Multidrug Resistance and Clinical Predictors of Mortality in Burkholderia cepacia complex Bacteremia: Local Evidence and Global Perspectives With a Review of the Literature
Abstract
Background Burkholderia cepacia complex (BCC) is an opportunistic, intrinsically multidrug-resistant (MDR) pathogen increasingly recognized as a cause of bloodstream infection (BSI) in non-cystic fibrosis adults. Data from South Asia remain limited, and predictors of outcomes have not been systematically evaluated using standardized MDR definitions. Materials and methods We conducted a six-year retrospective study (January 2019-December 2024) at a 2,000-bed tertiary care hospital in eastern India. Adults (≥18 years) with culture-confirmed BCC BSI and available antimicrobial susceptibility data were included. Antimicrobial susceptibility testing was performed using VITEK® 2 (bioMérieux, France) and interpreted according to Clinical and Laboratory Standards Institute (CLSI) M100 (33rd edition). MDR was defined as resistance to three or more of six antibiotic classes. Independent predictors of in-hospital mortality were assessed using multivariable logistic regression. The primary objective was to identify independent clinical predictors of in-hospital mortality in adults with BCC BSI. A secondary objective was to describe antimicrobial resistance patterns and contextualize findings through a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review (2004-2024). Results Among 124 patients (median age 48 years; 52.4% male), 64.5% of isolates were MDR. Overall in-hospital mortality was 33.9%. Carbapenem resistance was high (imipenem…
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