Turning a Disinfectant Into an Infectant: Burkholderia cepacia

“Handwashing with soap and water is one of the simplest, most effective ways to stop the spread of germs and stay healthy.”

Centers for Disease Control and Prevention

“The manufacturer of several types of hand soaps sold nationwide is recalling several individual lots after testing detected a dangerous bacterial contaminant that may result in serious and life-threatening infections…”

Beth Dalbey, Deputy National Editor, Patch

On August 8, 2025, DermaRite Industries, the New Jersey-based manufacturer of several types of hand soaps sold nationwide, issued an urgent recall of individual lots of soap after testing detected Burkholderia cepacia, a dangerous bacterial contaminant that may cause life-threatening infections. Fortunately, to date, no such infections have been reported. Even so, I thought this would be a good time for a Germ Gem post on the topic of hygiene with specific reference to B. cepacia, an opportunistic pathogen that has not been featured in previous posts.

The enormous importance of good hygiene. The word hygienic comes from the ancient Greek word hygies, meaning "healthy" or, literally, "living well," and the Greek goddess Hygieia represents the embodiment of health and cleanliness. Cleanliness is especially important with respect to the spread of infectious agents.

Improved sanitation and hygiene, including clean water, food safety, and handwashing have played a huge role in reducing the spread of many infectious diseases. (Available data, however, indicates that vaccines have saved significantly more lives than good hygiene practices.) The Centers for Disease Control and Prevention (CDC) emphasizes the role of proper handwashing in good hygiene. (See, CDC video, “Clean Hands in Healthcare Training,” March 8, 2024). And soap is considered very important for effective handwashing.

Soap molecules have a "head" that is attracted to water and a "tail" that is attracted to fats and oils. This allows the soap to latch onto the oily membranes of bacteria and viruses, disrupting them and ultimately destroying them. The lather created by soap also helps to trap and lift away pathogens that are then rinsed away with water. 

The CDC recommends using soap and clean water to physically remove germs and chemicals from your hands. While alcohol-based hand sanitizers also can be helpful when soap and water aren't available, they are not as effective at removing certain types of germs such as those that cause diarrhea. To be effective against pathogens like norovirus, alcohol-based hand sanitizers must contain at least 60% ethanol (also known as ethyl alcohol).

What is B. cepacia? Burkholderia are gram-negative bacilli. Several species have attracted considerable interest from the biotechnological and agricultural industry for biocontrol purposes. The genus also contains primary pathogens of animals and humans, such as B. cepacia and B. pseudomallei, the causative agent of melioidosis, an often fatal infection of humans and animals in tropical areas of Southeast Asia and northern Australia.

In 2021, B. pseudomallei found its way to America. No one knows how that species found its way here. Yet, it caused four cases of meliodosis. (See, “Burkholderia psueodomallei, an Invasive Bacterium Gets a Foothold in U.S. Soil and Water,” Germ Gems, August 2, 2023).

B. cepacia is found worldwide in soil and various aquatic environments. It can cause a variety of infections, particularly in immunocompromised people or those with underlying lung conditions, such as cystic fibrosis or bronchiectasis. While it’s an organism of relatively low virulence, it can colonize fluids used in the hospital, such as irrigation solutions and intravenous fluids leading to bloodstream infections. And it’s an opportunistic pathogen of patients with the neutrophil disorder chronic granulomatous disease.

Unfortunately, many B. cepacia isolates are resistant to antibiotics making them difficult to treat. But, B. cepacia rarely causes infection in healthy hosts, and it’s not a pathogen in the ambulatory setting.

What’s been learned from this wake-up call? You might ask how the devil did B. cepacia gain access to DermaRite’s hand soap products? To my knowledge, this remains a mystery, but DermaRite’s urgent recall of the soap products was the right thing to do. (The products are over-the-counter anti-septic lotion soaps, external analgesics, antimicrobial foam soaps and antiseptic cleansers with the brand names DermaKleen, Dermasarra, Keenfoam and Perigiene.)

The recognition that a bacterial pathogen, such as, B. cepacia, can colonize hand soap should serve both as a reminder of the incredible tenacity of some microbes (See “Extremophiles: Microbes That Love Extremes,” Germ Gems March 2, 2022) as well as a “wake-up call,” to remember to wash our hands properly with soap and water following the guidelines of the CDC. (See, CDC website “Life is Better with Clean Hands Campaign.”)