Abstract
Introduction: Burkholderia cepacie complex (Bcc) is an emerging multidrug-resistant gram-negative bacteria frequently isolated from health care facilities worldwide. The present study investigated the prevalence of Bcc in health care settings in Sebha, Libya. Methods: Two hundred swabs were initially collected. Forty-seven nosocomial Bcc isolates were identified from three medical care facilities, i.e., 40 (20%) from Sebha Medical Center, five from the Sebha Infertility Treatment Center, and two from Althanweya Clinic. The isolates were identified using a combination of biochemical tests and USP chapter <60> Microbiological Examination of Non-Sterile Products Tests for Burkholderia Cepacia Complex guidelines. A UPGMA dendrogram was used to examine the biochemical relationship of isolates. Some of the putative virulence factors contributing to the pathogenicity of the isolates were also explored. Results: Of the 47 isolates, 29.79% were B. cepcia, 23.40% B. cenocepcia, 12.77% B. thailandensis, 8.51% B. vietnamiensis, 6.38% B. ambifaria, B. pyrrocinia, and B. stabilis each, 4.26% B. anthina, and 2.13% B. arboris. A variation in virulence factors was observed among isolates; all (100%) isolates produced siderophore, 91% had capsules, 91% produced lipase, 89% formed a biofilm, and 49% produced alkaline protease. The UPGMA dendrogram revealed that Bcc species shared substantial phenotypical identity among themselves. Conclusion: In developing countries with limited resources, diagnostic challenges in identifying Bcc species can be resolved using selective media and USP chapter <60> guidelines.