Assessing the Impact of Burkholderia cepacia in Critical Care: Insights into Clinical Outcomes, Resistance Patterns, and Contamination Sources

Background and study aim: Burkholderia cepacia is known for causing severe infections in immunocompromised individuals. The bacteria's ability to form biofilms, secrete virulence factors, and resist multiple antibiotics exacerbates its pathogenicity. Despite the rising prevalence of B. cepacia infections in healthcare settings, particularly in critical care units, knowledge about its clinical profile, antimicrobial resistance patterns, and contamination sources in India remains limited. This study aimed to investigate the clinical characteristics, antibiotic susceptibility patterns, mortality rates, and potential sources of B. cepacia contamination in the critical care unit of G.B. Pant Hospital, Delhi. Patients and Methods: This cross-sectional study was conducted between January and July 2023. Blood samples from critically ill patients were cultured for B. cepacia identification and antimicrobial susceptibility testing using the Vitek 2 system. Environmental sampling (n=200) was performed to assess possible contamination sources. Data were analyzed using descriptive statistics, and associations were tested with chi-square and multivariate analyses. Results: Twenty-five patients with B. cepacia infections were included, with a 60% male predominance and an average age of 58.4 years. Diabetes (44%) and hypertension (40%) were common comorbidities. Ciprofloxacin (88%) and trimethoprim-sulfamethoxazole (88%) were the most effective antibiotics. The mortality rate was 40%, with chronic liver disease and prolonged ICU stay significantly associated with poor outcomes. Environmental sampling failed to identify a specific contamination source. Conclusion: B. cepacia poses a significant risk in critical care settings, with high antibiotic resistance and mortality. Tailored antibiotic therapy and stringent infection control measures are critical for managing infections and improving outcomes.