Burkholderia Cepacia Causing Nosocomial Urinary Tract Infection in Children
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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 sulfamethoxazoletrimethoprim, 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.
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 sulfamethoxazoletrimethoprim, 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.
참고문헌 (11)
- Avgeri SG, "Therapeutic options for Burkholderia cepacia infections beyond co-trimoxazole : a systematic review of the clinical evidence", Int J Antimicrob Agents, 33, pp.394~404 (2009)
- Lu DC, "Burkholderia cepacia bacteremia : a retrospective analysis of 70episodes", J Formos Med Assoc, 96, pp.972~978 (1997)
- Pegues CF, "Burkholderia cepacia respiratory tract acquisition : epidemiology and molecular characterization of a large nosocomial outbreak", Epidemiol Infect, 116, pp.309~317 (1996)
- Patra S, "Burkholderia cepacia sepsis among neonates", Indian J Pediatr, 81, pp.1233~1236 (2014)
- Alvarez-Lerma F, "Moisturizing body milk as a reservoir of Burkholderia cepacia:outbreak of nosocomial infection in a multidisciplinary intensive care unit", Crit Care, 12, pp.R10~ (2008)
- Gravel D, "Outbreak of burkholderia cepacia in the adult intensive care unit traced to contaminated indigo-carmine dye", Infect Control Hosp Epidemiol, 23, pp.103~106 (2002)
- Martin M, "Outbreak of Burkholderia cepacia complex caused by contaminated alcohol-free Mouthwash", Anaesthesist, 61, pp.25~29 (2012)
- Durham SH, "Burkholderia cepacia septicemia in a pediatric oncology patient: a pharmacotherapy challenge", Ann Pharmacother, 46, pp.e16~ (2012)
- Li FK, "Burkholderia urinary tract infection after renal transplantation", Transpl Infect Dis, 5, pp.59~61 (2003)
- Loertzer H, "Intramural bladderwall abscess: a late complication arising after a urethrocystoscopy?", Pediatr Surg Int, 21, pp.323~325 (2005)
- Zeeshan M, "Recurrent urinary tract infection by Burkholderia cepacia in a live related renal transplant recipient", J Pak Med Assoc, 62, pp.496~498 (2012)