Burkholderia Pseudomallei & Cepacia Complex

Burkholderia pseudomallei and the Burkholderia cepacia complex are gram-negative, catalase-positive, oxidase-positive, obligate aerobic bacilli that are transmitted through direct contact with contaminated soil or water. The former is responsible for melioidosis, and the latter is a collection of species causing opportunistic infections in immunocompromised patients. Burkholderia pseudomallei primarily affects tropical regions, leading to melioidosis, which is frequently subclinical or asymptomatic. When presenting symptoms, pneumonia is most common, and the infection can develop into illnesses resembling tuberculosis. On the other hand, the Burkholderia cepacia complex (BCC) also causes pneumonia, primarily in individuals who are immunocompromised. BCC critically impacts cystic fibrosis patients, leading to severe acute respiratory distress called cepacia syndrome and causing other complications, such as encephalomyelitis and abscess formation. A key concern with Burkholderia is its typical multi-drug resistance, necessitating careful selection of antibiotics for treatment.