BURKHOLDERI

Burkholderia
 is a genus of bacteria probably known for its
pathogenic members: Burkholderia mallei,
responsible for glanders, a disease that
occurs mostly in horses and related animals;
Burkholderia pseudomallei, causative
agent of melioidosis; and Burkholderia
cepacia, an important pathogen of
pulmonary infections in people with cystic
fibrosis (CF).
 The Burkholderia were previously part of
the Pseudomonas genus.
 Burkholderia pseudomallei are small,
motile, oxidase-positive, aerobic, gram-
negative bacilli.
 Burkholderia mallei are nonmotile.
 Burkholderia mallei
Melioidosis
 It is an infection of Burkholderia
pseudomallei in humans and other
animals such as sheep, goat, and horses.
 Signs of Melioidosis include pneumonia
and/or bacteremia, following development
of upper lobe cavities similar to
tubercolosis.
 Breaks and abscesses on the skin may
also develop.
 Meliodiosis
Glanders
 Is a disease of horses, mules and
donkeys that is transmissable to
humans caused by Burkholderia mallei
 In horses, the disease has prominent
pulmonary involvement, subcutaneous
ulcerative lesions and lyphatic
thickening of nodules.
 Inhalation can lead to primary
pneumonia.
Ulcerated lesion of a horse leg
Treatment to Melioidosis and Glanders
 B. pseudomallei and B. mallei are
generally susceptible to Ceftazidime,
Imipenem, Meropenem, Ceftriaxone,
Cefotaxime and Amoxicillin-Clavulanic
acid(Co-Amoxiclav)
 They are resistant to penicillin, ampicilin,
first and second generation
cephalosporins, gentamicin and
tobramycin
Treatment to Melioidosis and Glanders
 Therapy should be as follows:
10-14 days of
Ceftazidime/Imipenem/Meropenem
○ Sulfamethoxazole/Trimethoprim can be
considered for patients who have allergies
with the beta-lactam antibiotics.
Eradication therapy with Sulfamethoxazole-
Trimethoprim/Doxycycline should follow after
initial therapy for 3 months.
Burkholderia cepacia
Burkholderia cepacia complex
 Burkholderia cepacia complex consists of B.
cepacia plus at least 8 other species.
 B. cepacia has a low virulence ability, but is
an opportunistic pathogen.
 These grow in water, soil, plants, animals
and decaying vegetables.
 They are found in contaminated water in
hospitals and are able to infect patients with
cystic fibrosis.
B. cepacia complex
 B. cepacia are transmitted from patients
with cystic fibrosis(CF).
 They may have asymptomatic carriage
of the complex, a progressive
deterioration or a rapid progressive
deterioration of necrotizing pneumonia
with bacteremia.
Treatment of B. cepacia complex
 Patients who have the B. cepacia
complex with cystic fibrosis are difficult
to treat, since multidrug resistance
occurs.