AUTHOR=Shi Huixuan , Chen Xianrui , Chen Lili , Zhu Bizhen , Yan Weiyuan , Ma Xiaobo 

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

JOURNAL=Frontiers in Pediatrics

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1115877

DOI=10.3389/fped.2023.1115877

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p><italic>Burkholderia cepacia</italic> (<italic>B. cepacia</italic>) is an emerging pathogen of nosocomial infection in pediatric patient carrying cystic fibrosis. The clinical diagnosis and treatment of <italic>B. cepacia</italic> infection remains poorly studied. This study outlined the risk factors, antimicrobial susceptibility, and clinical characteristics aiming to improve the treatment of <italic>B. cepacia</italic> infection.</p></sec><sec><title>Methods</title><p>A retrospective study was conducted based on the 50 cases infection caused by <italic>B. cepacia</italic> in children without cystic fibrosis, which were diagnosed in the First Affiliated Hospital of Xiamen University, from January 1st, 2011 to December 31st, 2021.</p></sec><sec><title>Results</title><p>A total of 50 children were infected with <italic>B. cepacia</italic>, 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 <italic>B. cepacia</italic> 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 <italic>B. cepacia</italic> were the respiratory tract (68%), followed by the blood (20%), and the urinary tract (12%). It indicated that <italic>B. cepacia</italic> 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.</p></sec><sec><title>Conclusion</title><p><italic>B. cepacia</italic> is an opportunistic pathogen normally found in immunocompromised pediatric patients and highly likely to lead to drug resistance. Nosocomial <italic>B. cepacia</italic> infections occurred mostly in patients in the ICU based on our observations. The surveillance of <italic>B. cepacia</italic> 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.</p></sec>