Burkholderia cepacia Complex and Septic Transfusion Reactions: An In-depth Review

Abstract

Burkholderia cepacia complex has become serious healthcare concern because of its association with hospital outbreaks as this microbe has remarkable capability to colonize different surfaces like catheters, IV sets, respiratory devices, nebulizers and even disinfectants. Another worrisome concern with this bacterium is the problem of antibiotic resistance which leads to increased morbidity and mortality rate of the affected individuals. As it is generally considered as a nosocomial pathogen, so the ratio of community-acquired infections is very low. Common routes of transmission of BCC are through ingestion, inhalation or subcutaneous inoculation. Affected individuals typically represents wide range of non-specific and specific symptoms and signs, which mainly depends upon the immunity level of the patient and the route of transmission. Bacteraemia caused by this organism occurs through entry of this bacterium in the blood mainly via direct venous line injection and through respiratory tract. Since there are no specific nutritional requirements as well as they have the ability to grow in damp areas, so it can colonize the ventilators and ventilation system, which eventually leads them to come into contact with epithelial barriers. These organisms ae motile because of the presence of polar flagellum and also have the ability to evade phagocytosis from macrophages and epithelial cells, hence they can easily cross the epithelial barriers and can invade the underlying tissues and cause infection there. Eventually, they infiltrate the bloodstream which results in systemic spreading of this organism throughout the body. Treatment of infections caused by Burkholderia cepacia complex is comparatively difficult as they showed remarkable resistance against various classes of antimicrobial drugs. At present, there is no commercially available vaccine against any member of the BCC complex.