El Chakhtoura NG, et al. - In a cohort of non-cystic fibrosis (CF) patients from the US Veterans Health Administration (VHA), investigation of Burkholderia cepacia complex (Bcc) bloodstream infections (BSIs) was performed. In this study, researchers identified mostly hospital-acquired cases. There appeared high mortality, significant resistance to ceftazidime, and limited use of trimethoprim-sulfamethoxazole (TMP-SMX). Observations enhanced the understanding of Bcc infection in non-CF patients and highlighted the necessity for interventions to improve their outcome.

Methods

• Patients with Bcc BSI at facilities nationwide from 1999 through 2015 were identified using VHA databases.
• Clinical characteristics, treatments, and outcomes were ascertained and factors associated with 30-day mortality were identified in logistic regression analysis.

Results

• 248 patients with Bcc BSI were identified; these were of advanced age (mean, 68 years), chronically ill, and had severe disease.
• Central venous catheters (41%) and pneumonia (20%) were identified as the most common sources.
• Findings revealed that most of the cases were hospital-acquired (155 [62%]) or healthcare-associated (70 [28%]).
• Mortality of 16%, 25%, and 36% was observed at 14, 30, and 90 days respectively.
• Findings demonstrated activity of trimethoprim-sulfamethoxazole (TMP-SMX) and fluoroquinolones against 94% and 88% of isolates, respectively.
• Susceptibility to ceftazidime and meropenem was evident in approximately 70% of the isolates.
• Documentation indicated that fluoroquinolones (35%) was the most prescribed antibiotics, followed by carbapenems (20%), TMP-SMX (18.5%), and ceftazidime (11%).
• Regression analysis identified an association of age (OR, 1.06 [95% confidence interval {CI}, 1.02–1.10], per added year) and the Pitt bacteremia score (OR, 1.65 [95% CI, 1.44–1.94], per unit increase) with higher 30-day mortality.