# Clinical characteristics and prognostic impact of Burkholderia cepacia complex colonization and infection in patients with hematologic malignancies

## TL;DR

This study examines how Burkholderia cepacia complex colonization progresses to infection in cancer patients, identifying risk factors for poor outcomes.

## Contribution

The study is the first to report clinical characteristics and prognostic factors of Bcc colonization and infection in hematologic malignancy patients.

## Key findings

- Post-colonization infections are an independent risk factor for poor prognosis in Bcc-colonized patients.
- Hematopoietic stem cell transplant recipients with post-colonization infections face significantly higher mortality.
- Respiratory, hepatic, and renal insufficiency are strongly associated with adverse outcomes in these patients.

## Abstract

In recent years, there has been an increasing number of reports on infections caused by the Burkholderia cepacia complex (Bcc). However, the clinical characteristics and prognosis of Bcc infections in patients with hematological malignancies remain unreported. This study aimed to delineate the clinical trajectory from colonization to active infection and to identify prognostic factors influencing outcomes in hematologic malignancy patients with Bcc colonization.

We conducted a retrospective analysis of 185 hematological malignancy patients with Bcc colonization at the Department of Hematology, The First Affiliated Hospital of Soochow University, from November 2019 to November 2022. This study aimed to identify independent risk factors for mortality in this patient population.

Respiratory failure (P < 0.001), hepatic insufficiency (P < 0.001), renal insufficiency (P = 0.001), and post-colonization infections (P = 0.01) were significantly associated with adverse prognosis in Bcc-colonized hematological malignancy patients. Post-colonization infections emerged as an independent risk factor for poor prognosis (HR = 2.855, 95%CI 1.214–6.715, P = 0.016). Subgroup analysis revealed that hematopoietic stem cell transplantation (HSCT) recipients with post-colonization infections had particularly poor outcomes (HR = 3.733, 95%CI 1.179–11.824, P = 0.025).

Progression from Bcc colonization to active infection, particularly in HSCT recipients, signifies a critical juncture with markedly increased mortality. Implementing vigilant surveillance protocols to prevent this transition is paramount for improving survival in this vulnerable population.