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About Burkholderia cepacia (B. cepacia)
B. cepacia is the name for a group or “complex” of bacteria that can be found in soil and water. B. cepacia bacteria are often resistant to common antibiotics.

Populations susceptible to B. cepacia infection
B. cepacia poses little medical risk to healthy people. However, people who have certain health problems like weakened immune systems or chronic lung diseases, particularly cystic fibrosis (CF), may be more susceptible to infections with B. cepacia. B cepacia is a known cause of infections in hospitalized patients.

Symptoms of B. cepacia infection
The effects of B. cepacia on people vary widely, ranging from no symptoms at all, to serious respiratory infections, especially in patients with CF.

How B. cepacia infection is spread
Transmission of B. cepacia from contaminated medicines and devices has been reported.

CDC has been notified of reported cases of B. cepacia infection associated with contaminated over-the-counter nasal spray, distributed as Major Twice-a-Day 12 Hour Nasal Spray. There have been reports of human infection with B. cepacia associated with this nasal spray in Colorado and Missouri. The manufacturer, Propharma Inc., has recalled lot numbers E4410, F4433, H4464, K4496, L4529, L4535, M4536, A4558, A4588, and B4597 of this product.

In 1996-1998, reported cases of B. cepacia infection were associated with contaminated mouthwash. (See http://www.cdc.gov/mmwr/preview/mmwrhtml/00055575.htm.)

For a comprehensive list medicines and devices that have been associated with B. cepacia contamination, see p. 43 of CDC’s Environmental Guidelines for Healthcare Facilities at http://www.cdc.gov/ncidod/hip/enviro/guide.htm.

B. cepacia can also be spread to susceptible persons by

• person-to-person contact
• contact with contaminated surfaces
• exposure to B. cepacia in the environment

Careful attention to infection control procedures like hand hygiene can help reduce the risk of transmission of this organism. For more information on hand hygiene and infection control practices see, http://www.cdc.gov/handhygiene/ and http://www.cdc.gov/ncidod/hip/ISOLAT/Isolat.htm.

Treatment of B. cepacia infection
B. cepacia can be resistant to many common antibiotics. Decisions on the treatment of infections with B. cepacia should be made on a case-by-case basis.

What CDC is doing
CDC has issued a CDC Health Advisory about the current recall of contaminated nasal spray and is working with state and local health departments to monitor reported cases of infection. CDC is also working with the Food and Drug Administration (FDA) on this issue.

For more information:
See the Cystic Fibrosis Foundation’s Web site for more information about the risks of B. cepacia infection for people with CF.
See http://www.cdc.gov/mmwr/preview/mmwrhtml/00055575.htm for more information about B. cepacia.

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