The prevalence and antibiotics resistance profile of <i>Burkholderia cepacia</i> in neonatal sepsis: a pioneer study in Kurdistan Region-Iraq

Burkholderia cepacia (B. cepacia) is Gram-negative, multidrug-resistant bacteria that can infect neonates and hospitalized patients, often spreading through contaminated medical devices. It causes various infections including sepsis, and it is difficult to treat due its antibiotic resistance. Over a three-year period (2021-2023), data from the ICU at Hevi Pediatric Teaching Hospital were reviewed and analyzed. Sepsis cases were identified based on clinical signs and confirmed through blood culture. B. cepacia identification and sensitivity test were confirmed using the VITEK system. Out of a total 1046 blood samples, 524 (50.1%) demonstrated positive bacterial growth, among which 142 (27.1%) identified as B. cepacia sepsis. The total neonatal cases counted for 123, 112 (91.1%) occurred in males and 11(8.9%) in females. Early-onset sepsis (EOS, ≤72 h) accounted for 49 cases (39.8%) and late-onset sepsis (LOS, > 72 h) for 74 (60.2%). The overall in-hospital mortality rate was 10.6% (13/123). Notably, B. cepacia isolates exhibited extensive multidrug resistance. Only a limited number of antimicrobials, including meropenem (3% resistance), ceftazidime (5%) and trimethoprim/sulfamethoxazole (9%) demonstrated promising results. These findings underscore an urgent need for coordinated interventions, emphasizing prudent antibiotic use and the strengthening of antimicrobial stewardship program to mitigate further resistance.