Saturday, 2 April 2011

Burkholderia cepacia: The superbug that infects patients in intensive care units

By Syed Akbar
Hyderabad:  Intensive care units of many hospitals have been colonised by superbug Burkholderia cepacia, a multi-drug resistant bacteria that can survive even in anti-biotic solutions. The bacteria is so dangerous that it can actually eat up penicillin as a nutrient. It is one of the common sources of hospital-acquired infection in India.
Only a few city hospitals have successfully isolated Burkholderia cepacia, while many including corporate hospitals continue to wrongly recognise the superbug as a member of Pseudomonas species. As many hospitals do not have sufficient laboratory facilities to isolate Burkholderia superbug, the International Burkholderia cepacia Working Group has taken up the task of creating awareness among hospital staff about the dangers of this superbug.
City doctors have found colonies of Burkholderia cepacia living in contaminated ventilators, indwelling catheters, nebulisers, chlorhexidine solution, bottled and tap water, nasal sprays and ultrasound gel. The superbug is capable of causing severe health complications including blood poisoning and even death.
According to Dr V Gautam of the International Burkholderia cepacia Working Group, the IBCWG is looking for collegial exchange of information and promotion of co-ordinated approaches to research. "Burkholderia cepacia complex causes bacteraemia and urinary and respiratory tracts infection. It is one of the most anti-microbial-resistant organisms in the clinical laboratory and the infections it cause are quite difficult to treat," he pointed out.
Doctors admit that they have often encountered Burkholderia cepacia in ICUs. "Since the bacteria is generally found in colonies, it does not cause harm to people whose immune system is strong. Patients with weak immunity and those suffering from cystic fibrosis are generally targeted by the bacteria," senior physician Dr M Govardhan said.
Patients admitted to hospitals that do not have good infection control practices fall prey to this bacteria. Stating that in the recent times the major concern is the rapid increase in the numbers of gram negative infections in hospitals without proper sanitation, Dr Annam Ravindra Babu said these bacteria are usually resistant to a lot of known medications.
"Earlier, the bacteria seen in hospitals were mainly Pseudomonas and Acinetobacter. The scenario has gradually changed. Previously sensitive organisms like Klebsiella and E coli, have become resistant to most antibiotics," he added.
According to infectious diseases expert Dr Nutankalva Lavanya, the superbug is capable of spreading from person to person. "Burkholderia cepacia most often causes pneumonia in immune-compromised individuals with a lung disease called cystic fibrosis. These organisms are naturally resistant to many common antibiotics including aminoglycosides and polymyxin B," she said.

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