OBJECTIVE  To analyze the basic data, clinical characteristics and drug susceptibility test results of Burkholderia cepacia strains isolated from ICU patients with pulmonary infections, and to explore the risk factors associated with varying severities of infection, thereby providing evidences for rational clinical use of antimicrobial agents.

METHODS  We retrospectively collected the basic information, clinical data and microbiological drug susceptibility results of ICU patients with respiratory specimens testing positive for B. cepacia from Jan. 2021 to Sep. 2025, and analyzed the general infection profile, clinical characteristics and drug susceptibility patterns.

RESULTS  Among 403 ICU patients A total of 496 strains of B. cepacia were isolated and identified from sputum and/or bronchoalveolar lavage fluid （BALF） specimens in the ICU from Jan. 2021 to Sep. 2025. The highest detection rate was observed in the comprehensive ICU, specifically the first ward of critical care medicine （n=141, 34.99%）, while, the neurology ICU had the highest detection rate among specialized ICUs （n=79, 19.60%）. The highest number of detections occurred in 2023, with an upward trend observed in 2025 compared to 2024. Other bacteria were detected in respiratory specimens of 253 patients （62.78%）. Bacteria alone were detected in 131 patients （32.51%）, fungi alone in 59 patients （14.64%） and both bacteria and fungi in 63 patients （15.63%）. Antimicrobial agents were administered to 400 patients （99.26%）, with commonly observed single or combined administration of multiple antimicrobial agents. The severe pneumonia group had higher frequencies of hospitalization duration over 28 days before detection, ventilator intubation duration exceeding 14 days before detection, fiberoptic bronchoscopy performed more than five times before detection, co-detection of bacteria and fungi before detection and use of more than six types of antimicrobial agents before detection compared with the non-severe pneumonia group （P＜0.05）. B. cepacia exhibited high resistance rates to ticarcillin-clavulanate and ceftazidime, while showing high sensitivity rates to sulfamethoxazole/trimethoprim, meropenem, minocycline and levofloxacin.

CONCLUSION  Advanced age, multiple underlying diseases, prolonged hospitalization, extended ventilator intubation duration, frequent fiberoptic bronchoscopy, co-infection with fungi or other bacteria and fungi and the use of multiple types of antimicrobial agents before detection are all identified as risk factors for the progression of severe pneumonia in patients infected with B. cepacia.