Yonsei Med J.  2016 Jan;57(1):97-102. 10.3349/ymj.2016.57.1.97.

Burkholderia Sepsis in Children as a Hospital-Acquired Infection

• Kim KY
• Yong D
• Lee K
• Kim HS
• Kim DS

• KMID: 2466357
• DOI: http://doi.org/10.3349/ymj.2016.57.1.97

Abstract

PURPOSE
Hospital-acquired Burkholderia cepacia (B. cepacia) infection are not commonly recorded in patients without underlying lung disease, such as cystic fibrosis and chronic granulomatous disease. However, in 2014, B. cepacia appeared more frequently in pediatric blood samples than in any other year. In order to access this situation, we analyzed the clinical characteristics of B. cepacia infections in pediatric patients at our hospital.
MATERIALS AND METHODS
We conducted a retrospective study of blood isolates of B. cepacia taken at our hospital between January 2004 and December 2014. Patient clinical data were obtained by retrospective review of electronic medical records. We constructed a dendrogram for B. cepacia isolates from two children and five adult patients.
RESULTS
A total of 14 pediatric patients and 69 adult patients were identified as having B. cepacia bacteremia. In 2014, higher rates of B. cepacia bacteremia were observed in children. Most of them required Intensive Care Unit (ICU) care (12/14). In eleven children, sputum cultures were examined, and five of these children had the same strain of B. cepacia that grew out from their blood samples. Antibiotics were administered based on antibiotic sensitivity results. Four children expired despite treatment. Compared to children, there were no demonstrative differences in adults, except for history of ICU care.
CONCLUSION
Although there were not many pediatric cases at our hospital, awareness of colonization through hospital-acquired infection and effective therapy for infection of B. cepacia is needed, as it can cause mortality and morbidity.

Keyword

Burkholderia cepacia; sepsis; hospital infection; child

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents/therapeutic use
Bacteremia/drug therapy/*epidemiology
Burkholderia Infections/blood/drug therapy/*epidemiology
Burkholderia cepacia/drug effects/*isolation & purification
Child
Child, Preschool
Cross Infection/blood/*diagnosis/drug therapy/mortality
Disease Outbreaks
Female
Humans
Incidence
Infant
*Intensive Care Units
Male
Microbial Sensitivity Tests
Middle Aged
Republic of Korea/epidemiology
Retrospective Studies
Treatment Outcome
Young Adult
Anti-Bacterial Agents

Figure

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  Fig. 1 Annual incidence of B. cepacia infection in our hospital. B. cepacia, Burkholderia cepacia.

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  Fig. 2 Dendrogram of B. cepacia isolated in seven patients. Patients B, E, and F are pediatric patients; the others are adult patients. Patients A, B, C, D, and G were from the ICU, and Patients E and F were from the pediatric cardiovascular ICU. B. cepacia, Burkholderia cepacia; ICU, Intensive Care Unit.

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