Background: Burkholderia cepacia complex has emerged as an important nosocomial pathogen, which was often difficult to manage due to its high contagiousness and inherent resistance to many antibiotics. The objective of this study was to evaluate the clinical characteristics, antimicrobial susceptibilities and predictors of mortality in patients with B. cepacia complex bacteremia.
Methods: We conducted a retrospective study of adult patients (>18 years of age) with B.cepacia complex bacteremia between June 2006 and April 2015 at a tertiary hospital in South Korea.
Results: Total 46 episodes of B. cepacia complex bacteremia were included in this study and 43 (93.5%) were hospital-acquired. Most patients (87.0%) had underlying diseases. Central line-related infection (84.8%) was the most common source of B. cepacia complex bacteremia. Overall, the 30-day mortality rate and the bacteremia-related mortality rate was 41.3% (19/46) and 26.1% (12/19), respectively. Univariate analysis revealed that female, high charlson co-morbidity score, prolonged duration of central-line placement, septic shock, high Pitt bacteremia score, and delayed removal of central line were significantly associated with increased mortality. In multivariate analysis, delayed removal of central line (OR=13.4; 95% CI 1.9-94.3) and septic shock (OR=13.4; 95% CI 1.9-94.3) were independent predictors of 30-day mortality of B. cepacia complex bacteremia. Most isolates were susceptible to ceftazidime, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, and cefepime (Figure 1). Inappropriate antibiotics administration was tend to increase the mortality rate although not statistically significant (survivor 74.1% vs. non-survivor 47.4%, p = 0.07).
Conclusion: It is important to remove the eradicable infection focus such as central line promptly in patients with B. cepacia complex bacteremia.
Y. M. Lee,