Convergence of Hypervirulence and Multidrug-Resistance in Burkholderia cepacia Complex Isolates from Patients with COVID-19

Mengjiao Du; Cheng Chi; LuYing Xiong; Jincheng Rong; Maoli Yi; Qi Zhao; Xiaohui Chi

doi:10.2147/IDR.S495676

Convergence of Hypervirulence and Multidrug-Resistance in Burkholderia cepacia Complex Isolates from Patients with COVID-19

Infect Drug Resist. 2024 Dec 27:17:5855-5866. doi: 10.2147/IDR.S495676. eCollection 2024.

Authors

Mengjiao Du^#^{1

2}, Cheng Chi^#¹, LuYing Xiong², Jincheng Rong¹, Maoli Yi¹, Qi Zhao¹, Xiaohui Chi¹

Affiliations

¹ Department of Medical Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, People's Republic of China.
² State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Burkholderia is a conditioned pathogen in the medical setting and mainly affects patients with cystic fibrosis. We found co-infection with Burkholderia cepacia complex (Bcc) in many patients with respiratory tract infections, including H7N9 and COVID-19. However, previous studies have not focused on co-infections with BCC and respiratory viruses. Therefore, this study attempted to clarify the evolution of COVID-19-Bcc and H7N9-Bcc in terms of genetic background, antibiotic resistance, and virulence phenotypes.

Methods: This study retrospectively collected 49 Bcc isolated from patients with H7N9 and COVID-19 in a tertiary hospital of Zhejiang Province, of which 42 isolates were isolated from patients with H7N9, seven isolates were isolated from patients with COVID-19. The collected isolates were tested for antibiotic susceptibility, Galleria mellonella infection model, and whole-genome COVID-19-Bcc Characterization.

Results: The test results of 49 strains of Bcc showed that the strains isolated from COVID-19 patients accounted for 57.1% of multidrug-resistance resistant strains. Statistical analysis of the median lethal time of G. mellonella showed that the median fatal time for COVID-19-Bcc was shorter and more virulent than that of H7N9-Bcc (P<0.05). The results of phylogenetic analysis indicated that COVID-19-Bcc may have evolved from H7N9-Bcc.

Conclusion: In this study, co-infection with BCC in many patients with respiratory tract infections, including H7N9 and COVID-19, was first identified and clarified that COVID-19-Bcc may have evolved from H7N9-Bcc and has the characteristics of hypervirulence and multidrug resistance.

Keywords: Burkholderia cepacia complex; COVID-19; H7N9; comparative genomic analysis; hypervirulence; multidrug-resistance.

Grants and funding

This work was supported by research grants from the National Key Research and Development Program of China (Nos.2016YFD0501105 and 2017YFC1200203) and National Natural Science Foundation of China (No. 82072314).