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Jo IH, Ko SW. Acute cholangitis with Achromobacter xylosoxidans bacteremia after endoscopic retrograde cholangiopancreatography in hilar cholangiocarcinoma: A case report. World J Clin Cases 2024; 12:4377-4383. [PMID: 39015928 PMCID: PMC11235522 DOI: 10.12998/wjcc.v12.i20.4377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/14/2024] [Accepted: 05/27/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Achromobacter xylosoxidans is a Gram-negative opportunistic aerobe, usually causing nosocomial infections in immunocompromised patients with manifestations including bacteremia, pneumonia, and catheter-related infections. However, A. xylosoxidans have not yet been reported to cause biliary system infections. CASE SUMMARY A 72-year-old woman presented to the outpatient department of our hospital with a chief complaint of jaundice. Computed tomography of her abdomen revealed the presence of a mass of approximately 2.4 cm in the hilar portion of the common hepatic duct, consistent with hilar cholangiocarcinoma. We performed endoscopic retrograde cholangiopancreatography (ERCP) to decompress the obstructed left and right intrahepatic ducts (IHDs) and placed 10 cm and 11 cm biliary stents in the left and right IHDs, respectively. However, the day after the procedure, the patient developed post-ERCP cholangitis as the length of the right IHD stent was insufficient for proper bile drainage. The blood culture of the patient tested positive for A. xylosoxidans. Management measures included the replacement of the right IHD stent (11 cm) with a longer one (12 cm) and administering culture-directed antibiotic therapy, solving the cholangitis-related complications. After the cholangitis had resolved, the patient underwent surgery for hilar cholangiocarcinoma and survived for 912 d without recurrence. CONCLUSION A. xylosoxidans-induced biliary system infections are extremely rare. Clinical awareness of physicians and endoscopists is required as this rare pathogen might cause infection after endoscopic procedures.
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Affiliation(s)
- Ik Hyun Jo
- Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16471, South Korea
| | - Sung Woo Ko
- Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea
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Brochet T, Tonnelier M, Justinien E, Lecapitaine AL, Bouras A. A case of community-acquired spondylodiscitis caused by Achromobacter xylosoxidans. IDCases 2024; 36:e01980. [PMID: 38737915 PMCID: PMC11088332 DOI: 10.1016/j.idcr.2024.e01980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024] Open
Abstract
Achromobacter xylosoxidans is a Gram-negative, aerobic, non-fermenting bacillus mainly responsible for nosocomial infections. We report the first case of community-acquired spondylodiscitis caused by Achromobacter xylosoxidans in a 61-year-old woman, immunocompromised with necrotizing dermohypodermitis of the right lower limb successfully treated with ertapenem and ciprofloxacin.
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Affiliation(s)
- T. Brochet
- Infectious Diseases Department, CH Compiègne, Noyon, France
| | - M. Tonnelier
- Infectious Diseases Department, CH Compiègne, Noyon, France
| | - E. Justinien
- Endocrinology Department, CH Compiègne, Noyon, France
| | | | - A. Bouras
- Infectious Diseases Department, CH Compiègne, Noyon, France
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3
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Batool A, Chaudhry S, Batool K, Omar MA. Achromobacter pneumonia in a patient with advanced COPD, a diagnostic challenge. BMJ Case Rep 2024; 17:e254306. [PMID: 38195188 PMCID: PMC10806936 DOI: 10.1136/bcr-2022-254306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Bacterial pneumonia causes significant morbidity and mortality especially in elderly and immunocompromised hosts. Achromobacter xylosoxidans denitrificans pneumonia is very rarely reported. However, the reported cases have been in patients who are either immunocompromised or have bronchiectasis. We hereby present a unique case of Achromobacter xylosoxidans denitrificans pneumonia in an immunocompetent patient with advanced chronic obstructive pulmonary disease (COPD). Our patient is a Caucasian male admitted with shortness of breath, fever and cough. Chest X-ray demonstrated right-sided infiltrates and he was treated with intravenous ceftriaxone and azithromycin. He was discharged home on oral amoxicillin-clavulanate 875-125 mg two times per day for a total of 7 days. Patient returned to emergency room after 5 weeks with persistent symptoms and chest X-ray revealed persistent right-sided infiltrate and sputum culture showed Achromobacter xylosoxidans denitrificans. The patient was started on oral levofloxacin 750 mg one time per day for 2 weeks with resolution of symptoms.
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Affiliation(s)
- Aisha Batool
- Nephrology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Khadija Batool
- Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
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Zhou Y, Xu B, Wang L, Zhang C, Li S. Fine Particulate Matter Perturbs the Pulmonary Microbiota in Broiler Chickens. Animals (Basel) 2023; 13:2862. [PMID: 37760262 PMCID: PMC10525718 DOI: 10.3390/ani13182862] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Fine particulate matter (PM2.5) seriously affects the respiratory tract health of both animals and humans. Growing evidence indicates that the pulmonary microbiota is involved in the development of respiratory tract health; however, there is still much that is unknown about the specific changes of pulmonary microbiota caused by PM2.5 in broilers. (2) In this experiment, a total of 48 broilers were randomly divided into a control group and PM-exposure group. The experiment lasted for 21 days. Microbiota, inflammation biomarkers, and histological markers in the lungs were determined. (3) On the last day of the experiment, PM significantly disrupted the structure of lung tissue and induced chronic pulmonary inflammation by increasing IL-6, TNFα, and IFNγ expression and decreasing IL-10 expression. PM exposure significantly altered the α and β diversity of pulmonary microbiota. At the phylum level, PM exposure significantly decreased the Firmicutes abundance and increased the abundance of Actinobacteria and Proteobacteria. At the genus level, PM exposure significantly increased the abundance of Rhodococcus, Achromobacter, Pseudomonas, and Ochrobactrum. We also observed positive associations of the above altered genera with lung TNFα and IFNγ expression. (4) The results suggest that PM perturbs the pulmonary microbiota and induces chronic inflammation, and the pulmonary microbiota possibly contributes to the development of lung inflammation.
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Affiliation(s)
| | | | | | | | - Shaoyu Li
- Institute of Animal Husbandry and Veterinary Science, Henan Academy of Agricultural Sciences, Zhengzhou 450002, China; (Y.Z.); (B.X.); (L.W.); (C.Z.)
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5
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Mudey G, Kunjalwar R, Sahu G, Mahajan SM, Meshram S. Sepsis Due to Achromobacter xylosoxidans in a Tertiary Care Centre: Case Series. Cureus 2023; 15:e42052. [PMID: 37602012 PMCID: PMC10434726 DOI: 10.7759/cureus.42052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Achromobacter xylosoxidans, also known as Alcaligenes xylosoxidans, is a low-virulence, non-fermenter gram-negative bacillus mainly found in marine environments. We report a detailed series of four high-risk cases of septicemia with the common variable of positive blood cultures for A. xylosoxidans. All four blood isolates were multi-drug resistant and susceptible to meropenem and trimethoprim-sulfamethoxazole. Two patients responded well to the treatment with meropenem and trimethoprim-sulfamethoxazole and two patients died. It should never be assumed that Achromobacter is a contaminant even though it is relatively infrequently isolated from clinical samples. This infection can progress to fatal bacteremia, even in otherwise healthy people, and it can potentially cause severe conditions in premature infants. With only a limited number of antibiotics demonstrating bactericidal properties, the possibility of failure in empirical treatment is significant. As a result, it is important to have a precise comprehension of this uncommon yet deadly illness in order to increase the probability of successful treatment.
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Affiliation(s)
- Gargi Mudey
- Department of Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Radha Kunjalwar
- Department of Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gaurav Sahu
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shital M Mahajan
- Department of Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Supriya Meshram
- Department of Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Xu J, Molin G, Davidson S, Roth B, Sjöberg K, Håkansson Å. CRP in Outpatients with Inflammatory Bowel Disease Is Linked to the Blood Microbiota. Int J Mol Sci 2023; 24:10899. [PMID: 37446076 DOI: 10.3390/ijms241310899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
The circulation is a closed system that has been assumed to be free from bacteria, but evidence for the existence of a low-density blood microbiota is accumulating. The present study aimed to map the blood microbiota of outpatients with Crohn's disease (CD) or with ulcerative colitis (UC) by 16S metagenomics. A diverse microbiota was observed in the blood samples. Regardless of the type of disease, the alpha diversity of the microbiota was positively associated with C-reactive protein (CRP). The blood microbiota had a surprisingly high proportion of Proteobacteria in comparison with human oral and colonic microbiotas. There was no clear difference in the overall pattern of the microbiota between CD and UC. A non-template control (NTC) was included in the whole process to control for the potential contamination from the environment and reagents. Certain bacterial taxa were concomitantly detected in both blood samples and NTC. However, Acinetobacter, Lactobacillus, Thermicanus and Paracoccus were found in blood from both CD and UC patients but not in NTC, indicating the existence of a specific blood-borne microbiota in the patients. Achromobacter dominated in all blood samples, but a minor amount was also found in NTC. Micrococcaceae was significantly enriched in CD, but it was also detected in high abundance in NTC. Whether the composition of the blood microbiota could be a marker of a particular phenotype in inflammatory bowel disease (IBD) or whether the blood microbiota could be used for diagnostic or therapeutic purposes deserves further attention.
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Affiliation(s)
- Jie Xu
- Department of Food Technology, Engineering and Nutrition, Lund University, 22100 Lund, Sweden
| | - Göran Molin
- Department of Food Technology, Engineering and Nutrition, Lund University, 22100 Lund, Sweden
| | - Sanna Davidson
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
- Department of Gastroenterology and Nutrition, Skåne University Hospital, 20502 Malmö, Sweden
| | - Bodil Roth
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
- Department of Gastroenterology and Nutrition, Skåne University Hospital, 20502 Malmö, Sweden
| | - Klas Sjöberg
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
- Department of Gastroenterology and Nutrition, Skåne University Hospital, 20502 Malmö, Sweden
| | - Åsa Håkansson
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
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Siddiqui T, Patel SS, Ghoshal U, Sahu C. Clinicomicrobiological Profile of Infections by Achromobacter: An Emerging Nosocomial Pathogen in Indian Hospitals. Int J Appl Basic Med Res 2023; 13:59-63. [PMID: 37614834 PMCID: PMC10443449 DOI: 10.4103/ijabmr.ijabmr_520_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/16/2023] [Accepted: 04/17/2023] [Indexed: 08/25/2023] Open
Abstract
Background Achromobacter causes opportunistic nosocomial infections in immunocompromised patients with high mortality. It is underreported as it is often misidentified by conventional microbiological methods. Aims The aim of the study is to access the clinicomicrobiological profile and antibiogram of Achromobacter spp. from clinical isolates. Materials and Methods It is an observational study done from July 2020 to December 2021 in our hospital. All nonduplicate isolates of Achromobacter from blood and respiratory samples were initially identified with VITEK-2 GN card system and further confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiogram and treatment outcomes were also studied. Results Achromobacter spp. was isolated from 14 patients. Blood samples yielded most isolates (71.4%; n = 10) followed by tracheal aspirate and bronchoalveolar lavage fluid. Bacteremia followed by pneumonia was the most common clinical manifestation of Achromobacter infection. All the isolates were identified as A. xylosoxidans denitrificans and showed 100% susceptibility to minocycline and piperacillin-tazobactam. Diabetes mellitus and malignancy were the most common underlying condition in these patients. A favorable outcome was seen in 78.6% of the individuals with timely institution of antibiotics and proper diagnosis. Conclusion Infections due to Achromobacter are on the rise in developing countries like India. Resistance to many classes of antimicrobials makes its treatment more challenging therefore it should always be guided by antibiograms. The present study highlights the significance of this rare bacterium in patients with malignancies in India and advocates greater vigilance toward appropriate identification of this organism.
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Affiliation(s)
- Tasneem Siddiqui
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sangram Singh Patel
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ujjala Ghoshal
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Chinmoy Sahu
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Ong HS, Sharma N, Phee LM, Mehta JS. Atypical microbial keratitis. Ocul Surf 2023; 28:424-439. [PMID: 34768003 DOI: 10.1016/j.jtos.2021.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/16/2023]
Abstract
Atypical microbial keratitis refers to corneal infections caused by micro-organisms not commonly encountered in clinical practice. Unlike infections caused by common bacteria, cases of atypical microbial keratitis are often associated with worse clinical outcomes and visual prognosis. This is due to the challenges in the identification of causative organisms with standard diagnostic techniques, resulting in delays in the initiation of appropriate therapies. Furthermore, due to the comparatively lower incidence of atypical microbial keratitis, there is limited literature on effective management strategies for some of these difficult to manage corneal infections. This review highlights the current management and available evidence of atypical microbial keratitis, focusing on atypical mycobacteria keratitis, nocardia keratitis, achromobacter keratitis, and pythium keratitis. It will also describe the management of two uncommonly encountered conditions, infectious crystalline keratopathy and post-refractive infectious keratitis. This review can be used as a guide for clinicians managing patients with such challenging corneal infections.
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Affiliation(s)
- Hon Shing Ong
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore; Tissue Engineering and Cell Therapy Department, Singapore Eye Research Institute, Singapore; Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore.
| | - Namrata Sharma
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lynette M Phee
- Department of Pathology, Sengkang General Hospital, SingHealth, Singapore
| | - Jodhbir S Mehta
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore; Tissue Engineering and Cell Therapy Department, Singapore Eye Research Institute, Singapore; Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore; School of Material Science & Engineering and School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore.
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Janga C, Kramer M, Naeem I, Checchio L, Qamar Z. A Rare Case of Autopsy Proven Achromobacter xylosoxidans Endocarditis Involving Tricuspid Valve: A Case Report. Cureus 2023; 15:e38118. [PMID: 37252505 PMCID: PMC10217788 DOI: 10.7759/cureus.38118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Infective endocarditis refers to infection of one or more valves of the heart, with Achromobacter xylosoxidans (A. xylosoxidans) being a rare cause. So far, 24 cases of A. xylosoxidans endocarditis were reported, with only one case describing tricuspid valvular involvement. Despite the rarity of A. xylosoxidans endocarditis, it is important for clinicians to be aware of atypical presentation and the high mortality associated with it. We present an autopsy-proven case of tricuspid valve endocarditis in the setting of A. xylosoxidans bacteremia in a 43-year-old female.
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Affiliation(s)
- Chaitra Janga
- Internal Medicine, Jefferson Health-Abington, Abington, USA
| | | | - Ifrah Naeem
- Internal Medicine, Jefferson Health-Abington, Abington, USA
| | - Lucy Checchio
- Internal Medicine, Jefferson Health-Abington, Abington, USA
| | - Zahra Qamar
- Infectious Disease, Jefferson Health-Abington, Abington, USA
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An Unusual Case of Pyogenic Liver Abscess Secondary to Achromobacter xylosoxidans. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2023. [DOI: 10.1097/ipc.0000000000001231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Das A, Sinha S, Raj N, Dobhal S, Agarwal J. Achromobacter Spp.: A retrospective review of rare and emerging pathogen. MGM JOURNAL OF MEDICAL SCIENCES 2023. [DOI: 10.4103/mgmj.mgmj_41_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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Muacevic A, Adler JR, Kondo K, Ihara K, Isono M, Ogawa H. A Case of Pyometra Caused by Achromobacter xylosoxidans and γ-Streptococcus in an Elderly Frail Woman. Cureus 2022; 14:e32016. [PMID: 36600853 PMCID: PMC9798926 DOI: 10.7759/cureus.32016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Pyometra is an easily overlooked disease with nonspecific symptoms; however, a delayed diagnosis can lead to severe complications. An 80-year-old frail woman presented to our hospital with a chief complaint of persistent fever for 10 days. Her blood tests showed an elevated inflammatory response, and computed tomography showed a 10-cm cystic lesion in the pelvic floor compressing the bladder. A catheter was inserted from the vagina into the uterine cavity, resulting in pus drainage and pyometra diagnosis. A pus culture was subsequently performed, which detected Achromobacter xylosoxidans, a common cause of respiratory tract infections in cystic fibrosis and bloodstream infections, andγ-streptococcus. To the best of our knowledge, this is the first report of pyometra caused by Achromobacter xylosoxidans. The patient was treated with drainage and piperacillin-tazobactam administration. Pyometra is especially prevalent in older women with impaired activities of daily living and dementia. Although fever, lower abdominal pain, and increased discharge may occur, symptoms are often nonspecific, and half of such cases are asymptomatic. Furthermore, delayed diagnosis can lead to perforation of the uterus and consequent pan-peritonitis. Thus, the diagnosis of pyometra should be considered in older women presenting with unknown fever, and imaging studies and gynecological consultation should be requested promptly.
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Achromobacter Species: An Emerging Cause of Community-Onset Bloodstream Infections. Microorganisms 2022; 10:microorganisms10071449. [PMID: 35889168 PMCID: PMC9323057 DOI: 10.3390/microorganisms10071449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Case reports and small series indicate that Achromobacter species bloodstream infection (BSI) is most commonly a complication of hospitalization among patients with chronic lung disease. The aim of the present study was to determine the incidence, risk factors, and outcomes of Achromobacter sp. BSI in an Australian population. Methods: Retrospective, laboratory-based surveillance was conducted in Queensland, Australia (population ≈ 5 million) during 2000–2019. Clinical and outcome data were obtained by linkage to state hospital admissions and vital statistics databases. BSI diagnosed within the community or within the first two calendar days of stay in hospital were classified as community-onset. Community-onset BSIs were grouped into community-associated and healthcare-associated. Results: During more than 86 million person-years of surveillance, 210 incidents of Achromobacter sp. BSI occurred among 195 individuals for an overall age-and sex-standardized annual incidence of 2.6 per million residents. Older individuals and males were at highest risk (2.9 vs. 2.0 per million, IRR for males 1.5; 95% CI, 1.1–1.9; p = 0.008). Most (153; 73%) cases were of community-onset of which 100 (48%) and 53 (25%) were healthcare- and community-associated, respectively. An increasing proportion of community-onset cases were observed during twenty years of surveillance. Underlying medical illnesses were common with median (interquartile range) Charlson Comorbidity Index (CCI) scores of 3 (1–5). CCI scores of 0, 1, 2, and 3+ were observed in 37 (18%), 27 (13%), 40 (19%), and 105 (50%) of cases, respectively. All but one of the cases were admitted to hospital for a median (interquartile range) length of stay of 12 (5–34) days. All-cause case–fatality rates in hospital by day 30 and by day 90 were 30 (14%), 28 (13%), and 42 (20%), respectively. The 90-day case–fatality rate increased with increasing comorbidity and was 3% (1/37), 11% (3/27), 25% (10/40), and 27% (28/105) among those with Charlson Comorbidity Indices of 0, 1, 2, and 3+, respectively (p = 0.004). Conclusions: Although comorbidity is an important determinant of risk, most Achromobacter sp. BSI are of community-onset and one-fifth of cases occur in patients without significant underlying chronic co-morbidities. This study highlights the value of population-based methodologies to define the epidemiology of an infectious disease.
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Genomic Insights into Achromobacter mucicolens IA Antibiotic Resistance. Microbiol Spectr 2022; 10:e0191621. [PMID: 35377213 PMCID: PMC9045304 DOI: 10.1128/spectrum.01916-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Achromobacter denitrificans is an environmental opportunistic pathogen that is infecting a large number of immunocompromised patients. A more recently identified strain from the historical collection of strains of Achromobacter denitrificans is Achromobacter mucicolens. In hosts with a variety of underlying diseases, Achromobacter spp. can induce a wide spectrum of disorders. Because of the bacterium’s intrinsic genetic constitution and resistance gained over time, antibiotics are challenged to handle A. mucicolens. Due to the fact that A. mucicolens is rare and its taxonomy is not completely understood, it is difficult to define clinical symptoms, acquisition risk factors, and thus the best therapeutic course of action. To help comprehend this intrinsic and acquired resistance, we analyzed the entire genome of the A. mucicolens IA strain and utilized bioinformatics methods to estimate the strain's probable drug resistance profile. In our study, we have isolated and cultured a clinically important A. mucicolens strain and subjected it to antimicrobial susceptibility tests against antibiotics in the Vitek 2 testing system. The strain’s genome sequence as well as an investigation of 27 of its phenotypic traits provides important information regarding this pathogen. The genome of this A. mucicolens IA strain possesses a number of antibiotic resistance genes that code for efflux pump systems and other antibiotic-regulating as well as -modifying enzymes. Our research analysis predicted genes involved in drug resistance, including genes for efflux pump systems, antibiotic efflux, antibiotic inactivation, and antibiotic target alteration. In vitro studies validated the genomic evidence for its ability to exhibit resistance against a wide range of antibiotics. Our investigation paves the way for more research on understanding the functioning of the key discovered genes that contribute toward the pathogenicity of A. mucicolens and hence gives new information and treatment options for this emerging pathogen. IMPORTANCEAchromobacter species are well-known opportunistic human pathogens that can be found in water and soil and most commonly in hospital settings. They thrive in immunocompromised individuals, producing sporadic cases of pneumonia, septicemia, peritonitis, urinary tract infections, and other illnesses. Achromobacter strains are inherently resistant to a wide spectrum of antibiotics, making them difficult to treat promptly. The strain under study, A. mucicolens, was notably resistant to various antibiotics, and the infection could be controlled only after several rounds of prescription medications at different doses. This consumed a lot of time and put the already immunosuppressed leukemic patient through a great ordeal. The study aimed to raise awareness about the importance of the Achromobacter bacterium’s lethality, and doctors should evaluate the bacterium’s potential for resistance before prescribing antibiotics. Sanitation and other precautions should also be implemented in hospitals and other public places.
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An 18-Year Dataset on the Clinical Incidence and MICs to Antibiotics of Achromobacter spp. (Labeled Biochemically or by MAL-DI-TOF MS as A. xylosoxidans), Largely in Patient Groups Other than Those with CF. Antibiotics (Basel) 2022; 11:antibiotics11030311. [PMID: 35326774 PMCID: PMC8944543 DOI: 10.3390/antibiotics11030311] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Achromobacter spp. are intrinsically multidrug-resistant environmental microorganisms which are known to cause opportunistic, nosocomial, and sometimes chronic infections. The existing literature yields scarcely any larger datasets, especially with regard to the incidence in patient groups other than those with cystic fibrosis. The aim of this study was to fill this gap. We present a retrospective analysis of 314 clinical and 130 screening isolates detected in our diagnostic unit between 2004 and 2021, combined with patients’ demographic and clinical information (ward type and length of hospitalization), and the results of routine diagnostic antibiotic MIC determination. We found the apparent increase in prevalence in our diagnostic unit, in which cystic fibrosis patients are an underrepresented group, in large part to be attributable to an overall increase in the number of samples and, more importantly, changes in the diagnostic setting, such as the introduction of rigorous screening for Gram-negative multidrug-resistant pathogens. We found these Achromobacter spp. to be most commonly detected in urine, stool, wounds and airway samples, and found the resistance rates to vary strongly between different sample types. Intestinal carriage is frequently not investigated, and its frequency is likely underestimated. Isolates resistant to meropenem can hardly be treated.
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Houlihan E, Lucey M, Pandian A, Hanahoe B, Higgins F, DeLappe N, Krawczyk J, Keady D. Case of recurrent Achromobacter xylosoxidans bacteraemia and PICC (peripherally-inserted central catheter) line infection in an immunocompromised patient. Infect Prev Pract 2022; 4:100202. [PMID: 35198965 PMCID: PMC8844297 DOI: 10.1016/j.infpip.2022.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/13/2022] [Indexed: 11/02/2022] Open
Abstract
Background Presentation of Case Discussion Conclusion
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Steiner V, Rosel AC, Ruppitsch W, Allerberger F, Carranza Valencia A, Markovic M, Luckschander-Zeller N, Szostak MP, Spergser J, Loncaric I, Künzel F. The First Bacterial Endocarditis Due to Achromobacter xylosoxidans in a Dog. Pathogens 2021; 10:pathogens10121580. [PMID: 34959535 PMCID: PMC8709460 DOI: 10.3390/pathogens10121580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/21/2021] [Accepted: 11/30/2021] [Indexed: 12/04/2022] Open
Abstract
Infectious endocarditis (IE) in dogs is often associated with a high mortality rate as diagnostic work-up as well as antibiotic treatment might be challenging. The present case describes bacteremia in a dog caused by Achromobacter xylosoxidans, leading to an infectious endocarditis. Achromobacter xylosoxidans (A. xylosoxidans) is an aerobic Gram-negative rod-shaped bacterium, which has been associated with multiple nosocomial opportunistic diseases in human medicine. One such manifestation of A. xylosoxidans infection is endocarditis. A. xylosoxidans infections are challenging to treat due to the reduced effectiveness of a wide range of antimicrobial agents. To date, only a few case reports of infections with A. xylosoxidans in animals have been described. This is the first case report of A. xylosoxidans endocarditis in a dog. Whole-genome sequencing was performed to determine the sequencing type and to gain more information about this bacterium regarding its intrinsic resistance genes. With this case report, we seek to increase awareness of A. xylosoxidans as an opportunistic nosocomial pathogen in dogs and to provide a short summary regarding the current state of general knowledge and known resistance patterns.
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Affiliation(s)
- Verena Steiner
- Department for Companion Animals and Horses, Clinical Unit of Internal Medic and Small Animals, University of Veterinary Medicine, 1210 Vienna, Austria; (A.C.V.); (M.M.); (N.L.-Z.); (F.K.)
- Correspondence:
| | - Adriana Cabal Rosel
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, 1090 Vienna, Austria; (A.C.R.); (W.R.); (F.A.)
| | - Werner Ruppitsch
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, 1090 Vienna, Austria; (A.C.R.); (W.R.); (F.A.)
| | - Franz Allerberger
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, 1090 Vienna, Austria; (A.C.R.); (W.R.); (F.A.)
| | - Alejandra Carranza Valencia
- Department for Companion Animals and Horses, Clinical Unit of Internal Medic and Small Animals, University of Veterinary Medicine, 1210 Vienna, Austria; (A.C.V.); (M.M.); (N.L.-Z.); (F.K.)
| | - Mato Markovic
- Department for Companion Animals and Horses, Clinical Unit of Internal Medic and Small Animals, University of Veterinary Medicine, 1210 Vienna, Austria; (A.C.V.); (M.M.); (N.L.-Z.); (F.K.)
| | - Nicole Luckschander-Zeller
- Department for Companion Animals and Horses, Clinical Unit of Internal Medic and Small Animals, University of Veterinary Medicine, 1210 Vienna, Austria; (A.C.V.); (M.M.); (N.L.-Z.); (F.K.)
| | - Michael P. Szostak
- Institute of Microbiology, University of Veterinary Medicine, 1210 Vienna, Austria; (M.P.S.); (J.S.); (I.L.)
| | - Joachim Spergser
- Institute of Microbiology, University of Veterinary Medicine, 1210 Vienna, Austria; (M.P.S.); (J.S.); (I.L.)
| | - Igor Loncaric
- Institute of Microbiology, University of Veterinary Medicine, 1210 Vienna, Austria; (M.P.S.); (J.S.); (I.L.)
| | - Frank Künzel
- Department for Companion Animals and Horses, Clinical Unit of Internal Medic and Small Animals, University of Veterinary Medicine, 1210 Vienna, Austria; (A.C.V.); (M.M.); (N.L.-Z.); (F.K.)
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Ronin E, Derancourt C, Cabié A, Marion-Sanchez K. Achromobacter spp. Surgical Site Infections: A Systematic Review of Case Reports and Case Series. Microorganisms 2021; 9:microorganisms9122471. [PMID: 34946073 PMCID: PMC8704055 DOI: 10.3390/microorganisms9122471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
Achromobacter species are isolated from rare but severe healthcare-associated infections, including surgical site infections. They are considered to preferentially infect immunocompromised patients but so far with limited evidence. We conducted a systematic review on Achromobacter spp. surgical site infections (SSIs) to determine if such infections were indeed more commonly associated with immunocompromised patients. The secondary objective was to describe the characteristics of infected patients. Eligible articles had to be published before 30 September 2020 and to report Achromobacter spp. SSIs across all surgical specialties excluding ophthalmology. Analyses were performed on individual data without meta-analysis. Cases were divided into 2 subgroups: one group which had either prosthesis or implant and the other group which did not. A first selection led to a review of 94 articles, of which 37 were analyzed. All were case reports or case series and corresponded to 49 infected patients. Most of the patients were under 65 years of age and had undergone a heart or digestive surgery followed by deep infection with no co-infecting pathogens. Nine out of the 49 cases were immunocompromised, with similar distribution between the two subgroups (16.6% and 20%, respectively). This review suggests that Achromobacter spp. SSIs do not preferentially target immunocompromised patients.
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Affiliation(s)
- Eve Ronin
- Department of Hospital Hygiene, CHU Martinique, F-97200 Fort-de-France, Martinique;
| | | | - André Cabié
- Department of Infectious Diseases, CHU Martinique, F-97200 Fort-de-France, Martinique;
- Unité Mixte de Recherche 1058 : Pathogenesis and Control of Chronic and Emerging Infections, 34000 Montpellier, France
| | - Karine Marion-Sanchez
- Department of Hospital Hygiene, CHU Martinique, F-97200 Fort-de-France, Martinique;
- Unité Mixte de Recherche 1058 : Pathogenesis and Control of Chronic and Emerging Infections, 34000 Montpellier, France
- Correspondence: ; Tel.: +596-596-55-97-42
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Prevalence of Fungi in Primary Endodontic Infections of a Greek-living Population Through Real-time Polymerase Chain Reaction and Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry. J Endod 2021; 48:200-207. [PMID: 34800484 DOI: 10.1016/j.joen.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 10/27/2021] [Accepted: 11/07/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Fungi are considered to be opportunistic pathogens that may play a significant role in the pathogenesis of endodontic infections. The main purpose of this study was to assess the prevalence of 2 selected genera of fungi, Candida albicans and Aspergillus spp., using real-time polymerase chain reaction (RT-PCR) and to compare the findings with the respective ones obtained by a culture-dependent approach, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-ToF MS). A secondary aim was to assess the presence of other bacteria growing under aerobic conditions. METHODS Microbial samples were obtained from the root canals of 60 teeth associated with pulp necrosis and apical periodontitis. DNA was extracted, and RT-PCR was applied for the detection of C. albicans and Aspergillus spp. pathogenic subtypes. In addition, MALDI-ToF MS was performed to identify microorganisms grown under aerobic conditions. RESULTS Based on RT-PCR, Aspergillus was detected in 8 cases, whereas C. albicans was detected in 4 cases. Using MALDI-ToF MS, no trace of Aspergillus was detected, whereas C. albicans was identified in 2 cases. Significant differences were revealed in the detection potential for Aspergillus spp. between MALDI-ToF MS and RT-PCR (P = .01); conversely, this was not the case for C. albicans (P = .50). After MALDI-ToF MS, 35 samples showed evidence of bacterial growth. The vast majority was colonized by Achromobacter xylosoxidans followed by Lactobacillus spp., Methylobacterium spp., and Enterococcus faecalis. CONCLUSIONS The findings confirm the presence of fungi in primarily infected canals with apical periodontitis as well as some rarely inspected aerobic bacterial species. A. xylosoxidans was prevalent; however, the clinical relevance of its presence needs to be investigated further.
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Borni M, Znazen M, Borni FC, Boudawara MZ. A case of meningitis due to Achromobacter xylosoxidans in a child with a polymalformative syndrome: a case report. Pan Afr Med J 2021; 39:124. [PMID: 34527140 PMCID: PMC8418177 DOI: 10.11604/pamj.2021.39.124.29794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/27/2022] Open
Abstract
Achromobacter xylosoxidans (AX), also called alcaligenes xylosoxidans, is an aerobic, non-fermenting mobile, gram-negative bacillus which was first isolated in an otorrhea samples in 1971. Infections with these species are quite rare and have often been described in immunocompromised and in premature infants. However, very few cases of meningitis related to AX have been reported in the literature. The authors report a new case of meningitis due to AX in a 45-day-old female infant with polymarformative syndrome meningitis was confirmed by a cyto-biochemical analysis and culture of the cerebrospinal fluid and was treated by antibiotherapy. Hydrocephalus was managed initially with external ventricular drainage followed by a ventriculoperitoneal shunt after rigorous cerebrospinal fluid (CSF) sterilization, with good clinical and radiological outcomes. The prompt and adequate antibiotic adjustment following bacterial isolation has been shown to rapidly modify the clinical outcomes.
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Affiliation(s)
- Mehdi Borni
- Department of Neurosurgery, University Hospital Center Habib Bourguiba, Sfax, Tunisia
| | - Mohammed Znazen
- Department of Neurosurgery, University Hospital Center Habib Bourguiba, Sfax, Tunisia
| | - Fatma Chaker Borni
- Department of Obstetrics and Gynecology, University Hospital Center Hedi Chaker, Sfax, Tunisia
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Sanz-García F, Gil-Gil T, Laborda P, Ochoa-Sánchez LE, Martínez JL, Hernando-Amado S. Coming from the Wild: Multidrug Resistant Opportunistic Pathogens Presenting a Primary, Not Human-Linked, Environmental Habitat. Int J Mol Sci 2021; 22:8080. [PMID: 34360847 PMCID: PMC8347278 DOI: 10.3390/ijms22158080] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 12/24/2022] Open
Abstract
The use and misuse of antibiotics have made antibiotic-resistant bacteria widespread nowadays, constituting one of the most relevant challenges for human health at present. Among these bacteria, opportunistic pathogens with an environmental, non-clinical, primary habitat stand as an increasing matter of concern at hospitals. These organisms usually present low susceptibility to antibiotics currently used for therapy. They are also proficient in acquiring increased resistance levels, a situation that limits the therapeutic options for treating the infections they cause. In this article, we analyse the most predominant opportunistic pathogens with an environmental origin, focusing on the mechanisms of antibiotic resistance they present. Further, we discuss the functions, beyond antibiotic resistance, that these determinants may have in the natural ecosystems that these bacteria usually colonize. Given the capacity of these organisms for colonizing different habitats, from clinical settings to natural environments, and for infecting different hosts, from plants to humans, deciphering their population structure, their mechanisms of resistance and the role that these mechanisms may play in natural ecosystems is of relevance for understanding the dissemination of antibiotic resistance under a One-Health point of view.
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Affiliation(s)
| | | | | | | | - José L. Martínez
- Centro Nacional de Biotecnología, CSIC, 28049 Madrid, Spain; (F.S.-G.); (T.G.-G.); (P.L.); (L.E.O.-S.); (S.H.-A.)
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22
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Patra PK, Banday AZ, Sadanand R, Sharma B, Angrup A, Vignesh P, Rawat A. Achromobacter xylosoxidans Pneumonia in a Young Child with Chronic Granulomatous Disease-a Case-Based Review. J Clin Immunol 2021; 41:1686-1692. [PMID: 34263392 DOI: 10.1007/s10875-021-01079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/25/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Pratap Kumar Patra
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Aaqib Zaffar Banday
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Rohit Sadanand
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Bhawna Sharma
- Department of Microbiology, PGIMER, Chandigarh, India
| | | | - Pandiarajan Vignesh
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Amit Rawat
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
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23
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Imani S, Wijetunga A, Shumborski S, O’Leary E. Chronic osteomyelitis caused by Achromobacter xylosoxidans following orthopaedic trauma: A case report and review of the literature. IDCases 2021; 25:e01211. [PMID: 34277350 PMCID: PMC8267561 DOI: 10.1016/j.idcr.2021.e01211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background Achromobacter xylosoxidans is an opportunistic environmental aerobe. In cases where A. xylosoxidans infects humans, it most commonly manifests as bacteraemia in the immunosuppressed. A. xylosoxidans causing chronic osteomyelitis is rare, particularly in the immunocompetent and young. Case We present the case of a 23-year-old man with chronic osteomyelitis of the right femur caused by co-infection of A. xylosoxidans and Staphylococcus aureus. Five years earlier, he had sustained a right femur fracture and was treated with intramedullary fixation at a peripheral hospital in a developing nation. Past medical history was otherwise unremarkable. Management comprised of surgical debridement and culture-directed antibiotic therapy, resulting in clinical cure. Conclusion In the context of local trauma and previous surgery, osteomyelitis caused by atypical pathogens must be considered. A multidisciplinary approach commensurate with duration and severity of infection and tailored to the causative organism is paramount.
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Affiliation(s)
- Sahand Imani
- Department of Orthopaedic Surgery, Hornsby Ku-Ring-Gai Hospital, Sydney, New South Wales, Australia
| | - Asanka Wijetunga
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Corresponding author.
| | - Sarah Shumborski
- Department of Orthopaedic Surgery, Hornsby Ku-Ring-Gai Hospital, Sydney, New South Wales, Australia
| | - Edmund O’Leary
- Department of Orthopaedic Surgery, Hornsby Ku-Ring-Gai Hospital, Sydney, New South Wales, Australia
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24
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Khademi SMH, Gabrielaite M, Paulsson M, Knulst M, Touriki E, Marvig RL, Påhlman LI. Genomic and Phenotypic Evolution of Achromobacter xylosoxidans during Chronic Airway Infections of Patients with Cystic Fibrosis. mSystems 2021; 6:e0052321. [PMID: 34184916 PMCID: PMC8269239 DOI: 10.1128/msystems.00523-21] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/02/2021] [Indexed: 11/22/2022] Open
Abstract
Bacterial pathogens evolve during chronic colonization of the human host by selection for pathoadaptive mutations. One of the emerging and understudied bacterial species causing chronic airway infections in patients with cystic fibrosis (CF) is Achromobacter xylosoxidans. It can establish chronic infections in patients with CF, but the genetic and phenotypic changes associated with adaptation during these infections are not completely understood. In this study, we analyzed the whole-genome sequences of 55 clinical A. xylosoxidans isolates longitudinally collected from the sputum of 6 patients with CF. Four genes encoding regulatory proteins and two intergenic regions showed convergent evolution, likely driven by positive selection for pathoadaptive mutations, across the different clones of A. xylosoxidans. Most of the evolved isolates had lower swimming motility and were resistant to multiple classes of antibiotics, while fewer of the evolved isolates had slower growth or higher biofilm production than the first isolates. Using a genome-wide association study method, we identified several putative genetic determinants of biofilm formation, motility and β-lactam resistance in this pathogen. With respect to antibiotic resistance, we discovered that a combination of mutations in pathoadaptive genes (phoQ and bigR) and two other genes encoding regulatory proteins (spoT and cpxA) were associated with increased resistance to meropenem and ceftazidime. Altogether, our results suggest that genetic changes within regulatory loci facilitate within-host adaptation of A. xylosoxidans and the emergence of adaptive phenotypes, such as antibiotic resistance or biofilm formation. IMPORTANCE A thorough understanding of bacterial pathogen adaptation is essential for the treatment of chronic bacterial infections. One unique challenge in the analysis and interpretation of genomics data is identifying the functional impact of mutations accumulated in the bacterial genome during colonization in the human host. Here, we investigated the genomic and phenotypic evolution of A. xylosoxidans in chronic airway infections of patients with CF and identified several mutations associated with the phenotypic evolution of this pathogen using genome-wide associations. Identification of phenotypes under positive selection and the associated mutations can enlighten the adaptive processes of this emerging pathogen in human infections and pave the way for novel therapeutic interventions.
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Affiliation(s)
- S. M. Hossein Khademi
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | | | - Magnus Paulsson
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
- Division of Infectious Diseases, Skåne University Hospital Lund, Lund, Sweden
| | - Mattis Knulst
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Eleni Touriki
- Clinical Microbiology, Labmedicin Skåne, Lund, Sweden
| | - Rasmus L. Marvig
- Center for Genomic Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Lisa I. Påhlman
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
- Division of Infectious Diseases, Skåne University Hospital Lund, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
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25
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Agassi AM, Pollock E, Carter MM, Sherertz RJ, Mangano AP. Meropenem-Resistant Achromobacter xylosoxidans, Subspecies Denitrificans Bacteremia in a Patient With Stage IV Adenocarcinoma of the Lung. Cureus 2021; 13:e15546. [PMID: 34277171 PMCID: PMC8269378 DOI: 10.7759/cureus.15546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/24/2022] Open
Abstract
Achromobacter xylosoxidans,subspecies denitrificans is a rare Gram-negative bacillus that causes health care associated infections in immunocompromised hosts. Carbapenems and anti-pseudomonal penicillins are listed as suitable empiric therapy in the literature. Herein, we report a case of a 77-year-old male with stage IV adenocarcinoma of the lung who presented with and was improving from Salmonella javiana enterocolitis, only to subsequently develop A. xylosoxidans,subspecies denitrificans bacteremia that was resistant to both meropenem and piperacillin-tazobactam. With empiric antibiotic coverage falling short of microbial clearance, timelyin vitrosusceptibility testing and prompt infectious disease consultation are of the utmost importance for treatment.
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Affiliation(s)
- Andre M Agassi
- Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA
| | - Erin Pollock
- Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA
| | - Mary M Carter
- Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA
| | - Robert J Sherertz
- Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA
| | - Andrew P Mangano
- Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA
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Choudhury S, Papineni S, Ramachandruni S, Molina J, Surani S. Achromobacter xylosoxidans/denitrificans Bacteremia in a Patient With Good's Syndrome. Cureus 2021; 13:e13827. [PMID: 33854849 PMCID: PMC8035986 DOI: 10.7759/cureus.13827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Good's syndrome is a rare, adult-onset immunodeficiency syndrome associated with thymomas. Here, we present a 71-year-old, previously healthy male with a history of opportunistic infections status post-thymectomy, who presented with a septic knee complicated with bacteremia without any inciting factor. Therefore, a diagnosis of Good syndrome was made. While this is a rare disease, clinicians should have a high suspicion in patients with a history of thymoma. Early diagnosis and treatment can reduce opportunistic infections and improve morbidity and mortality.
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Affiliation(s)
- Saiara Choudhury
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA
| | - Sudhakar Papineni
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA
| | | | - Jurairat Molina
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA
| | - Salim Surani
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA.,Internal Medicine, University of North Texas, Dallas, USA
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27
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André C, Durand ML, Buckley T, Cadorette J, Gilmore MS, Ciolino JB, Bispo PJM. A Cluster of Corneal Donor Rim Cultures Positive for Achromobacter Species Associated With Contaminated Eye Solution. Cornea 2021; 40:223-227. [PMID: 33395117 PMCID: PMC8551930 DOI: 10.1097/ico.0000000000002473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate a cluster of corneoscleral rim cultures positive for Achromobacter species over a 6-month period at Massachusetts Eye and Ear. METHODS An increased rate of positive corneal donor rim cultures was noted at Massachusetts Eye and Ear between July and December 2017. Positive cultures were subjected to identification and antimicrobial susceptibility testing by phenotypic (MicroScan WalkAway) and genotypic (16S rDNA sequencing) methods. Samples of the eye wash solution (GeriCare) used in the eye bank were also evaluated. Antimicrobial activity of Optical-GS against Achromobacter spp. at 4°C and 37°C was assessed by time-kill kinetics assay. RESULTS Of 99 donor rims cultured, 14 (14.1%) grew bacteria with 11 (78.6%) due to uncommon nonfermenting Gram-negative bacilli. These had been identified by standard automated methods as Achromobacter (n = 3), Alcaligenes (n = 3), Ralstonia (n = 2), Pseudomonas (n = 2), and Stenotrophomonas (n = 1). Eight of these 11 isolates were subsequently available for molecular identification, and all were identified as Achromobacter spp. Six bottles of eyewash solution were evaluated and were positive for abundant Achromobacter spp. (3.4 × 105 ± 1.1 CFU/mL). Optisol-GS had no bactericidal activity against Achromobacter spp. at 4°C after 24-hour incubation but was bactericidal at 37°C. None of the patients who had received the contaminated corneas developed postoperative infection. CONCLUSIONS An eyewash solution arising from a single lot was implicated in the contamination of donor rims by Achromobacter spp. The isolates were able to survive in the Optisol-GS medium at the recommended storage temperature. This highlights the need to continue improving protocols for tissue preparation and storage.
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Affiliation(s)
- Camille André
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA. Dr. André is now with Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Lyon, France
| | - Marlene L. Durand
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA. Dr. André is now with Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Lyon, France
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - James Cadorette
- Henry Whittier Porter Bacteriology Laboratory, Massachusetts Eye and Ear, Boston, MA
| | - Michael S. Gilmore
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA. Dr. André is now with Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Lyon, France
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA
| | - Joseph B. Ciolino
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA. Dr. André is now with Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Lyon, France
| | - Paulo J. M. Bispo
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA. Dr. André is now with Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Lyon, France
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Oyama Y, Yasunaga M, Honda A, Maki H, Masamoto Y, Kobayashi T, Wakabayashi Y, Okugawa S, Moriya K, Kurokawa M. Severe cellulitis caused by Achromobacter xylosoxidans after allogeneic hematopoietic stem cell transplantation. J Infect Chemother 2021; 27:770-772. [PMID: 33468424 DOI: 10.1016/j.jiac.2020.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/15/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
Achromobacter xylosoxidans (A. xylosoxidans) is an aerobic gram-negative bacillus and often isolated from aquatic environments. It is supposed to cause infections in patients with malignancy or immunodeficiency. It causes various healthcare-associated infections, but cellulitis is rare. Herein, we report the first case of sever cellulitis by A. xylosoxidans after allogeneic hematopoietic stem cell transplantation (HSCT). A 49-year-old man underwent allogeneic HSCT from 8/8 HLA-matched unrelated donor with myeloablative conditioning for relapsed acute myeloid leukemia. He developed skin chronic graft versus host disease 11 months after HSCT. During the prolonged treatment with prednisolone and cyclosporine, he developed cellulitis on his left leg and admitted to our hospital. Blood and exudate culture revealed A. xylosoxidans. Although empirical therapy with cefepime was ineffective, his symptoms were dramatically improved after administration of meropenem. To our knowledge, this is the first case of A. xylosoxidans cellulitis after allogeneic HSCT. A. xylosoxidans should be considered as a possible cause of cellulitis in post-allogeneic HSCT patients on prolonged immunosuppressive therapy.
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Affiliation(s)
- Yu Oyama
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Megumi Yasunaga
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Honda
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Maki
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yosuke Masamoto
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Kobayashi
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Japan
| | - Yoshitaka Wakabayashi
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Japan
| | - Shu Okugawa
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Japan
| | - Kyoji Moriya
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan.
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Chronic otomastoiditis and otitis externa caused by Achromobacter xylosoxidans. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2020.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Isler B, Kidd TJ, Stewart AG, Harris P, Paterson DL. Achromobacter Infections and Treatment Options. Antimicrob Agents Chemother 2020; 64:e01025-20. [PMID: 32816734 PMCID: PMC7577122 DOI: 10.1128/aac.01025-20] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Achromobacter is a genus of nonfermenting Gram-negative bacteria under order Burkholderiales Although primarily isolated from respiratory tract of people with cystic fibrosis, Achromobacter spp. can cause a broad range of infections in hosts with other underlying conditions. Their rare occurrence and ever-changing taxonomy hinder defining their clinical features, risk factors for acquisition and adverse outcomes, and optimal treatment. Achromobacter spp. are intrinsically resistant to several antibiotics (e.g., most cephalosporins, aztreonam, and aminoglycosides), and are increasingly acquiring resistance to carbapenems. Carbapenem resistance is mainly caused by multidrug efflux pumps and metallo-β-lactamases, which are not expected to be overcome by new β-lactamase inhibitors. Among the other new antibiotics, cefiderocol, and eravacycline were used as salvage therapy for a limited number of patients with Achromobacter infections. In this article, we aim to give an overview of the antimicrobial resistance in Achromobacter species, highlighting the possible place of new antibiotics in their treatment.
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Affiliation(s)
- Burcu Isler
- University of Queensland, Faculty of Medicine, UQ Center for Clinical Research, Brisbane, Australia
| | - Timothy J Kidd
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia
- University of Queensland, Faculty of Science, School of Chemistry and Molecular Biosciences, Brisbane, Australia
| | - Adam G Stewart
- University of Queensland, Faculty of Medicine, UQ Center for Clinical Research, Brisbane, Australia
- Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Patrick Harris
- University of Queensland, Faculty of Medicine, UQ Center for Clinical Research, Brisbane, Australia
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - David L Paterson
- University of Queensland, Faculty of Medicine, UQ Center for Clinical Research, Brisbane, Australia
- Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Draft Genome Sequence of an Unusually Multidrug-Resistant Strain of Achromobacter xylosoxidans from a Blood Isolate. Microbiol Resour Announc 2020; 9:9/22/e00194-20. [PMID: 32467264 PMCID: PMC7256251 DOI: 10.1128/mra.00194-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Achromobacter xylosoxidans strain DN2019 was isolated from blood of a septicemia patient. We describe the draft genome and antibiotic susceptibility of this strain. Achromobacter xylosoxidans strain DN2019 was isolated from blood of a septicemia patient. We describe the draft genome and antibiotic susceptibility of this strain.
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First Documented Case of Percutaneous Endoscopic Gastrostomy (PEG) Tube-Associated Bacterial Peritonitis due to Achromobacter Species with Literature Review. Case Rep Gastrointest Med 2020; 2020:4397930. [PMID: 32047677 PMCID: PMC7007964 DOI: 10.1155/2020/4397930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/24/2019] [Accepted: 11/11/2019] [Indexed: 01/25/2023] Open
Abstract
Introduction. Achromobacter species (spp.) peritonitis has seldom been identified in medical literature. Scarce cases of Achromobacter peritonitis described previously have been correlated with peritoneal dialysis and more sparingly with spontaneous bacterial peritonitis. Achromobacter exhibits intrinsic and acquired resistance, especially in chronic infections, to most antibiotics. This article conducts a literature review of all previously reported Achromobacter spp. peritonitis and describes the first reported case of Achromobacter peritonitis as a complication of percutaneous endoscopic gastrostomy (PEG) tube placement. Discussion. Achromobacter peritonitis as a complication of PEG-tube placement has not been previously reported. In our patients' case, the recently placed PEG-tube with ascitic fluid leakage was identified as the most plausible infection source. Although a rare bacterial peritonitis pathogen, Achromobacter may be associated with wide antimicrobial resistance and unfavorable outcomes. Conclusion. No current guidelines provide significant guidance on treatment of PEG-tube peritonitis regardless of microbial etiology. Infectious Disease Society of America identifies various broad-spectrum antibiotics targeting nosocomial intra-abdominal coverage; some of these antimicrobial selections (such as cefepime and metronidazole combination) may yet be inadequate for widely resistant Achromobacter spp. Recognizably, the common antibiotics utilized for spontaneous bacterial peritonitis, i.e., third generation cephalosporins and fluoroquinolones, to which Achromobacter is resistant and variably susceptible, respectively, would be extensively insufficient. Piperacillin/tazobactam (P/T) and carbapenem were identified to provide the most reliable coverage in vitro; clinically, 5 out of the 8 patients who received either P/T or a carbapenem, or both, eventually experienced clinical improvement.
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Hematogenous pleural infection caused by Achromobacter xylosoxidans in a patient undergoing maintenance hemodialysis. J Infect Chemother 2019; 26:389-392. [PMID: 31837898 DOI: 10.1016/j.jiac.2019.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/10/2019] [Accepted: 11/16/2019] [Indexed: 12/22/2022]
Abstract
A 78-year-old Japanese man, undergoing maintenance hemodialysis for 20 years and having received coronary artery bypass grafting two months before, was hospitalized because of fever with subclinical left-sided pleurisy. Achromobacter xylosoxidans strains exhibiting identical genomic patterns on a macrorestriction analysis were isolated from the blood and the pleural effusion obtained on admission. Physical and radiological examinations did not reveal any lesions in either chest wall or lung adjacent to the effusion, indicating that the organism in the effusion had entered the pleural space via the bloodstream. Immunocompromising conditions due to undergoing maintenance hemodialysis and the presence of the antecedently accumulated pleural effusion may have been associated with the development of hematogenous dissemination. The patient fully recovered only with antibiotic therapy. To our knowledge, the present report is the first describing a case of hematogenous pleural infection caused by A. xylosoxidans.
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Marion-Sanchez K, Pailla K, Olive C, Le Coutour X, Derancourt C. Achromobacter spp. healthcare associated infections in the French West Indies: a longitudinal study from 2006 to 2016. BMC Infect Dis 2019; 19:795. [PMID: 31500579 PMCID: PMC6734299 DOI: 10.1186/s12879-019-4431-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/30/2019] [Indexed: 01/14/2023] Open
Abstract
Background Bacteria of the Achromobacter genus, more particularly xylosoxidans species, are responsible for various healthcare associated infections (HAI) which are increasingly described since the last decade. Cystic fibrosis (CF) patients are considered as potential reservoirs in hospitals. We performed a retrospective study to estimate the frequencies of Achromobacter spp. HAI among patients from French West Indies, to determine characteristics of infected patients and establish a possible link between CF and infections. Methods All adults with at least one Achromobacter spp. positive sample and infection criteria in accordance with European official definitions of HAI, hospitalized in University Hospital of Martinique from 2006 to 2016 for more than 48 h, were included. Patient clinical features, immune status and underlying diseases were obtained from medical files. A list of CF patients was given by clinicians. Antibiotic-susceptibility profiles of the strains were determined using an automated method. Results Mean incidence density was 0.038/1000 days of hospitalization. Achromobacter spp. HAI evolved as an endemic situation with a low but pretty much stable incidence rate over the 11-year observation period. An epidemic peak was noticed in 2013. Among the 66 included patients, 56.1% were immunocompetent and no one had CF. Pneumonia and bacteraemia were the two main HAI. Among the 79 isolated strains, 92.4% were resistant to at least 1 major antibiotic and 16.4% met the definition of multidrug-resistant bacteria. Conclusions This microorganism, little known in our country because of the scarcity of CF patients, represents a threat for both immunosuppressed and immunocompetent patients and a therapeutic challenge because of its high resistance.
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Affiliation(s)
- Karine Marion-Sanchez
- Department of Hospital Hygiene, CHU Martinique, Fort-de-France, Martinique. .,Unité de Surveillance et de Prévention des Infections Nosocomiales, CHU de Martinique, Site Pierre-Zobda-Quitman, CS 90632, 97290, Fort-de-France Cedex, Martinique.
| | - Karine Pailla
- Bacteriology Laboratory, CHU Martinique, Fort-de-France, Martinique
| | - Claude Olive
- Bacteriology Laboratory, CHU Martinique, Fort-de-France, Martinique
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Hwang CH, Kim WJ, Jwa HY, Song SH. Community-acquired Achromobacter xylosoxidans infection presenting as a cavitary lung disease in an immunocompetent patient. Yeungnam Univ J Med 2019; 37:54-58. [PMID: 31661759 PMCID: PMC6986962 DOI: 10.12701/yujm.2019.00276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/02/2019] [Indexed: 11/16/2022] Open
Abstract
Achromobacter xylosoxidans is a gram-negative bacterium that can oxidize xylose. It is commonly found in contaminated soil and water but does not normally infect immunocompetent humans. We report a case of a cavitary lung lesion associated with community-acquired A. xylosoxidans infection, which mimicked pulmonary tuberculosis or lung cancer in an immunocompetent man. The patient was hospitalized due to hemoptysis, and chest computed tomography (CT) revealed a cavitary lesion in the superior segment of the left lower lobe. We performed bronchoscopy and bronchial washing, and subsequent bacterial cultures excluded pulmonary tuberculosis and identified A. xylosoxidans. We performed antibiotic sensitivity testing and treated the patient with a 6-week course of amoxicillin/clavulanate. After 2 months, follow-up chest CT revealed complete resolution of the cavitary lesion.
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Affiliation(s)
- Chan Hee Hwang
- Republic of Korea Defence Intelligence Command, Anyang, Korea
| | - Woo Jin Kim
- Department of Laboratory Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Hye Young Jwa
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Sung Heon Song
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
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Bates AS, Natarajan M, Reddy RV. Achromobacter xylosoxidans in idiopathic cystic bronchiectasis. BMJ Case Rep 2018; 11:11/1/e211610. [PMID: 30567079 DOI: 10.1136/bcr-2015-211610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This is the first case in the English language describing Achromobacter xylosoxidans in a patient with idiopathic bronchiectasis. A 66-year-old man with bronchiectasis presented with shortness of breath to the emergency department of our institution, a district hospital in the UK. His medications included long-term supplemental oxygen therapy and prophylactic azithromycin. Following 2 days admission to the respiratory unit, his saturations significantly deteriorated, and the patient was admitted to intensive care with type II respiratory failure. Following a week of intubation and ventilation, multidrug resistant A. xylosoxidans was isolated from the tracheal aspiration secretions. The patient recovered after receiving targeted intravenous antimicrobial therapy.
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Fluoroquinolone-resistant Achromobacter xylosoxidans clinical isolates from Serbia: high prevalence of the aac-(6')-Ib-cr gene among resistant isolates. Folia Microbiol (Praha) 2018; 64:153-159. [PMID: 30105450 DOI: 10.1007/s12223-018-0639-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
The aim of this study was to evaluate the contribution of plasmid-mediated genes and efflux to fluoroquinolone resistance in collection of Achromobacter spp. gathered during a 3-year period. Susceptibility to ciprofloxacin and levofloxacin was tested by disk diffusion and microdilution tests for a collection of 98 Achromobacter spp. clinical isolates. Identification of fluoroquinolone-resistant isolates was performed by sequencing and phylogenetic analyses of the nrdA gene. Genetic relatedness among resistant isolates was determined by pulsed-field gel electrophoresis (PFGE) analysis. The influence of an H+ conductor cyanide m-chlorophenyl hydrazone (CCCP) and a resistance-nodulation-division-type efflux pump inhibitor phenylalanine-arginine beta-naphthylamide (PAβN) on minimal inhibitory concentration (MIC) value was evaluated by broth microdilution. The presence of the plasmid-mediated qnrA, qnrB, qnrC, qnrS, and aac-(6')-Ib-cr genes was investigated by PCR and sequencing. Achromobacter spp. isolates that were resistant or intermediately resistant to fluoroquinolones in disk diffusion tests (44/98) were subjected to microdilution. As a result, 20/98 isolates were confirmed to be resistant to ciprofloxacin while 10/98 was resistant to levofloxacin. CCCP decreased twofold MIC value for ciprofloxacin in six isolates and more than 16 times in one isolate, while MIC value for levofloxacin was decreased in all isolates (twofold to more than eightfold). Fluoroquinolone-resistant isolates were identified as A. xylosoxidans with the nrdA gene sequencing. PFGE revealed that resistant isolates belonged to seven different genotypes. Ten isolates belonging to four genotypes were positive for the aac-(6')-Ib-cr gene. Although resistance to fluoroquinolones was not widespread among analyzed isolates, detected contribution of efflux pumps and the presence of the aac-(6')-Ib-cr gene present a platform for emergence of more resistant strains.
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Recio R, Brañas P, Martínez MT, Chaves F, Orellana MA. Effect of respiratory Achromobacter spp. infection on pulmonary function in patients with cystic fibrosis. J Med Microbiol 2018; 67:952-956. [DOI: 10.1099/jmm.0.000763] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- R. Recio
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - P. Brañas
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - M. T. Martínez
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Cystic Fibrosis Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F. Chaves
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - M. A. Orellana
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
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Lee B, Cai CX, Srikumaran D, Woreta FA. Severe Achromobacter xylosoxidans keratitis with deep corneal involvement. Am J Ophthalmol Case Rep 2018; 11:128-130. [PMID: 29984332 PMCID: PMC6031244 DOI: 10.1016/j.ajoc.2018.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 05/04/2018] [Accepted: 06/18/2018] [Indexed: 01/07/2023] Open
Abstract
Purpose To describe a case of Achromobacter xylosoxidans keratitis with deep involvement of the corneal stroma and discuss its management. Observations A 73 year-old monocular male with infectious keratitis of the right eye was referred to the Wilmer Eye Institute after a month of empiric treatment with besifloxacin. On presentation, slit lamp examination of the right eye demonstrated a diffusely edematous cornea with three areas of corneal infiltrates and an overlying epithelial defect and a 1.3 mm hypopyon in the anterior chamber. The corneal culture performed grew A. xylosoxidans. Empiric antibiotic regimen was adjusted once corneal culture susceptibility results were available. Seven days later, slit lamp examination demonstrated a resolving epithelial defect, stable infiltrates, and resolution of the hypopyon. After approximately two months of follow up with his primary ophthalmologist, he was noted to have recurrent hypopyon and infiltrates and was referred back to Wilmer. Slit lamp examination again demonstrated an epithelial defect, diffuse corneal haze, deep stromal infiltrates, and a 1 mm hypopyon. Corneal infiltrates were too deep to culture. Ultimately, the patient underwent a therapeutic penetrating keratoplasty with anterior chamber washout resulting in improvement of vision. Conclusions and importance The indolent progression of A. xylosoxidans keratitis may predispose patients to delayed presentation and treatment. This can result in deep stromal infection that complicates management due to poor antibiotic penetration. Deep stromal infections in A. xylosoxidans keratitis warrant the consideration of intrastromal antibiotic injection or early therapeutic penetrating keratoplasty.
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Affiliation(s)
- Benjamin Lee
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Wilmer, Baltimore, MD, 21287, USA
| | - Cindy X Cai
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Wilmer, Baltimore, MD, 21287, USA
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Wilmer, Baltimore, MD, 21287, USA
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Wilmer, Baltimore, MD, 21287, USA
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Proteomic identification of Axc, a novel beta-lactamase with carbapenemase activity in a meropenem-resistant clinical isolate of Achromobacter xylosoxidans. Sci Rep 2018; 8:8181. [PMID: 29802257 PMCID: PMC5970244 DOI: 10.1038/s41598-018-26079-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 05/04/2018] [Indexed: 01/24/2023] Open
Abstract
The development of antibiotic resistance during treatment is a threat to patients and their environment. Insight in the mechanisms of resistance development is important for appropriate therapy and infection control. Here, we describe how through the application of mass spectrometry-based proteomics, a novel beta-lactamase Axc was identified as an indicator of acquired carbapenem resistance in a clinical isolate of Achromobacter xylosoxidans. Comparative proteomic analysis of consecutively collected susceptible and resistant isolates from the same patient revealed that high Axc protein levels were only observed in the resistant isolate. Heterologous expression of Axc in Escherichia coli significantly increased the resistance towards carbapenems. Importantly, direct Axc mediated hydrolysis of imipenem was demonstrated using pH shift assays and 1H-NMR, confirming Axc as a legitimate carbapenemase. Whole genome sequencing revealed that the susceptible and resistant isolates were remarkably similar. Together these findings provide a molecular context for the fast development of meropenem resistance in A. xylosoxidans during treatment and demonstrate the use of mass spectrometric techniques in identifying novel resistance determinants.
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Achromobacter endocarditis in native cardiac valves - an autopsy case report and review of the literature. Cardiovasc Pathol 2018; 36:6-10. [PMID: 29906520 DOI: 10.1016/j.carpath.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/10/2018] [Accepted: 05/11/2018] [Indexed: 11/21/2022] Open
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Wood GC, Jonap BL, Maish GO, Magnotti LJ, Swanson JM, Boucher BA, Croce MA, Fabian TC. Treatment of Achromobacter Ventilator-Associated Pneumonia in Critically Ill Trauma Patients. Ann Pharmacother 2017; 52:120-125. [PMID: 28906137 DOI: 10.1177/1060028017730838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Achromobacter sp are nonfermenting Gram-negative bacilli (NFGNB) that rarely cause severe infections, including ventilator-associated pneumonia (VAP). Data on the treatment of Achromobacter pneumonia are very limited, and the organism has been associated with a high mortality rate. Thus, more data are needed on treating this organism. OBJECTIVE To evaluate the treatment of Achromobacter VAP in critically ill trauma patients. METHODS This retrospective, observational study evaluated critically ill trauma patients who developed Achromobacter VAP. A previously published pathway for the diagnosis and management of VAP was used according to routine patient care. This included the use of quantitative bronchoscopic bronchoalveolar lavage cultures to definitively diagnose VAP. RESULTS A total of 37 episodes of Achromobacter VAP occurred in 34 trauma intensive care unit patients over a 15-year period. The most commonly used definitive antibiotics were imipenem/cilastatin, cefepime, or trimethoprim/sulfamethoxazole. The primary outcome of clinical success was achieved in 32 of 37 episodes (87%). This is similar to previous studies of other NFGNB VAP (eg, Pseudomonas, Acinetobacter) from the study center. Microbiological success was seen in 21 of 28 episodes (75%), and VAP-related mortality was 9% (3 of 34 patients). CONCLUSIONS Achromobacter is a rare but potentially serious cause of VAP in critically ill patients. In this study, there was an acceptable success rate compared with other causes of NFGNB VAP in this patient population.
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Affiliation(s)
| | - Brittany L Jonap
- 1 University of Tennessee Health Science Center, Memphis, TN, USA
| | - George O Maish
- 1 University of Tennessee Health Science Center, Memphis, TN, USA
| | - Louis J Magnotti
- 1 University of Tennessee Health Science Center, Memphis, TN, USA
| | - Joseph M Swanson
- 1 University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Martin A Croce
- 1 University of Tennessee Health Science Center, Memphis, TN, USA
| | - Timothy C Fabian
- 1 University of Tennessee Health Science Center, Memphis, TN, USA
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Rodrigues CG, Rays J, Kanegae MY. Native-valve endocarditis caused by Achromobacter xylosoxidans: a case report and review of literature. Autops Case Rep 2017; 7:50-55. [PMID: 29043211 PMCID: PMC5634435 DOI: 10.4322/acr.2017.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/12/2017] [Indexed: 11/29/2022]
Abstract
Achromobacter xylosoxidans is a Gram-negative aerobic bacterium first described by Yabuuchi and Ohyama in 1971. A. xylosoxidans is frequently found in aquatic environments. Abdominal, urinary tract, ocular, pneumonia, meningitis, and osteomyelitis are the most common infections. Infective endocarditis is rare. As far as we know, until now, only 19 cases have been described, including this current report. We report the case of community-acquired native valve endocarditis caused by A. xylosoxidans in an elderly patient without a concomitant diagnosis of a malignancy or any known immunodeficiency. The patient presented with a 2-month history of fever, weight loss, and progressive dyspnea. On physical examination, mitral and aortic murmurs were present, along with Janeway's lesions, and a positive blood culture for A. xylosoxidans. The transesophageal echocardiogram showed vegetation in the aortic valve, which was consistent with the diagnosis of infective endocarditis.
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Affiliation(s)
- Caio Godoy Rodrigues
- University of São Paulo (USP), School of Medicine, Internal Medicine Department. São Paulo, SP, Brazil
| | - Jairo Rays
- University of São Paulo (USP), Hospital Universitário, Internal Medicine Division. São Paulo, SP, Brazil
| | - Marcia Yoshie Kanegae
- University of São Paulo (USP), Hospital Universitário, Internal Medicine Division. São Paulo, SP, Brazil
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Rath SN, Ray M, Pattnaik A, Pradhan SK. Drug Target Identification and Elucidation of Natural Inhibitors for Bordetella petrii: An In Silico Study. Genomics Inform 2016; 14:241-254. [PMID: 28154518 PMCID: PMC5287131 DOI: 10.5808/gi.2016.14.4.241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 11/24/2016] [Accepted: 11/24/2016] [Indexed: 11/20/2022] Open
Abstract
Environmental microbes like Bordetella petrii has been established as a causative agent for various infectious diseases in human. Again, development of drug resistance in B. petrii challenged to combat against the infection. Identification of potential drug target and proposing a novel lead compound against the pathogen has a great aid and value. In this study, bioinformatics tools and technology have been applied to suggest a potential drug target by screening the proteome information of B. petrii DSM 12804 (accession No. PRJNA28135) from genome database of National Centre for Biotechnology information. In this regards, the inhibitory effect of nine natural compounds like ajoene (Allium sativum), allicin (A. sativum), cinnamaldehyde (Cinnamomum cassia), curcumin (Curcuma longa), gallotannin (active component of green tea and red wine), isoorientin (Anthopterus wardii), isovitexin (A. wardii), neral (Melissa officinalis), and vitexin (A. wardii) have been acknowledged with anti-bacterial properties and hence tested against identified drug target of B. petrii by implicating computational approach. The in silico studies revealed the hypothesis that lpxD could be a potential drug target and with recommendation of a strong inhibitory effect of selected natural compounds against infection caused due to B. petrii, would be further validated through in vitro experiments.
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Affiliation(s)
- Surya Narayan Rath
- BIF Centre, Department of Bioinformatics, Orissa University of Agriculture and Technology, Bhubaneswar 751003, India
| | - Manisha Ray
- BIF Centre, Department of Bioinformatics, Orissa University of Agriculture and Technology, Bhubaneswar 751003, India
| | - Animesh Pattnaik
- BIF Centre, Department of Bioinformatics, Orissa University of Agriculture and Technology, Bhubaneswar 751003, India
| | - Sukanta Kumar Pradhan
- BIF Centre, Department of Bioinformatics, Orissa University of Agriculture and Technology, Bhubaneswar 751003, India
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45
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Al-Jasser AM, Al-Anazi KA. Complicated septic shock caused by Achromobacter xylosoxidans bacteremia in a patient with acute lymphoblastic leukaemia. Libyan J Med 2016. [DOI: 10.3402/ljm.v2i4.4736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A M Al-Jasser
- Department of Pathology, Armed Forces Hospital, Riyadh, Saudi Arabia
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46
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Takei T, Konuma T, Takahashi S, Miharu Y, Suzuki M, Shibata H, Ishii H, Kato S, Takahashi S, Tojo A. Multi-locus sequence analysis for identification of Achromobacter xylosoxidans from blood culture. Infect Dis (Lond) 2016; 48:864-6. [DOI: 10.1080/23744235.2016.1203987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Tomomi Takei
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Takaaki Konuma
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | | | - Yuta Miharu
- Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masato Suzuki
- Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroko Shibata
- Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroto Ishii
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Seiko Kato
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Satoshi Takahashi
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Arinobu Tojo
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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47
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48
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Lee JH, Lee SY, Park IY, Park SY, Lee JS, Kang G, Kim JS, Eom JS. A Case of Septic Shock caused by Achromobacter xylosoxidans in an Immunocompetent Female Patient after Extracorporeal Shock Wave Lithotripsy for a Ureteral Stone. Infect Chemother 2016; 48:47-50. [PMID: 27104016 PMCID: PMC4835435 DOI: 10.3947/ic.2016.48.1.47] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 10/08/2014] [Accepted: 10/10/2014] [Indexed: 11/24/2022] Open
Abstract
Achromobacter xylosoxidans can cause various types of infections, but its infection in humans is rare. A. xylosoxidans has been reported as a rare etiological agent of infections including primary bacteremia, catheter-related bloodstream infection, endocarditis, otitis, and pneumonia, particularly in immunocompromised hosts. We encountered a case of septic shock caused by A. xylosoxidans in a 52-year-old, immunocompetent woman with no underlying disease, who received extracorporeal shock wave lithotripsy to remove a left upper ureteral stone. She was treated with antibiotics to which the organism was susceptible but died as a result of septic shock.
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Affiliation(s)
- Jae Hyuk Lee
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
| | - So Yon Lee
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
| | - In Young Park
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
| | - So Yeon Park
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
| | - Jin Seo Lee
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
| | - Goeun Kang
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
| | - Jae Seok Kim
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
| | - Joong Sik Eom
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical College, Seoul, Korea
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49
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Deng MC, Li J, Hong YH, Xu XM, Chen WX, Yuan JP, Peng J, Yi M, Wang JH. Characterization of a novel biosurfactant produced by marine hydrocarbon-degrading bacterium Achromobacter sp. HZ01. J Appl Microbiol 2016; 120:889-99. [PMID: 26788863 DOI: 10.1111/jam.13065] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/11/2016] [Accepted: 01/14/2016] [Indexed: 11/29/2022]
Abstract
AIMS To purify and characterize the biosurfactants produced by Achromobacter sp. HZ01. METHODS AND RESULTS After fermentation, one biosurfactant was successfully purified from the fermentation broth of strain HZ01 by centrifugation, extraction using ethyl acetate, silica gel chromatography and reversed phase-high performance liquid chromatography. The critical micelle concentration (CMC) of the biosurfactant and the effects of temperatures, pH and salinities on its stability were determined. Fourier transform infrared spectroscopy, analysis of fatty acids and amino acids and mass spectrometry were used to characterize the biosurfactant. The maximum production yield of the crude biosurfactant reached to 6·84 g l(-1) after incubation for 96 h. Except the favourable adaptability to a wide range of temperatures, pH and salinities, the biosurfactant with a CMC value of 48 mg l(-1) could efficiently emulsify diverse hydrophobic compounds. The chemical formula of this biosurfactant was confirmed to be CH3 -(CH2 )17 -CHO-CH2 -CO-Gly-Gly-Leu-Met-Leu-Leu, in which the oxygen atom of group CHO linked to the last amino acid (Leu), a structure had never been reported before. CONCLUSIONS The purified biosurfactant is a novel cyclic lipopeptide. SIGNIFICANCE AND IMPACT OF THE STUDY One novel lipopeptide was purified and characterized. The novel biosurfactant exhibited good potential applications, such as bioremediation.
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Affiliation(s)
- M-C Deng
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, School of Marine Sciences, Sun Yat-Sen University, Guangzhou, China.,Department of Food and Bioengineering, Guangdong Industry Technical College, Guangzhou, China
| | - J Li
- Department of Food and Bioengineering, Guangdong Industry Technical College, Guangzhou, China.,College of Environment and Energy, South China University of Technology, Guangzhou, China
| | - Y-H Hong
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, School of Marine Sciences, Sun Yat-Sen University, Guangzhou, China
| | - X-M Xu
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, School of Marine Sciences, Sun Yat-Sen University, Guangzhou, China
| | - W-X Chen
- Department of Food and Bioengineering, Guangdong Industry Technical College, Guangzhou, China
| | - J-P Yuan
- South China Sea Bioresource Exploitation and Utilization Collaborative Innovation Center, Sun Yat-Sen University, Guangzhou, China
| | - J Peng
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, School of Marine Sciences, Sun Yat-Sen University, Guangzhou, China
| | - M Yi
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, School of Marine Sciences, Sun Yat-Sen University, Guangzhou, China
| | - J-H Wang
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, School of Marine Sciences, Sun Yat-Sen University, Guangzhou, China.,South China Sea Bioresource Exploitation and Utilization Collaborative Innovation Center, Sun Yat-Sen University, Guangzhou, China
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50
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Abstract
Achromobacteria are ubiquitous environmental organisms that may also become opportunistic pathogens in certain conditions, such as cystic fibrosis, hematologic and solid organ malignancies, renal failure, and certain immune deficiencies. Some members of this genus, such as xylosoxidans, cause primarily nosocomially acquired infections affecting multiple organ systems, including the respiratory tract, urinary tract, and, less commonly, the cardiovascular and central nervous systems. Despite an increasing number of published case reports and literature reviews suggesting a global increase in achromobacterial disease, most clinicians remain uncertain of the organism's significance when clinically isolated. Moreover, effective treatment can be challenging due to the organism's inherent and acquired multidrug resistance patterns. We reviewed all published cases to date of non-cystic fibrosis achromobacterial lung infections to better understand the organism's pathogenic potential and drug susceptibilities. We found that the majority of these cases were community acquired, typically presenting as pneumonias (88%), and were most frequent in individuals with hematologic and solid organ malignancies. Our findings also suggest that achromobacterial lung infections are difficult to treat, but respond well to extended-spectrum penicillins and cephalosporins, such as ticarcillin, piperacillin, and cefoperazone.
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