Child Kidney Dis.  2015 Oct;19(2):143-147. 10.3339/chikd.2015.19.2.143.

Burkholderia Cepacia Causing Nosocomial Urinary Tract Infection in Children

• Lee KW
• Lee ST
• Cho H

• KMID: 2168415
• DOI: http://doi.org/10.3339/chikd.2015.19.2.143

Abstract

PURPOSE
Burkholderia cepacia is an aerobic, glucose-non-fermenting, gramnegative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients.
METHODS
Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records.
RESULTS
Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28. 6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazole-trimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI.
CONCLUSION
Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.

Keyword

Burkholderia cepacia; Children; Urinary tract infection

MeSH Terms

Amikacin
Aminoglycosides
Anti-Infective Agents
Bacillus
Burkholderia cepacia*
Burkholderia*
Catheters
Causality
Ceftazidime
Child*
Colistin
Heart Defects, Congenital
Humans
Incidence
Intensive Care Units
Medical Records
Republic of Korea
Retrospective Studies
Risk Factors
Seoul
Tertiary Care Centers
Urinary Bladder
Urinary Tract Infections*
Urinary Tract*
Vesico-Ureteral Reflux
Amikacin
Aminoglycosides
Anti-Infective Agents
Ceftazidime
Colistin