BURKHOLDERIA

BURKHOLDERIA:
Burkholderia mallei
Burkholderia pseudomallei
Burkholderia cepacian
OVERVIEW:
• opportunistic Gram-negative bacilli
• catalase-producing, lactose-nonfermenting
• obligately aerobic
• motile by means of single or multiple polar flagella
• exception: Burkholderia mallei is nonmotile
BURKHOLDERIA PSEUDOMALLEI:
 Saprophyte in soil, rice paddies

 Acquired by direct inoculation or inhalation of aerosols
 Cause melioidosis – acute pneumonia
 Although healthy people may get melioidosis, the major risk factors are diabetes, liver disease,
renal disease, thalassemia, cancer or another immune-suppressing.
**melioidosis=is usually an acute pneumonia; however, it is sufficiently
variable that subacute, chronic, and even relapsing infections may follow systemic
spread
LOCALIZED INFECTION:
 presents as an ulcer, nodule, or skin abscess and may result from inoculation through a break in
the skin
PULMONARY INFECTION:
 most common form of presentation of disease

 mild bronchitis den pneumonia ya qeder olabiler
 Cavitary lesions may be seen on chest X-ray, similar to those seen in pulmonary tuberculosis.
SEPSIS
DISSEMINATED INFECTION:
Treatment = intrinsically resistant to many antibacterials
Prevention= avoid contact with soil

BURKHOLDERIA CEPACIA COMPLEX:
• is a group of opportunistic species that has been found to contaminate reagents, disinfectants,
and medical devices similar to P aeruginosa
• causes health care-associated infections
• can complicate the course of CF but do not produce the mucoid polymer seen with P aeruginosa
• B. cepacia can be spread to susceptible persons by:
✓person-to-person contact
✓contact with contaminated surfaces
✓exposure to b. cepacia in the environment
BURKHOLDERIA MALLEI:
 Cause glanders disease

 Primarily affects horses
 Transmitted to humans by contact with tissues or body fluids of infected animals
 bacteria enter the body through abrasions in the skin and through mucosal surfaces or inhaled
via infected aerosols or dust contaminated by infected animals
IMPORTANT:
Melioidosis is a tropical pneumonia that relapses
Burkholderia cepacia infects CF patients and hospitalized patients
B.pseudomallei—facultative intracellular growth
B.cepacia – pili, invasion, elastase, biofilm

OTHER GRAM(-) RODS:
• There are many other gram-negative rods that rarely cause disease in humans.
• Some are members of the resident flora, and others come from the environment.
• Because many of these do not ferment carbohydrates or react in many of the tests routinely used
to characterize bacteria, their identification is frequently delayed while additional tests are tried
or the organism is sent to a reference laboratory.
• The clinical significance of all these organisms is essentially the same. The clinician usually
receives report of a “nonfermenter” or another descriptive term and a susceptibility test result,
and the significance of the isolate must then be determined on clinical grounds.
STENOTROPHOMONAS:
• Gram-negative bacilli
• at least ten species
•have pilli; twitching motility and biofilm formation
• Stenotrophomonas species range from:
common soil organisms =(S. nitritireducens)
opportunistic human pathogens = (S. maltophilia)
• Some of S. maltophilia strains are pathogenic to humans with multidrug resistant profile.
• S. indologenes can also cause or be part of polymicrobial infections in humans, especially small
children.
• S. maltophilia was initially named as Pseudomonas maltophilia, then named as Xanthomonas
maltophilia and then finally recognized as a genus itself.

S.MALTOPHILIA:
• an emerging nosocomial pathogen associated with opportunistic infections in patients with
cystic fibrosis, cancer, and HIV
virulence factor=protease
• Adherence to abiotic surfaces such as medical implants and catheters represents a major risk
for hospitalized patients.
• is a widespread environmental microorganism; main reservoirs are soil and plants
• recovered from water faucets, water traps, respirometers, sinks, suction catheters, and
occasionally, from cultures of the hands of hospital personnel
• patients with serious medical conditions or weakened immune system are more susceptible to
an infection
• can cause septicemia, endocarditis, conjunctivitis, mastoiditis, meningitis, postoperative
wounds, abscesses, urinary tract infections, and pneumonia
• Most healthy people do not get S. maltophilia infections even when exposed to the bacteria.
TREATMENT= resistant to many antimicrobials
S.maltophilia is dangerous for immunocompromised
ALCALIGENES:
• Gram-negative, aerobic cocco-bacillo or bacilli
• motile with amphitrichous flagella and rarely nonmotile
• non-fermenting bacteria
• from the family Alcaligenaceae
• found mostly in the intestinal tracts of vertebrates, decaying materials, dairy products, water,
and soil
• can be isolated from human respiratory and gastrointestinal tracts and wounds in hospitalized
patients with compromised immune systems
• are occasionally the cause of opportunistic infections, including nosocomial sepsis
• Alcaligenes faecalis causes nosocomial sepsis, arising from contaminated hemodialysis or
intravenous fluid, in immunocompromised patients.

• reported to cause sepsis, meningitis, peritonitis, enteric fever, appendicitis, cystitis, chronic
suppurative otitis media, abscesses, arthritis, pneumonitis, and endocarditis
• associated with fatal outcomes because of resistance to commonly used antibiotics
STAIN: Alcaligenes faecalis = Flagella stain
BRANHAMELLA:
• Branhamella catarrhalis is the only species
• formerly known as Moraxella catarrhalis
➢ Order: Pseudomonadales
➢ Family: Moraxellaceae
• Gram-negative diplococcus
• aerobic or facultative anaerobe
• non-flagellated and non-motile
• non-encapsulated
• oxidase(+), catalase(+)
• non-fermentative
(Neisseria can ferment sugars)
= is an opportunistic pulmonary invader, and causes harm especially in patients who have
compromised immune systems or any underlying chronic disease
• causes bacterial pneumonia, especially in adults with a compromised immune system
• cause infective exacerbations in adults with chronic lung disease
TREATMENT= resistant to penicillin
UNIQUE:
The hockey puck test = M. catarrhalis coloniescould be slid across the plate.
FLAVOBACTERIUM:
• Gram-negative bacilli
• nonmotile and motile
• Family: Flavobacteriaceae
• found in soil and fresh water in a variety of environments
 oxidase(+)
 catalase(+)
 yellow pigment
 resistant to antibiotics
UNIQUE: Flavobacterium species on sheep blood agar showing distinctive yellow pigmentation.

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BURKHOLDERIA:

• opportunistic Gram-negative bacilli

• motile by means of single or multiple polar flagella

• exception: Burkholderia mallei is nonmotile

 Saprophyte in soil, rice paddies

**melioidosis=is usually an acute pneumonia; however, it is sufficiently

 most common form of presentation of disease

Treatment = intrinsically resistant to many antibacterials

Prevention= avoid contact with soil

and medical devices similar to P aeruginosa

• causes health care-associated infections

• B. cepacia can be spread to susceptible persons by:

✓contact with contaminated surfaces

✓exposure to b. cepacia in the environment

 Cause glanders disease

Melioidosis is a tropical pneumonia that relapses

Burkholderia cepacia infects CF patients and hospitalized patients

B.pseudomallei—facultative intracellular growth

B.cepacia – pili, invasion, elastase, biofilm

or the organism is sent to a reference laboratory.

• at least ten species

•have pilli; twitching motility and biofilm formation

• Stenotrophomonas species range from:

common soil organisms =(S. nitritireducens)

opportunistic human pathogens = (S. maltophilia)

• S. maltophilia was initially named as Pseudomonas maltophilia, then named as Xanthomonas

maltophilia and then finally recognized as a genus itself.

• an emerging nosocomial pathogen associated with opportunistic infections in patients with

cystic fibrosis, cancer, and HIV

for hospitalized patients.

• is a widespread environmental microorganism; main reservoirs are soil and plants

occasionally, from cultures of the hands of hospital personnel

• can cause septicemia, endocarditis, conjunctivitis, mastoiditis, meningitis, postoperative

wounds, abscesses, urinary tract infections, and pneumonia

TREATMENT= resistant to many antimicrobials

S.maltophilia is dangerous for immunocompromised

• Gram-negative, aerobic cocco-bacillo or bacilli

• motile with amphitrichous flagella and rarely nonmotile

• from the family Alcaligenaceae

patients with compromised immune systems

• are occasionally the cause of opportunistic infections, including nosocomial sepsis

• Alcaligenes faecalis causes nosocomial sepsis, arising from contaminated hemodialysis or

intravenous fluid, in immunocompromised patients.

suppurative otitis media, abscesses, arthritis, pneumonitis, and endocarditis

• associated with fatal outcomes because of resistance to commonly used antibiotics

STAIN: Alcaligenes faecalis = Flagella stain

• Branhamella catarrhalis is the only species

• formerly known as Moraxella catarrhalis

• aerobic or facultative anaerobe

• non-flagellated and non-motile

(Neisseria can ferment sugars)

compromised immune systems or any underlying chronic disease

• causes bacterial pneumonia, especially in adults with a compromised immune system

• cause infective exacerbations in adults with chronic lung disease

TREATMENT= resistant to penicillin

• nonmotile and motile

• found in soil and fresh water in a variety of environments

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