Burkholderia cenocepacia associated nosocomial lower respiratory tract infections: risk factors and drug resistance

Abstract

Objective To identify the risk factors of Burkholderia cenocepacia associated nosocomial lower respiratory tract infections (NLRTIs), and to investigate the drug resistance of Burkholderia cenocepacia strains. Methods A total of 138 patients with Burkholderia cenocepacia associated NLRTIs and 40 patients with non-Burkholderia cenocepacia associated NLRTIs were enrolled in the study. All patients were collected from the Second Affiliated Hospital of Wenzhou Medical University during January 2009 and December 2012. Clinical data and results of drug sensitivity tests were retrospectively reviewed. Chi-square test and Logistic regression analysis were performed to identify the risk factors of Burkholderia cenocepacia associated NLRTIs. Results Logistic regression analysis showed that combination use of 2 or more antimicrobial agents, mechanical ventilation, stay in intensive care unit (ICU) for more than two weeks, use of antacid H2 antagonist and deep venous puncture were the independent risk factors of Burkholderia cenocepacia associated NLRTIs (OR=6.315, 5.957, 5.254, 4.585 and 2.017, P<0.05). Burkholderia cenocepacia strains were sensitive to levofloxacin, ceftazidime and sulfamethoxazole; More than 40% strains were resistant to cefotaxime, ceftriaxone, cefepime, aztreonam and tetracycline; And nearly 100% strains were resistant to gentamicin, amikacin and tobramycin. Conclusion Burkholderia cenocepacia associated NLRTIs are more likely to occur in patients with combination use of 2 or more antimicrobial agents, mechanical ventilation, and those who stay in ICU for more than two weeks, or received antacid and deep venous punctures, and most Burkholderia cenocepacia strains are multiple drug resistant. Key words: Burkholderia cenocepacia; Cross infection; Risk factors; Drug resistance