(0307) Comprehensive Analysis of Burkholderia Species Head and Neck Infections: A Systematic Review and Meta-analysis

Introduction: Burkholderia species head and neck infections pose significant mortality to patients, especially to those who are immunocompromised. We aim to discuss the demographics, symptoms, treatment, and comorbidities associated with this pathogen.

Methods: PRISMA 2020 guidelines were followed. CINAHL, PubMed, and Scopus were searched from inception until October, 18 2023. Inclusion criteria included non-surgical patients who were diagnosed with any head and neck Burkholderia infection. Demographics included N of patients, patient age, and gender. Symptoms, antibiotics given, bacteriology, and mortality were analyzed. Meta-analysis of continuous measures (mean, median) and proportions (%) with a 95% confidence interval (CI) was conducted. Studies were accessed for bias via the JBI appraisal tool.

Results: In total, 740 studies were screened with 45 studies (N = 132) being included. In total, 50.1% were female (95% CI: 43-57). The total mean age was 28.7 years (SD = 16.3, range 3-83). The mortality rate was 9% (95% CI: 5-14) with septic shock occurring in 10% of patients (6.2-15.1). Common symptoms at presentation included pyrexia at 60.3% (95% CI: 47.2-72.6), headache at 19% (12.8-26.1), facial palsy at 11.6% (7.5-17), chills at 11.4% (8.2-17.9), trismus at 10.9% (6.9-16.1). Common investigational findings included: edematous neck at 38.4% (95% CI: 27.5-49.9), suppurative lymphadenitis at 22.9% (7.3-29.4), parotid abscess at 22.8% (17.2-29.3), pharyngitis at 10.4% (6.6-15), and pharyngeal abscess at 9.5% (5.8-14.4). Most common treatments included: TMP-SMX at 63% (95% CI: 55.9-69.8), ceftazidime at 47.9% (40.7-55.1), and doxycycline at 26.7% (20.8-33.1). Comorbidities included: DM II at 29.8% (95% CI: 23.5-36.7), chronic renal failure at 11.7% (7.5-17) and CF at 9% (5.4-13.9).

Conclusions: Burkholderia species infections can lead to significant symptoms which can be fatal. Clinicians must have this on their differential, consider travel history to endemic areas, promptly intervene, prescribe appropriate antibiotics, and ensure vigilant follow-up for affected individuals.