Burkholderia cepacia complex

Lisa Spacek, M.D., Ph.D.
Burkholderia cepacia complex is a topic covered in the Johns Hopkins ABX Guide.

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  • Multi-species complex of bacteria, B. cepacia complex (Bcc) with species: B. cepacia, B. cenocepacia, B. multivorans, B. stablis, B. vietnamiensis, B. dolosa, B. ambifaria, B. lata, B. pyrrocinia.
    • Known to produce secondary metabolites with antifungal and antimicrobial properties.[10]
      • Biosynthesis of antibiotics is controlled by quorum sensing, a global regulatory system that coordinates bacteria behavior, allows cell-to-cell communication, and alters gene expression according to population density.[10][15]
  • Non-fermenting, aerobic Gram-negative rod [Fig 1]. Originally described by Burkholder as a causative agent of bacterial rot of onion bulbs (Latin, cepacia = onion).[11]
    • Formerly known as Pseudomonas cepacia.
  • Waterborne, nosocomial, opportunistic pathogen. Ubiquitous in water, soil, plants.
  • Recognized as the etiologic agent of "foot rot" or "swamp rot," maceration and hyperkeratosis affecting the toe webs of American soldiers who trained in wet terrain.[6]
    • Adheres to epithelial cells and mucin; survives inside epithelial cells and macrophages; forms biofilms; secretes catalases, proteases and siderophores.[1]
    • B. cenocepacia associated with the highest risk of mortality.[12]
    • Inherently resistant to many antibiotics, including first and second-generation cephalosporins, carboxypenicillins, aminoglycosides and polymyxins.[6] Multi-drug resistance is common.[16][8]

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Last updated: December 2, 2019