1.Violet-pigmented Burkholderia contaminans sequence type 922 bacteremia in an end-stage renal disease patient – a case report and review of the literature
Ahmad S. ; Mohd Sukhaimi N.A. ; Shahimi S.S. ; Mahfodz N.H. ; Soh Y.H. ; AbuBakar S. ; Choong K.Y. ; Loong S.K.
Tropical Biomedicine 2026;43(No. 1):1-4
Burkholderia cepacia complex (Bcc) is an emerging nosocomial pathogen, with violet-pigmented
strains representing a rare and possibly neglected but clinically important subset. We report a case
of a 62-year-old man with end-stage renal disease on dialysis who presented with fever and cough.
Blood cultures from central and peripheral lines grew violet-pigmented, non-lactose fermenting
colonies on MacConkey agar, later identified as Burkholderia contaminans sequence type 922 (ST922)
via a multimodal approach. Initial phenotypic methods (VITEK-2, API20NE and MALDI-ToF) and 16S
rDNA sequencing were inconclusive; however, multilocus sequence typing confirmed ST922, a strain
previously reported in India and associated with nosocomial outbreaks. The isolate was susceptible to
ceftazidime, trimethoprim/sulfamethoxazole, minocycline, and meropenem. The patient responded
well to intravenous ceftazidime, with subsequent blood cultures yielding no growth. Notably,
antimicrobial susceptibility varied geographically, with some ST922 isolates resistant to third-generation
cephalosporins. This case illustrates the diagnostic challenges in Bcc speciation and highlights the value
of molecular tools such as MLST. The detection of this strain in Malaysia raises concerns about global
dissemination, potentially via contaminated medical devices or water systems. Early recognition of
violet-pigmented Bcc in resource-limited settings can facilitate prompt, targeted treatment. This report
underscores the need for environmental surveillance and antimicrobial stewardship to prevent spread,
while reinforcing Bcc’s ecological adaptability and clinical significance, especially in immunocompromised
individuals.


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