B. cepacia group of bacteria contains 24 closely related species known as Burkholderia cepacia complex (BCC).

It is gram-negative bacillus type which present in aquatic environments. This complex is known for diverse metabolism and adaptability.

B cepacia is a low-virulence organism commonly found in hospital fluids.

Healthy hosts are rarely infected due to B cepacia. Burkholderia cepacia was first identified in the 1950.

It is found in soil, water, and plant roots can degrade organic compounds for bioremediation.

BCC bacteria carry range of virulence including biofilm formation, lipopolysaccharides, and secreted enzymes.

BCC infections are difficult to treat due to resistance from efflux pumps, beta-lactamases, and target sites.

B cepacia harmless outside hospital but can cause respiratory infections in cystic fibrosis patients.

B cepacia causes skin, surgical, and genitourinary infections in reports. It harmless in ambulatory patients but can infect respiratory tract of cystic fibrosis patients.

Direct injection of B cepacia from infusate can cause gram-negative bacteremia. Age and disease severity predict mortality independently.

High mortality linked to malignancy and high SOFA score. No racial or age predisposition is observed.

It colonizes instead of infects but can be significant when found in sterile fluids. CF patients prone to respiratory tract infections due to bacteria attaching with pili, flagella, and other structures.

Bacteria manipulate immune response to prevent infection clearance and disrupt cytokine production in hosts.

Bacterium releases enzymes that break down proteins and lipids in host tissues to promote inflammation and damage.

Bacteria form biofilms with polysaccharides, proteins, and DNA in communities. B. cepacia in lungs causes chronic inflammation to lung damage and bronchiectasis.

The causes B. cepacian are:

Sources and Reservoirs

Mode of transmission

Risk Factors

Pathogenesis factors

B cepacia symptoms mimic other pathogen infections based on affected organ systems. Cystic Fibrosis patients with Burkholderia cepacia has poor prognosis.

Resistance to multiple antibiotics in strains creates challenges in treatment. Biofilm formation complicates treatment and leads to poor outcomes.

Older adults with B. cepacia infection and comorbidities may have poorer prognosis due to reserves.

Detailed information including identification, the understanding of pathogenicity, and impact on specific patient populations of patients should be gathered.

Physical Examination

Respiratory examination

Cardiovascular assessment

Mild to Moderate symptoms are:

Increased cough, sputum production, mild shortness of breath, Low-Grade Fever and Fatigue

Severe symptoms are:

Rapid Deterioration, High Fever, Respiratory Distress/failure, and Sepsis

Infection control measures can prevent B cepacia spread. Minimize foley catheter usage for shorter durations to prevent urinary infections in vulnerable patients.

Difficult to prevent B cepacia colonization in intubated ICU patients on antibiotics.

Unnecessary antimicrobial treatment may be harmful. Select antimicrobial treatment based on susceptibility testing.

Adjust duration based on symptom resolution and inflammation decline.

Cystic fibrosis patients have B cepacia complex isolates more resistant than non-patients due to antibiotics exposure and species variations in patient groups.

Ceftazidime-avibactam effective against resistant B cepacia complex in persistent bacteremia

Infectious Disease

Respiratory device users should regularly clean and disinfect equipment using sterile water to prevent contamination and maintain hygiene.

Ventilate room with fans or open windows to disperse viral particles and lower risk of airborne transmission.

Patient should daily wash their hands with soap and water.

Patient should avoid contaminated water and use only sterile water for daily purposes.

Proper awareness about Burkholderia cepacia should be provided and its related causes with management strategies.

Appointments with a specialist and preventing recurrence of disorder is an ongoing life-long effort.

Infectious Disease

Trimethoprim/sulfamethoxazole:

It inhibits synthesis of dihydrofolic acid and blocks biosynthesis of nucleic acids to many bacteria.

Tigecycline:

It inhibits bacterial protein translation binds to 30S ribosomal subunit in ribosome A site.

Meropenem:

It inhibits bacterial cell wall synthesis and is effective against gram-positive and gram-negative bacteria.

Ceftazidime:

It binds to the penicillin-binding proteins in bacterial cell walls, which inhibits the final step of peptidoglycan synthesis.

Cefiderocol:

It prevents the formation of cross-links between peptidoglycan chains that cause bacterial death.

Infectious Disease

In pulmonary interventions physician should refer for bronchoscopy and

chest physiotherapy.

Surgical interventions include use of surgical drainage and removal of infected devices.

Infectious Disease

In initial treatment phase evaluation of medical history, physical examination and diagnostic test to confirm diagnosis.

Pharmacologic therapy is effective in the treatment phase as it includes use of antibiotic therapy.

In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.

The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.