Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases
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 clin...
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Frontiers Media S.A.
2023-05-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1115877/full |
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author | Huixuan Shi Huixuan Shi Huixuan Shi Xianrui Chen Lili Chen Lili Chen Lili Chen Bizhen Zhu Bizhen Zhu Bizhen Zhu Weiyuan Yan Weiyuan Yan Weiyuan Yan Xiaobo Ma Xiaobo Ma Xiaobo Ma |
author_facet | Huixuan Shi Huixuan Shi Huixuan Shi Xianrui Chen Lili Chen Lili Chen Lili Chen Bizhen Zhu Bizhen Zhu Bizhen Zhu Weiyuan Yan Weiyuan Yan Weiyuan Yan Xiaobo Ma Xiaobo Ma Xiaobo Ma |
author_sort | Huixuan Shi |
collection | DOAJ |
description | 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. |
first_indexed | 2024-04-09T12:38:19Z |
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spelling | doaj.art-22bf6b0fc64346fc8a779d4690a100072023-05-15T04:48:03ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-05-011110.3389/fped.2023.11158771115877Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 casesHuixuan Shi0Huixuan Shi1Huixuan Shi2Xianrui Chen3Lili Chen4Lili Chen5Lili Chen6Bizhen Zhu7Bizhen Zhu8Bizhen Zhu9Weiyuan Yan10Weiyuan Yan11Weiyuan Yan12Xiaobo Ma13Xiaobo Ma14Xiaobo Ma15Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, ChinaPediatric Key Laboratory of Xiamen, Xiamen Science and Technology Bureau, Xiamen, ChinaInstitute of Pediatrics, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Pediatric Rehabilitation, Xiamen Rehabilitation Hospital, Xiamen, ChinaDepartment of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, ChinaPediatric Key Laboratory of Xiamen, Xiamen Science and Technology Bureau, Xiamen, ChinaInstitute of Pediatrics, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, ChinaPediatric Key Laboratory of Xiamen, Xiamen Science and Technology Bureau, Xiamen, ChinaInstitute of Pediatrics, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, ChinaPediatric Key Laboratory of Xiamen, Xiamen Science and Technology Bureau, Xiamen, ChinaInstitute of Pediatrics, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Clinical Laboratory, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, ChinaXiamen Key Laboratory of Genetic Testing, Xiamen Science and Technology Bureau, Xiamen, ChinaSchool of Public Health, Xiamen University, Xiamen, ChinaBackgroundBurkholderia 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.https://www.frontiersin.org/articles/10.3389/fped.2023.1115877/fullBurkholderia cepaciaopportunistic pathogenhospital infectionchildantimicrobial susceptibilitypediatric disease |
spellingShingle | Huixuan Shi Huixuan Shi Huixuan Shi Xianrui Chen Lili Chen Lili Chen Lili Chen Bizhen Zhu Bizhen Zhu Bizhen Zhu Weiyuan Yan Weiyuan Yan Weiyuan Yan Xiaobo Ma Xiaobo Ma Xiaobo Ma Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases Frontiers in Pediatrics Burkholderia cepacia opportunistic pathogen hospital infection child antimicrobial susceptibility pediatric disease |
title | Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases |
title_full | Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases |
title_fullStr | Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases |
title_full_unstemmed | Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases |
title_short | Burkholderia cepacia infection in children without cystic fibrosis: a clinical analysis of 50 cases |
title_sort | burkholderia cepacia infection in children without cystic fibrosis a clinical analysis of 50 cases |
topic | Burkholderia cepacia opportunistic pathogen hospital infection child antimicrobial susceptibility pediatric disease |
url | https://www.frontiersin.org/articles/10.3389/fped.2023.1115877/full |
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