Microbiology · Other clinically important bacteria
Burkholderia cepacia complex and Burkholderia pseudomallei !
- Bacterium
- Gram-negative
- Contact
- For completeness
Soil and water bacteria: B. cepacia infects the lungs in cystic fibrosis; B. pseudomallei causes tropical melioidosis.
Updated 2026-11-01
Also called: melioidosis
At a glance
- Gram
- Gram-negative
- Shape
- Rod
- Oxygen
- Obligate aerobe
- Family
- Burkholderiaceae
- Stain
- B. pseudomallei: bipolar "safety pin" staining
Morphology
- Non-fermenting, oxidase-positive Gram-negative rod
- Grows on common media and on Burkholderia-selective media
- Related to Pseudomonas, whose genus it once shared
Transmission
- B. cepacia: contaminated water, solutions and medical products; equipment; person to person among patients with cystic fibrosis
- B. pseudomallei: wounds in contact with contaminated soil or water, inhaled dust or droplets, or untreated drinking water
- B. pseudomallei very rarely passes from person to person
Reservoir: Soil and water; B. pseudomallei in moist tropical soil (Southeast Asia, northern Australia, also foci in the Americas)
Isolation precautions
What the care team adds to standard precautions.
- Contact
- Gown and gloves; dedicated equipment. For C. difficile, soap-and-water hand washing.
Virulence factors
- Intrinsic resistance to many antibiotics, including aminoglycosides and polymyxins
- B. pseudomallei survives inside cells and can stay latent for years
- Forms biofilms in the cystic fibrosis lung and on devices
Diseases it causes
- Melioidosis: pneumonia, abscesses, skin ulcers or sepsis Melioidosis →
- Lung infection in cystic fibrosis ("cepacia syndrome", sometimes with rapidly fatal bacteraemia)
- Healthcare-associated infections from contaminated products or water Sepsis and septic shock →
Clinical picture
- Melioidosis: fever, pneumonia, liver, spleen or prostate abscesses, or sepsis; may appear months or years later
- Melioidosis risk factors: diabetes, alcohol, kidney or liver disease, chronic lung disease
- B. cepacia in cystic fibrosis: rapid decline in lung function
Diagnosis
- Culture of blood, sputum, pus or urine; warn the laboratory, because B. pseudomallei is a laboratory hazard
- Selective media to grow Burkholderia from cystic fibrosis sputum
- Identification by mass spectrometry or molecular tests
Treatment
Melioidosis: an intensive phase with ceftazidime or a carbapenem (meropenem), then a long eradication phase with trimethoprim-sulfamethoxazole. B. cepacia complex: guided by susceptibility testing; strains are multidrug-resistant (trimethoprim-sulfamethoxazole, ceftazidime or meropenem when susceptible).
Drug class only; doses and regimens are set by the clinician from the current guideline.
In Pharmacology:
Prevention
- Hand hygiene and keeping patients with cystic fibrosis apart from one another
- Keep wounds and devices away from non-sterile water
- In endemic areas, boots and gloves for work in soil and standing water
Test yourself
Think of the answer, then tap the question to see it.
Which patients are at highest risk of severe Burkholderia cepacia complex infection?
People with cystic fibrosis or other chronic lung disease and immunocompromised hospital patients.
Which disease does Burkholderia pseudomallei cause, and how is it acquired?
Melioidosis; through broken skin in contact with contaminated soil or water, by inhalation or by ingestion.
Which risk factor is most associated with melioidosis?
Diabetes mellitus.
Why is the laboratory warned when melioidosis is suspected?
Because B. pseudomallei can infect laboratory staff and must be handled with biosafety measures.
Related
Related conditions
← Back to the group: Other clinically important bacteria
Educational content on microorganisms; not a treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: About Melioidosis | Melioidosis | CDC (CDC, 2024); About Burkholderia cepacia complex | B. cepacia | CDC (CDC, 2024).
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Representative model, for educational purposes only.