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Title: Burkholderia cepacia: Understanding Pathogenicity, Virulence Factors, and Therapeutic Strategies
Authors: Muhammad Saeed, Farhan Rasheed, Iqra Jamil, Muhammad Hidayat Rasool, Noore Saba, Maqsood Ahmad, Akhlaaq Wazeer, Abdul Waheed, Mohsin Khurshid
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2024
Volume: 13
Issue: 1
Language: English
DOI: 10.35787/jimdc.v13i1.1183
Burkholderia cepacia, formerly described as Pseudomonas cepacia, belongs to the Burkholderia cepacia complex (Bcc), a collection of closely related gram-negative bacteria that is considered a leading organism in causing pulmonary infections in humans. In healthcare settings, Burkholderia species have the ability to colonise medical equipment and surfaces, posing a threat of nosocomial infections. Moreover, they exhibit inherently resistance to various classes of antibiotics, thus being nominated as multi-drug resistant pathogens (MDR), that is why treatment of infections caused by these organisms is challenging. Enzymes such as metalloproteases, serine proteases, metalloproteases, and other extracellular lipases play a major role in its pathogenesis. In addition to this, different components, such as pili, flagella, and lipopolysaccharide (LPS), have a role in both the motility of the bacterial cell as well as its adherence to host cells. Identification is usually done with different biochemical reactions such as late oxidase activity, oxidation of glucose, variable lysine decarboxylation, maltose, mannitol, and lactose, and hydrogen sulphide gas production. Advanced techniques like semi-nested PCR, real-time PCR, or MALDI-TOF mass spectrometry enable quick and precise identification.
Key words: Multi-drug resistant, Polymerase chain reaction, Burkholderia cepacia complex, matrix assisted laser desorption ionisation, time of flight mass spectrometry
To understand the pathogenicity, virulence factors, and therapeutic strategies related to Burkholderia cepacia complex (BCC).
This is a review article that synthesizes information from various sources to provide a comprehensive overview of Burkholderia cepacia complex. It discusses its taxonomy, habitat, dispersion, prevalence, transmission, virulence mechanisms, disease associations, microbial detection and characterization, and antimicrobial resistance.
graph TD
A["Literature Search and Review"] --> B["Analysis of Pathogenicity Factors"];
B --> C["Analysis of Virulence Factors"];
C --> D["Review of Therapeutic Strategies"];
D --> E["Synthesis of Findings"];
E --> F["Article Drafting"];
F --> G["Review and Editing"];
G --> H["Final Publication"];
The article highlights the opportunistic nature of BCC, its ability to survive in diverse environments, and its significant threat to immunocompromised individuals, especially those with CF. The complex taxonomy and the presence of multiple virulence factors contribute to its pathogenicity. The inherent antimicrobial resistance of BCC poses a major challenge for effective treatment, necessitating prompt and accurate identification for targeted interventions. The contamination of disinfectants further exacerbates the transmission risk.
- Burkholderia cepacia complex (BCC) is a group of Gram-negative bacteria that are significant causes of pulmonary infections, particularly in cystic fibrosis (CF) patients.
- BCC species are often multi-drug resistant (MDR) and can colonize medical equipment, leading to nosocomial infections.
- Virulence factors include enzymes like metalloproteases and serine proteases, as well as components such as pili, flagella, and lipopolysaccharide (LPS). Biofilm formation is also a key virulence mechanism.
- Identification of BCC can be challenging with conventional methods, necessitating advanced techniques like PCR and MALDI-TOF mass spectrometry.
- Intrinsic resistance to various antibiotics, coupled with mechanisms like altered outer membranes and efflux pumps, contributes to treatment challenges.
Burkholderia cepacia complex is a significant pathogen with multiple virulence factors and intrinsic antibiotic resistance, making infections difficult to treat. Its opportunistic nature and ability to cause outbreaks in healthcare settings, particularly in CF patients, underscore the importance of precise identification and effective infection control strategies. Advanced molecular techniques are crucial for rapid and accurate diagnosis, enabling timely and appropriate therapeutic interventions.
- Burkholderia cepacia was formerly described as Pseudomonas cepacia. (Confirmed in text)
- BCC comprises at least nine genetic species that are difficult to distinguish phenotypically. (Confirmed in text, though later mentions at least 17 closely related species)
- BCC species are Gram-negative rods and are non-fermenters. (Confirmed in text)
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