Microbiological assessment ofBurkholderia cepaciacomplex (Bcc) isolates in Alexandria Main University Hospital

Abstract

Nosocomial spread of B. cepacia complex (Bcc) isolates amongst non-CF patients has been documented, where inadequate laboratory identification and limited treatment options are considered the main obstacles hindering accurate diagnosis and thus proper therapeutic outcome.The present study aimed to detect the isolation percentage of Bcc from patients in Alexandria Medical University Hospital (AMUH) according to site of infection (specimen), throughout a 6 month period. Out of 2079 specimens submitted to the microbiology laboratory, 35 strains were isolated on BCSA and biochemically identified as Bcc for the first time in this laboratory. The highest rate of isolation of Bcc isolates was from pus (85.7%) isolated from patients in the burn unit. Antibiotic susceptibility tests revealed that all Bcc isolated were Multi Drug Resistant (MDR), the highest susceptibility was to meropenem (88.5%) followed by ceftazidime (60%), tobramycin, chloramphenicol, piperacillin-tazobactam and tetracycline, while all strains were resistant to cotrimoxazole and ciprofloxacin.Minimal Inhibitory Concentration (MIC) determining tests showed that only 11.5% were resistant to meropenem at MIC > 16 lg/ml, while 40% of the strains were resistant to ceftazidime at MIC > 32 lg/ml. Those results for the time being indicate that meropenem is the best therapeutic option for Bcc infections in AMUH.

Burkholderia cepacia an emerging cause of septicaemia, in an intensive care unit from a tertiary care hospital, Nellore, India

“…But when compare to Omar et al, the isolation rate was 1.7%, this study shows high prevalence rate. 16 The rate of isolation (7.9%) of this study nearly correlates with the study done by Hadir El Kady et al, found that B. cepacia rate of isolation was 5.3% (8/150). 17 The reasons for varying in results may be attributed to the fact that variation in geographical distribution, sample size, duration of study period, socioeconomic factors, infection control practices in various hospitals.…”

Occurrence of unusual non-fermentative gram negative bacilli in intensive care units of a university hospital, Egypt

“…[21] [22] [25]but the striking point, in our results, is the high level of ceftazidime resistance (100%) which was not recorded previously, as far as we know. This could be attributed to the excess use of 3 rd generation cephalosporins in our hospital.…”

“…In a Turkish study, ETA was the main source for Bccisolation(58.9%) [21]. However, 62.7% of Bcc were isolated from blood specimens in another study [19] and in a previous Egyptian study, the highest percent (85.7%) of Bcc isolates were from pus specimens [22]. This difference could be attributed to the difference in the clinical conditions of patients along with different hospital wards selected in each study.…”

Existence of Burkholderia cepacia at Burn and Intensive Care Units in Alexandria Main University Hospital, Egypt

“…(25) More discrepancies are observed as regards piperacillin-tazobactam, where BCC strains in the study of Gautam et al (25) and Dizbay et al (20) were more sensitive to this antibiotic than those tested in the present study showing (86.7%, 61.6%) respectively, and the sensitivity for ciprofloxacin were (83.3%, 46.2%) while none of the 32 B. cepacia complex strains in the present study were sensitive to piperacillin-tazobactam and ciprofloxacin. Another study in Alexandria University 2011, (19) the antibiotic resistance pattern of the 35 BCCstrains as detected by the modified Bauer Kirby single disc diffusion technique revealed that altogether the 35 strains were distributed among 17 different resistance profiles. The largest cluster of strains of identical resistance profile was from patients in the burn unit where 5 strains shared the resistance pattern (TE, SXT, CIP, TZP) and 4 strains shared the resistance pattern (TE, SXT, CIP, TZP, C) with resistance to chloramphenicol as the only added minor variation so the 9 strains could be safely accepted to have almost identical resistance pattern which may implicate a common source or origin.…”