Burkholderia cepacia

Also called B. cepacia, Burkholderia cepacia complex, or Bcc

Published
December 18, 2024
Last updated
May 24, 2024

About Bcc

The Burkholderia cepacia complex (Bcc) is a group of closely related Gram negative, rod-shaped bacteria that can be found in soil and water. 

Bcc can be spread by person-to-person contact, contact with contaminated surfaces, and environmental exposure. Outbreaks have been linked to intrinsic and extrinsic contamination of various products used in healthcare settings. These products usually have an aqueous component or are exposed to tap water. Contaminated medical products which have led to outbreaks in healthcare facilities include saline flushes, mouthwash, oral liquid docusate, skin cleanser, ultrasound gel, nasal spray, nebulizers, antiseptics, disinfectant solutions, balloon pumps, and temperature probes. 

Key Point: Maintain a low threshold (e.g., single case or small cluster) for reporting a Bcc outbreak or product concern.

Bcc have intrinsic resistance to antimicrobials and preservatives which enhance their ability to contaminate aqueous products. 

Bcc can form biofilms in building water systems, including healthcare facilities and product manufacturing sites. 

Bcc emerged in the healthcare setting as a significant and transmissible pathogen causing pulmonary infections among pediatric patients with cystic fibrosis.

Resources, Guides, Reports, & Toolkits

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Featured New Updated

Example line list and data collection tool for a Bcc outbreak investigation


This form can be adapted by adjusting the fields to collect the specific case and exposure information relevant to the investigation.

Featured New Updated

MedWatch Online Voluntary Reporting Form

By FDA

Use this form to report a Bcc-related outbreak or product concern.

Featured New Updated

Burkholderia cepacia in Healthcare Settings

By CDC

CDC website on Bcc

Featured New Updated

Best practices for manufacturers of non-sterile, water-based drug products

By FDA

This resource could be helpful to investigators when responding to a Bcc outbreak with potential medical product contamination.

New Updated

Burkholderia cepacia: This Decision Is Overdue

By Journal

FDA authors reviewed the regulatory and scientific impact of Bcc, describing FDA guidance, manufacturing control measures, and possible points of origin for microbial contamination.

New Updated

Bcc: a Feared Contamination Risk in Water-Based Pharmaceutical Products

By Journal

This article summarizes Bcc outbreaks and describes the mechanisms behind pharmaceutical product contamination.

Burkholderia cepacia Outbreak Reports & News