chen

2022

JCNR

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Objective: To investigate the etiological characteristics, clinical manifestations, and early identification methods of neonatal brain abscess. Methods: The baseline characteristics, clinical manifestations, and laboratory results of 12 neonatal brain abscess cases were retrospectively analyzed. Results: The clinical manifestations were fever, convulsion, and lethargy. A small number of them had respiratory and circulatory failure. The diagnosis made was based on imaging examination. All 12 cases were confirmed by cranial enhanced computed tomography (CT) or magnetic resonance imaging (MRI). Blood cultures of 9 cases were positive, with Escherichia coli in 6 cases, ?-hemolytic Streptococcus in 1 case, methicillin-resistant Staphylococcus aureus in 1 case, and Enterococcus faecium in 1 case. However, only 3 of them had positive cerebrospinal fluid (CSF) cultures. All the 12 neonates were treated with antibiotic therapy upon admission, with only 3 cases treated with surgery. Among them, 4 recovered and were discharged, while the remaining 8 discontinued their therapy. Conclusion: Escherichia coli is the most common pathogen of neonatal brain abscess in our study. The clinical manifestations of neonatal brain abscess are atypical, and the prognosis is poor. Respiratory and circulatory failure in children with intracranial infection may indicate the presence of brain abscess. For children with suspected brain abscess, cranial enhanced CT or MRI should be performed as soon as possible to make an early diagnosis. The prevention of brain abscess should be prioritized; neonates with sepsis or meningitis should receive prompt and strong antibiotic therapy in an effort to prevent the development of brain abscess.

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Burkholderia cepacia Brain Abscess in a Term Neonate

Cited by 5 publications

References 3 publications

Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases

Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases

Burkholderia cepacia Induced Occipital Subcutaneous Abscess and Fracture in a Brain-Dead Woman

Neonatal Brain Abscess: Case Report of 12 Cases and Literature Review

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