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[Microbiology](https://durgical.com/en/microbiology/) · [Other clinically important bacteria](https://durgical.com/en/microbiology/groups/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

## Key points

- Cystic fibrosis with rapid decline and a multidrug-resistant Gram-negative rod: B. cepacia complex.
- Melioidosis: a diabetic with pneumonia or abscesses after contact with moist tropical soil.
- Intrinsically resistant to aminoglycosides and polymyxins.
- B. pseudomallei can reactivate years later; it needs a long eradication phase.

## 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 →](https://durgical.com/en/conditions/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 →](https://durgical.com/en/conditions/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:

- [Ceftazidime](https://durgical.com/en/pharmacology/ceftazidime/)
- [Meropenem](https://durgical.com/en/pharmacology/meropenem/)

## 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

## Memory aid

"Burkholderia lives in the mud": in tropical mud it waits for the diabetic (melioidosis), and in hospital water it waits for the cystic fibrosis lung.

## 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.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/microbiology/burkholderia-cepacia-complex-and-burkholderia-pseudomallei/)

## Related

- [Pseudomonas aeruginosa](https://durgical.com/en/microbiology/pseudomonas-aeruginosa/)
- [Acinetobacter baumannii](https://durgical.com/en/microbiology/acinetobacter-baumannii/)

## Related conditions

- [Melioidosis](https://durgical.com/en/conditions/melioidosis/)
- [Sepsis and septic shock](https://durgical.com/en/conditions/sepsis-and-septic-shock/)

## What the colours mean

**Gram-positive**
Thick peptidoglycan wall: stains purple.

**Gram-negative**
Thin wall with an outer membrane: stains pink.

**Acid-fast**
Lipid-rich wall (mycobacteria): Ziehl–Neelsen stain.

**Contact**
Gown and gloves; dedicated equipment. For C. difficile, soap-and-water hand washing.

**Droplet**
Surgical mask within about a metre; single room.

**Airborne**
N95 respirator and a negative-pressure room.

[← Back to the group: Other clinically important bacteria](https://durgical.com/en/microbiology/groups/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](https://www.cdc.gov/melioidosis/about/index.html) (CDC, 2024); [About Burkholderia cepacia complex | B. cepacia | CDC](https://www.cdc.gov/b-cepacia/about/index.html) (CDC, 2024).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/microbiology/burkholderia-cepacia-complex-and-burkholderia-pseudomallei/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/microbiology/burkholderia-cepacia-complex-and-burkholderia-pseudomallei/