[Burkholderia cepacia: a new pathogen causing nosocomial infections].
Burkholderia cepacia is an opportunistic gram-negative, inherently resistant to multiple antibiotics and highly transmissible bacteria found in the soil and moist environments. The bacteria is known as a cause of severe lung infections in cystic fibrosis and immunocompromised patients. The authors observed a nosocomial outbreak of B. cepacia, the strains were isolated from five patients. In one case occurred colonization of the decubitus and in the other four severe pneumonia or sepsis. Four patients developed respiratory failure and septic shock and were admitted to intensive care unit. The infections led to death of two patients. The aim of the study was to evaluate the possibility that the hospital environment or cross-infection were the source of pathogen. The authors discussed the influence of previously used antibiotics on B. cepacia selection and drug susceptibility data as well, as the influence of obtained microbiological data on therapeutic decision making process. We were not able to confirm origin of B. cepacia strains, but in our opinion the hospital environment was the most probable source of pathogen. Increasing multidrug resistance were observed during the time of outbreak. In a case of the last patient we observed only weak susceptibility to imipenem.


CONCLUSIONS
B. cepacia may be an etiologic agent of severe hospital acquired pneumonia and sepsis among immunocompromised patients. Clinically infection develops picture of superinfection and usually is life-threatening condition.
Klinika Chorób Zakaźnych dla Dorosłych Akademia Medyczna w Warszawie. darlip@amwaw.edu.pl
Dariusz
D
Lipowski
Ewa
E
Rzadkiewicz
Ewa
E
Czekalska-Lachowicz
D000328:Adult; D000368:Aged; D019121:Burkholderia Infections / Q000175:diagnosis / Q000382:microbiology* / Q000635:transmission*; D016956:Burkholderia cepacia / Q000302:isolation & purification*; D003428:Cross Infection / Q000382:microbiology* / Q000635:transmission; D003550:Cystic Fibrosis / Q000382:microbiology; D018562:Disease Transmission, Infectious; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000382:microbiology*; D012141:Respiratory Tract Infections / Q000382:microbiology; D016896:Treatment Outcome