Clinical characteristics of children with Burkholderia cepacia infection and study on drug susceptibility

ZHU Ting-ting; XU Ming-ji; WEN Shun-hang; LIU Cai-xia

doi:10.19538/j.ek2025060614

Abstract：Objective To analyze the clinical characteristics of Burkholderia cepacia(BC)infections in pediatric patients and evaluate the drug susceptibility of isolated strains,thereby providing a reference for clinical diagnosis and treatment.Methods Clinical data and drug susceptibility profiles were collected from 58 pediatric patients hospitalized with Burkholderia cepacia infections at the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between January 1,2019,and December 31,2023.A retrospective analysis was performed,encompassing patients' demographic information,high-risk factors,sample sources,departmental distribution,laboratory test results,antibiotic susceptibility patterns,and clinical outcomes.Results Among the 58 patients,there were 34 males and 24 females,with ages ranging from 49 days to 17 years and a median age of 9 months(4.0-54.3).The age distribution was as follows:≤1 year:31 cases(53.4％);＞1-3 years:8 cases(13.8％);＞3-5 years:6 cases(10.3％);＞5-10 years:6 cases(10.3％);＞10 years:7 cases(12.1％).The department with the highest incidence was the pediatric intensive care unit(86.2％,50/58),followed by pediatric nephrology(10.3％,6/58).The sample sources comprised sputum(n=50),urine(n=6),blood(n=5),abdominal effusion(n=3),catheter tips(n=1),and cerebrospinal fluid(n=1),totaling 66 strains.Burkholderia cepacia was detected across multiple sites in 6 patients.The clinical diagnoses encompassed lung infection(n=50),urinary tract infection(n=6),sepsis(n=5),peritonitis(n=3),among others.Notably,49 cases(84.5％)were identified as hospital-acquired infections,while 9 cases(15.5％)were classified as community-acquired infections.Among the 58 BC strains analyzed,the resistance rate of Burkholderia cepacia to ceftazidime was 3.4％(2/58),while levofloxacin exhibited no resistance,though an intermediate susceptibility rate of 6.9％(4/58)was observed.The resistance rate to sulfamethoxazole/trimethoprim was 5.2％(3/58).Clinical outcomes of the cases were as follows:35 patients were cured,12 showed improvement,9 discontinued treatment,and 2 died.Conclusion Pediatric BC infections are primarily nosocomial infections,frequently occurring in intensive care units(ICUs),with pulmonary infections representing the most prevalent clinical manifestation,demonstrating a high susceptibility to ceftazidime,sulfamethoxazole/trimethoprim,and levofloxacin.