Burkholderia cepacia Complex Comprising Divergent Strains Identified as a Dominant Cause of Pediatric Bloodstream Infections in Myanmar

Burkholderia cepacia complex (Bcc) consists of genetically diverse species having highly pathogenic potential to humans, causing nosocomial infections via environmental sources. In Myanmar, Bcc has been known as one of the common pathogens of infectious diseases, with relatively low prevalence. However, recently, an increase in isolation from bloodstream infections was noted in a pediatric hospital in Yangon. From December 2023 to June 2025, among the organisms isolated from blood samples (n = 586), Bcc was the most dominant species (n = 178, 30.4%), followed by Klebsiella pneumoniae (16.4%) and Candida spp. (12.7%). Species of Bcc and their genetic types were identified by sequence analysis of partial recA and gyrB genes. Based on the recA sequence, Bcc isolates were identified as B. cepacia (49%), B. cenocepacia (43%), and B. contaminans (7%), having 10, 3, and 2 recA-allelic types, respectively. Similarly, sequences of gyrB revealed the three Bcc species with multiple allelic types. Ceftazidime MIC > 32 mg/L and meropenem MIC > 16 mg/L were found in 38% and 34% of Bcc isolates, respectively. These findings indicated that Bcc, comprising three species with genetically diverse clones, has become the main cause of bloodstream infections in the pediatric hospital in Myanmar.