Burkholderia cepacia Complex Bacteria: a Feared Contamination Risk in Water-Based Pharmaceutical Products

Abstract

SUMMARY Burkholderia cepacia (formerly Pseudomonas cepacia) was once thought to be a single bacterial species but has expanded to the Burkholderia cepacia complex (Bcc), comprising 24 closely related opportunistic pathogenic species. These bacteria have a widespread environmental distribution, an extraordinary metabolic versatility, a complex genome with three chromosomes, and a high capacity for rapid mutation and adaptation. Additionally, they present an inherent resistance to antibiotics and antiseptics, as well as the abilities to survive under nutrient-limited conditions and to metabolize the organic matter present in oligotrophic aquatic environments, even using certain antimicrobials as carbon sources. These traits constitute the reason that Bcc bacteria are considered feared contaminants of aqueous pharmaceutical and personal care products and the frequent reason behind nonsterile product recalls. Contamination with Bcc has caused numerous nosocomial outbreaks in health care facilities, presenting a health threat, particularly for patients with cystic fibrosis and chronic granulomatous disease and for immunocompromised individuals. This review addresses the role of Bcc bacteria as a potential public health problem, the mechanisms behind their success as contaminants of pharmaceutical products, particularly in the presence of biocides, the difficulties encountered in their detection, and the preventive measures applied during manufacturing processes to control contamination with these objectionable microorganisms. A summary of Bcc-related outbreaks in different clinical settings, due to contamination of diverse types of pharmaceutical products, is provided.

Post intravitreal bevacizumab recurrent Burkholderia cepacia endophthalmitis treated with clear lens extraction in an African

“… 1 Furthermore, as described in this case report, persistence and recurrence may be associated with the microbe's ability to colonize intraocular structures such as the crystalline lens or intraocular lens, lens zonules, ciliary body, and protecting itself from the effect of sensitive antimicrobials. 1 , 16 , 17 Despite the repeated use of intravitreal Ceftazidime which microbiology assessment revealed the B. cepacia was sensitive to, yet a heavy yield was cultured at the second sampling. The persistence of B. cepacia, in this case, could be as a result of the colonization of intraocular structures, since it succumbed when the lens was removed, without any change in antibiotic treatment.…”

“…Burkholderia cepacia is a gram-negative bacillus found in soil and water; and a dreaded contaminant of pharmaceutical and medical devices. 1 , 2 It is a cause of postoperative infective endophthalmitis and is associated with recurrent disease. 3 It has gained prominence in recent years because of its resistance to treatment, which often results in poor visual outcomes.…”

“…Besides, it has a high capacity for rapid mutation, inherent resistance to antibiotics and antiseptics, can survive under nutrient-limited conditions, and can use some antimicrobials as its source of carbon. 1 It has been reported to account for 1.8% of cases of postoperative endophthalmitis. 2 B. cepacia endophthalmitis like other gram-negative infections is associated with a poor prognostic outcome.…”

Untitled

“…The existence of microbial contaminants was not only found to generate physicochemical changes that led to the spoilage of multiple products [1][2][3] , but was also proved to be a possible health threat to the consumer [4][5][6] as documented by numerous incidents of drug-related infections 1,[7][8][9] .…”

Characterization of the Burkholderia cenocepacia J2315 Surface-Exposed Immunoproteome

“…BLAST Expect value of 10e −10 for query within 80-120% of subject length; Class 3-Subcellular localization computationally predicted by PSORTb V3.0[32]. Abbreviations: OM-outer membrane; E-extracellular; U-unknown 4. Pfam Database[31,41] 5…”