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Achromobacter xylosoxidans Bacteremia: A 10-Year Analysis of 54 Cases

  • J. Gómez-Cerezo
  • I. SuárezEmail author
  • J. J. Ríos
  • P. Peña
  • M. J. García de Miguel
  • M. de José
  • O. Monteagudo
  • P. Linares
  • A. Barbado-Cano
  • J. J. Vázquez
Concise Article

Abstract

Fifty-four cases of Achromobacter xylosoxidans bacteremia diagnosed over a 10-year period in patients from 2 months to 87 years of age were reviewed. Fifty-two episodes were nosocomial. The most frequent underlying condition was neoplasm (solid or hematological). The source of infection was a contaminated intravenous catheter in 35 patients (60%) and pneumonia in 6 patients. Eight (15%) patients died. The only risk factors significantly associated with mortality were age over 65 years and neutropenia. The results of in vitro susceptibility studies of the isolates showed that antibiotic therapy with antipseudomonal penicillins or carbapenems would be a reasonable choice. An epidemiological study conducted in the hemodialysis unit showed Achromobacter xylosoxidans in tap water and on the hands of two healthcare workers but not in the hemodialysis systems. Patients were probably contaminated when healthcare workers manipulated the intravenous catheters without wearing gloves.

Keywords

Chronic Obstructive Pulmonary Disease Cystic Fibrosis Blood Culture Nosocomial Infection Healthcare Worker 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Duggan JM, Goldstein SJ, Chenoweth CE, Kauffman CA, Bradley SF (1996) Achromobacter xylosoxidans bacteremia: report of four cases and review of the literature. Clin Infect Dis 23:569–576PubMedGoogle Scholar
  2. 2.
    Knippschild M, Schmid EN, Uppenkamp M, Konig E, Meusers P, Brittinger G, Hoffkes HG (1996) Infection by Alcaligenes xylosoxidans subsp. xylosoxidans in neutropenic patients. Oncology 53:258–262PubMedGoogle Scholar
  3. 3.
    Legrand C, Anaissie E (1992) Bacteremia due to Achromobacter xylosoxidans in patients with cancer. Clin Infect Dis 14:479–484PubMedGoogle Scholar
  4. 4.
    Hernandez JA, Martino R, Pericas R, Sureda A, Brunet S, Domingo-Albos A (1998) Achromobacter xylosoxidans bacteremia in patients with hematologic malignancies. Haematologica 83:284–285PubMedGoogle Scholar
  5. 5.
    Manfredi R, Nanetti A, Ferri M, Chiodo F (1997) Bacteremia and respiratory involvement by Alcaligenes xylosoxidans in patients infected with the human immunodeficiency virus. Eur J Clin Microbiol Infect Dis 16:933–938PubMedGoogle Scholar
  6. 6.
    American College of Chest Physicians/Society of Critical Care Consensus Conference (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874PubMedGoogle Scholar
  7. 7.
    Raad II, Bodey GP (1992) Infectious complications of indwelling vascular catheters. Clin Infect Dis 15:197–208Google Scholar
  8. 8.
    Maki DG, Weise CE, Sarafin HW (1977) A semiquantitative culture method for identifying intravenous catheter-related infections. N Engl J Med 296:1305–1309PubMedGoogle Scholar
  9. 9.
    National Committee for Clinical Laboratory Standards (1990) Performance standards for antimicrobial disk susceptibility tests. Approved standard M2-A4. NCCLS, Villanova, PAGoogle Scholar
  10. 10.
    National Committee for Clinical Laboratory Standards (1990) Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard M7-A2. NCCLS, Villanova, PAGoogle Scholar
  11. 11.
    Reina J, Antich M, Siquier B, Alomar P (1998) Nosocomial outbreak of Achromobacter xylosoxidans associated with a diagnostic contrast solution. J Clin Pathol 41:920–921Google Scholar
  12. 12.
    Spear JB, Fuhrer J, Kirby BD (1988) Achromobacter xylosoxidans (Alcaligenes xylosoxidans subsp. xylosoxidans) bacteremia associated with a well-water source: case report and review of the literature. J Clin Microbiol 26:598–599PubMedGoogle Scholar
  13. 13.
    Reverdy ME, Freney J, Fleurette J, Coulet M, Surgot M, Marmet D, Ploton C (1984) Nosocomial colonization and infection by Achromobacter xylosoxidans. J Clin Microbiol 19:140–143PubMedGoogle Scholar
  14. 14.
    Rutala WA, Weber DJ (1997) Water as a reservoir of nosocomial pathogens. Infect Control Hosp Epidemiol 18:609–616PubMedGoogle Scholar
  15. 15.
    Queensland Health Capital Works Branch and Communicable Diseases Unit (2002) Building and refurbishment: infection control guidelines. In: Capital works guidelines, 2nd edn. Queensland Government, Brisbane, pp 30–31Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • J. Gómez-Cerezo
    • 1
  • I. Suárez
    • 1
    Email author
  • J. J. Ríos
    • 1
  • P. Peña
    • 2
  • M. J. García de Miguel
    • 3
  • M. de José
    • 3
  • O. Monteagudo
    • 4
  • P. Linares
    • 1
  • A. Barbado-Cano
    • 1
  • J. J. Vázquez
    • 1
  1. 1.Department of Internal MedicineHospital Universitario "La Paz"MadridSpain
  2. 2.Department of MicrobiologyHospital Universitario "La Paz"MadridSpain
  3. 3.Department of PediatricsHospital Universitario "La Paz"MadridSpain
  4. 4.Department of Preventive MedicineHospital Universitario "La Paz"MadridSpain

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