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Management and outcomes of Burkholderia cepacia complex bacteremia in patients without cystic fibrosis: a retrospective observational study

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Abstract

Burkholderia cepacia complex (BCC) is an emerging pathogen of nosocomial infection in chronic or critically ill patients without cystic fibrosis (CF). The objective was to evaluate the management and outcomes of BCC bacteremia in patients without CF. We conducted a retrospective study of non-CF adult patients with BCC bacteremia between January 1997 and December 2016 at 4 tertiary hospitals in South Korea. A total of 216 non-CF patients with BCC bacteremia were identified. Most cases were hospital-acquired (79.2%), and the most common source was a central venous catheter (CVC) (42.1%). The rates of susceptibility to trimethoprim-sulfamethoxazole and piperacillin-tazobactam of BCC isolates were high as 92.8% and 90.3%, respectively. The rates of susceptibility to ceftazidime, meropenem, and levofloxacin were 75.5%, 72.3%, and 64.1%, respectively. The 14-day, 30-day, and in-hospital mortality rate was 19.4%, 23.1%, and 31.0%, respectively. Female (OR = 3.1; 95% CI, 1.4–6.8), liver cirrhosis (OR = 6.2; 95% CI, 1.6–16.6), septic shock (OR = 11.2; 95% CI, 5.1–24.8), and catheter-related infection (OR = 2.6, 95% CI, 1.2–5.8) were the independent risk factors for 30-day mortality. The outcome did not differ according to type of antibiotics used. Among 91 patients with CVC-related BCC bacteremia, delayed CVC removal (> 3 days) had a higher rate of persistent bacteremia (54.5 vs. 26.1%; P = 0.03) and lower rate of clinical response (49.0 vs. 71.9%; P = 0.04), compared with early CVC removal (within 3 days). BCC bacteremia occurring in non-CF patients was mostly hospital-acquired and CVC-related. Early removal of the catheter is crucial in treatment of CVC-related BCC bacteremia.

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Funding

This work has supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. NRF-2018R1C1B5043292).

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea

    Yu-Mi Lee, Ki-Ho Park, Dong Youn Kim & Mi Suk Lee

  2. Department of Infectious Diseases, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea

    Chisook Moon

  3. Department of Internal Medicine, SoonChunHyang University Bucheon Hospital, Bucheon, Republic of Korea

    Tark Kim & Eun Ju Choo

  4. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Yong Pil Chong, Sung-Han Kim, Yang Soo Kim & Jun Hee Woo

  5. Department of Pathology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea

    Mee Soo Chang

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  1. Yu-Mi Lee
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  2. Ki-Ho Park
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  9. Sung-Han Kim
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Correspondence to Jun Hee Woo or Mee Soo Chang.

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The authors declare that they have no conflict of interest.

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This study was approved by the Institutional Review Board of Kyung Hee University Hospital (2018-10-038).

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Informed consent was not required because of the retrospective nature of the present study.

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Lee, YM., Park, KH., Moon, C. et al. Management and outcomes of Burkholderia cepacia complex bacteremia in patients without cystic fibrosis: a retrospective observational study. Eur J Clin Microbiol Infect Dis 39, 2057–2064 (2020). https://doi.org/10.1007/s10096-020-03960-2

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  • DOI: https://doi.org/10.1007/s10096-020-03960-2

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