Evaluation of Antibiotic Resistance of Burkholderia Species in the Last 10 Years in a Tertiary Care Hospital in Turkey

Introduction: Burkolderia cepecia complex (a cepacia complex) is a pathogen that can be found as a contaminant in hospital equipment and supplies, resistant to many antibiotics, and the isolation rate has also increased among patients other than cystic fibrosis in recent years. In this retrospective study, we aimed to evaluate the antibiotic susceptibility and antimicrobial resistance changes of a cepacia complex strains isolated from various clinical specimens in our hospital for the last 10 years. Materials and Methods: B. cepacia complex strains isolated from various clinkal specimens of patients without cystic fibrosis between 2010 and 2019 were included in this retrospective study. The strains were identified and antibiotic susceptibility were performed using automated VITEK-2 (BioMerieux, France) identification system. Results: A total of 131 a cepacia complex strains were included in this study. The mean age of the patients was 67.95 +/- 15.945; the male/female ratio was 3.85. Most of the samples (42.8%) were obtained from respiratory tract of the patients mostly from the intensive care units (34.4). It has been observed that the most isolation was in recent years (2018-2019) Pan-resistant were detected in 5.38% of a cepacia complex strains. 71.4% of the pan-resistant strains have been detected in recent years. Antibiotic resistance rates were 13% for trimethoprim-sulfamethoxazole (TMP-SXT), 15.2% for levofloxacin, 26% for ceftazidime, and 35.9% for meropenem, respectively. The highest resistance rate was against meropenem (47% to 35.9%), and the lowest resistance rate was against TMP-SXT (17% to 13%). Comparing the resistance rates in five-year periods, it was observed that meropenem resistance decreased from 64.3% to 22.5% (p< 0.001), and levofloxacin resistance decreased from 50% to 4.9% (p< 0.001) in the last period. TMP-SXT resistance rate increased from 9.5% to 14.6% in the last 5 year-period (p> 0.05). Conclusion: In conclusion, B. cepacia complex infections have increased in recent years among patients other than cystic fibrosis. Establishment of antimicrobial resistance surveillance systems and revealing the resistance patterns that have changed over the years are essential in determining treatment alternatives.