Complicated treatment of Burkholderia cepacia complex (Bcc) and Pseudomonas aeruginosa in cystic fibrosis (CF) patients, an overview

Document Type : Review article

Authors

1 Department of Microbiology and Immunology, Faculty of Pharmacy, Egyptian Russian University, Badr City, Cairo, Egypt

2 Department of Microbiology and Immunology, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt

Abstract

Cystic fibrosis (CF) disorder is thought to be the most autosomal recessive condition with high morbidity and mortality rates in Caucasians. The primary cause of these individuals' early death is persistent airway bacterial infections. Pseudomonas aeruginosa and Burkholderia cepacia complex (Bcc) are the major pathogens that colonize the airways and cause progressive respiratory failure with high mortality in CF patients. It is important to note that both of these pathogens have large genomes compared to other known prokaryotes and can induce infections displaying a high degree of innate and acquired resistance to antimicrobial agents in the unique environment of CF lungs.  They are not only harmful to CF patients but also are significant pathogens in other vulnerable patients. Bcc has frequently been misidentified with other non-fermentative Gram-negative bacilli (NFGNB), particularly Pseudomonas species, in cases from nations with poor infrastructure. It must be accurately identified and distinguished since it has an inherently different susceptibility pattern from P. aeruginosa. This narrative review aims to highlight the most important information about these selected difficult-to-treat pathogens, whose management is particularly challenging, to understand the similarities and differences better and provide possible therapeutic approaches.

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