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

[Link]—facultative intracellular growth

[Link] – 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.

[Link]:

• 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

[Link] 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.