Prevalences, distribution and antibiotic sensitivity profile of

Burkholderia cepacia complex.

Isolated from Blood, Urine and Sputum Specimens in

General Hospital Dr. Soetomo Surabaya

TIAR SONDANG ULI SIHOTANG*, AGUNG DWI WAHYU WIDODO

Microbiology Department, Medical Faculty University of Airlangga Surabaya

Clinical Microbiology Unit General Hospital Dr. Soetomo, East Java Indonesia

TIAR SONDANG ULI SIHOTANG*

Corresponding E-mail: agungmdimun19@gmail.com, Telp : +6281331111760

ABSTRACT

Background: Burkholderia cepacia complex (Bcc) was a nosocomial organism that primaily

affects patients with immune dysfunction or with preexisting damage to their respiratory

epithelium¹. Moreover, the occurrence of Bcc isolates that were resistant to multiple antibiotics

keeps increasing. Those isolates may become potential reservoirs of resistant genes and cause

theraupeutic difficulties in clinical settings ² ³.

Objectives: The aim of this study was to investigate of Bcc isolates from blood, urine, sputum

specimens sent to Clinical Microbiology Unit General Hospital Dr. Soetomo from 1 July 2018 –

31 December 2018 and its antibiotic susceptibility pattern to various antibiotics.

Method: This was a retrospective studied using blood, urine, sputum specimens sent to Clinical

Microbiology Unit General Hospital Dr. Soetomo, in the period of 1 July – 31 December 2018.

Identification and susceptibility tests of Bcc were performed by the phoenix system and CLSI

standard.

Results: We were successfully identified 19 isolates Bcc, from blood 6 isolates, urine 11 isolates,

sputum 2 isolates and no isolates came from pus specimens. Most samples obtained from female

patients (63%) and patient came from medical ward (58%) and from patient’s age was highest at

0-40 years old range (63%). All of those isolates were resistant to Ampicillin, Piperacillin,

Ampicillin-sulbactam, Amoxicillin-Clavulanate and Fosfomycin. However, most of them were

sensitive to Ceftazidime (89%), Trimethoprim-Sulfamethoxazole (73%), Chloramphenicol (47%)

and Levofloxacin (47%) ⁵.

Discussion : Bcc is an aerobic, Gram-negative and multi-drug resistance bacteria that cannot

ferment glucose. Bcc, important opportunistic bacteria in immunosuppressed patients, causes

severe pulmonary infections ³. Bcc due to contaminated medicines or medical devices. Bcc is

naturally resistant to many antimicrobialagents including carboxypenicillins, polymyxin, and

often, aminoglycosides due to the efflux pump activity. However, trimethoprim–

sulfamethoxazole, meropenem, doripenem, doxycycline, minocycline, and ceftazidime have been

shown to be among the most active antimicrobial agents to date ². For this reason, the disease

should be effectively treated otherwise it should not be forgotten that the disease will result in

mortality ³.

Conclusions: We were identified Bcc have multiantibiotic resistance, except Ceftazidime,

Trimethoprim-Sulfamethoxazole, Chloramphenicol and Levofloxacin were sensitive.

Acknowledgment: Thank God, I was able to finish this article. Likewise for my teacher Agung

dwi wahyu Widodo, that there have been many give enter when making this article and my friends

who already support during the making of this article.

Conflict of interest: No potential conflict of interest was reported by the authors.

Keywords: Burkholderia cepacia complex, Nosocomial, General Hospital Dr. Soetomo,

susceptibility pattern

Reference :

1. Iabai Los-arcos, Oscar len, Maria Teresa martin-Gomez, et al. Lung transplantation in two

cystic fibrosis patients infected with previously pandrug-resistant Burkholderia cepacia

complex treated with ceftazidime-avibactam. Infection. 2019;47(2):289-292

2. Maroun M Sfeir. Burkholderia cepacian complex infections : More complex than the

bacterium nama suggest. Journal of infection. 2018 Sep;77(3):166-170

3. Selcuk Nazik, Bircan Topal, Ahmet Riza Sahin, Selma Ates. Nosocomial Burkholderia

cepacian infection in a tertiary hospital ; Five-year surveillance : A retrospective cross-

sectional study. Journal of Surgery and Medicine. 2019;3(2):121-123

4. Shu shun Li, Marwah saleh, Richard F Xiang, et al. Natural Killer cells kill Burkholderia

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5. Wayne, PA : Clinical and Laboratory Standards institute CLSI. Performance Standards for

Antimicrobial Susceptibility Testing. 29th ed. CLSI supplemen M100.2019

 SEX

70

60

50

40

30

20

10

0
FEMALE MALE

SEX
 63 37

AGE

70

60

50

40

30

20

10

0
0 - 40 41 - 80

AGE
 21 58 21

WARD

60

50

40

30

20

10

0
SURGICAL MEDICAL ICU

WARD

31 58 10

SPECIMEN

60

50

40

30

20

10

0
BLOOD URINE SPUTUM

SPECIMEN
SENSITIVITY ACCORD TO CLSI 2019

GRUP A LEVOFLOXACIN MEROPENEM TRIMETHOPRIM-

PRIMARY TEST 47 % - SULFAMETHOXAZOLE

AND REPORT 73 %

GRUP B CEFTAZIDIME MINOCYCLINE

OPTIONAL 89% -

PRIMARY TEST

REPORT

SELECTIVELY

GRUP C CHLORAMPHENICOL

SUPPLEMENTAL 47%

REPORT

SELECTIVELY