Epidemiology, microbiological, clinical characteristics, and outcome of Burkholderia cepacia complex infections in non-cystic fibrosis adult patients from Qatar

Infections secondary to Burkholderia species are associated with diverse and challenging clinical presentations because of distinct virulence and antimicrobial resistance factors. The aim of the study is to evaluate the epidemiology, microbiological, and clinical outcomes of Burkolderia cepacia complex (Bcc) infections in non-CF patients from Qatar. A retrospective study was conducted on adult patients across all hospitals at Hamad Medical Corporation between January 2012-December 2018 to evaluate clinically relevant Bcc in non-CF patients. Over the 7 years period, 72 episodes of Burkolderia species infections were recorded, 64 were secondary to Bcc primarily affecting males (78.12%) with mean age of 53, from Middle and Southeastern region (92.2 %) affected predominantly by diabetes mellitus (34.4%), chronic kidney (23.4 %), coronary heart (20.3%), and hypertensive diseases (17.2%) while recent hospitalization, and admission to critical care were evident in 45.3% and 93.8 % of cases respectively. Main infection sites were urinary (43.8 %) and respiratory (29.7%) with associated bacteremia recorded in 26.6 % of cases. Microbiological characteristics demonstrated high level resistance profiles leading to delayed microbiological clearance in case of bacteremia (61 %) and management with multiple therapeutic agents (range 4-6) resulting in disease resolution in 90.6 % of cases with observed 30-day mortality of 7.8 %. Burkolderia cepacia infections is infrequent, recorded mainly in middle aged males with chronic comorbidities presenting as urinary, respiratory and bacteremia associated with hospitalization, admission to critical care and invasive procedures. High level antimicrobial resistance is observed necessitating multiple therapeutic agents and suboptimal bacteriological clearance.