目的:洋葱伯克霍尔德菌(Bcc),最初被认为是单一物种,代表一组24种不同的物种,通常对多种抗生素具有抗性,通常已知会在囊性纤维化患者中引起危及生命的肺部感染。在这里,我们描述了一系列非呼吸性Bcc感染,危险因素和流行病学因素,除了临床课程。
方法:这是2005年6月至2020年2月在贝鲁特美国大学医学中心(AUBMC)收治的44例有记录的从呼吸道以外部位分离出的洋葱状芽孢杆菌感染的患者的回顾性图表回顾。黎巴嫩和中东地区的三级转诊医院。这些患者的流行病学背景,他们潜在的风险因素,使用的抗生素方案,并收集了B的敏感性。
结果:大多数Bcc感染(26/44,59.1%)是医院获得性感染。患者中最常见的国籍是伊拉克人(18/44,40.9%),最常见的感染部位是菌血症(17/44,38.6%),其次是皮肤和软组织感染(16/44,36.4%)和椎体骨髓炎(8/44,18.2%)。大多数孤立的接生易感头孢他啶,碳青霉烯类,其次是TMP-SMX。患者对治疗反应良好,总体效果良好。
结论:Bcc可引起呼吸道外感染,主要是医院获得性感染和免疫功能低下的患者。大多数患者来自战争造成的国家,这增加了冲突的潜在作用的可能性,需要在未来的研究中进行调查。根据易感性结果进行的定向治疗在大多数患者中被证明是有效的。
OBJECTIVE: The Burkholderia cepacia complex (Bcc), which was originally thought to be a single species, represents a group of 24 distinct species that are often resistant to multiple antibiotics, and usually known to cause life-threatening pulmonary infections in cystic fibrosis patients. Herein we describe a series of non-respiratory Bcc infections, the risk factors and epidemiologic factors, in addition to the clinical course.
METHODS: This is a retrospective chart review of 44 patients with documented B. cepacia infections isolated from sites other than the respiratory tract admitted between June 2005 and February 2020 to the American University of Beirut Medical Center (AUBMC), a tertiary referral hospital for Lebanon and the Middle East region. The epidemiological background of these patients, their underlying risk factors, the used antibiotic regimens, and the sensitivities of the B. cepacia specimens were collected.
RESULTS: The majority of the Bcc infections (26/44, 59.1%) were hospital-acquired infections. The most common nationality of the patients was Iraqi (18/44, 40.9%), and the most common site of infection was bacteremia (17/44, 38.6%), followed by skin and soft tissues infections (16/44, 36.4%) and vertebral osteomyelitis (8/44, 18.2%). Most of the isolated B. cepacia were susceptible to ceftazidime, carbapenems, followed by TMP-SMX. Patients responded well to therapy with good overall outcome.
CONCLUSIONS: Bcc can cause infections outside the respiratory tract, mostly as hospital-acquired infections and in immunocompromised patients. Most patients were referred from countries inflicted by wars raising the possibility of a potential role of conflicts which need to be investigated in future studies. Directed therapy according to susceptibility results proved effective in most patients.