Abstract
Seven cases ofAlcaligenes xylosoxidans bacteremia and/or respiratory disease in patients infected with the human immunodeficiency virus (HIV) are described. Reported only thrice previously in this setting, these bacterial complications occurred during different phases of HIV infection and were associated with leukopenia-neutropenia in four patients and a central vascular catheter in two. Although the majority of cases were diagnosed after day 3 of hospitalization, a distinct source of infection was never identified. In four patients with advanced underlying disease, a polymicrobial infection was present. In vitro resistance to aminoglycosides, first-generation cephalosporins, and aztreonam was identified, but treatment with fluoroquinolones, piperacillin, or an aminoglycoside in combination with either ceftazidime or pefloxacin was successful in all cases. The relevance ofAlcaligenes xylosoxidans and related species of gramnegative non-glucose fermenting bacilli as opportunistic pathogens in the immunocompromised host and in the setting of HIV infection is briefly reviewed.
Similar content being viewed by others
References
Mandell WF, Garvery GJ, Neu HC:Alcaligenes xylosoxidans bacteraemia. Reviews of Infectious Diseases 1987, 9: 1001–1005.
McGann KA, Provencher M, Hoegg C, Talbot GH:Achromobacter xylosoxidans bacteremia. Infection Control and Hospital Epidemiology 1990, 11: 539–541.
Hearn YR, Gander RM:Achromobacter xylosoxidans. An unusual neonatal pathogen. American Journal of Clinical Pathology 1991, 96: 211–214.
Roilides E, Mueller BU, Letterio JJ, Butler K, Pizzo PA:Agrobacterium radiobacter bacteremia in a child with human immunodeficiency virus infection. Pediatric Infectious Disease Journal 1991, 10: 337–338.
Legrand C, Anaissie E: Bacteremia due toAchromobacter xylosoxidans in patients with cancer. Clinical Infectious Diseases 1992, 14: 479–484.
Cieslak TJ, Robb ML, Drabick CJ, Fischer GW: Catheter-associated sepsis caused byOchrobactrum anthropi: report of a case and review of related nonfermentative bacteria. Clinical Infectious Diseases 1992, 14: 902–907.
Gransden WR, Eykyn SJ: Seven cases of bacteremia due toOchrobactrum anthropi. Clinical Infectious Diseases 1992, 15: 1068–1069.
Hulse M, Johnson S, Ferrieri P:Agrobacterium infections in humans: experience at one hospital and review. Clinical Infectious Diseases 1993, 16: 112–117.
Boukadida J, Monastiri K, Snoussi N, Jeddi M, Berche P: Nosocomial neonatal meningitis byAlcaligenes xylosoxidans transmitted by aqueous eosin. Pediatric Infectious Disease Journal 1993, 12: 696–697.
Kern WW, Oethinger M, Kaufhold A, Rozdzinski E, Marre R:Ochrobactrum anthropi bacteremia: report of four cases and short review. Infection 1993, 21: 306–310.
Dupont M, Winnock S, Rogues AM, Janvier G, DeBarbeyrac B, Saric J:Achromobacter xylosoxidans (Alcaligenes xylosoxidans subspeciesxylosoxidans) bacteremia after liver transplantation. Intensive Care Medicine 1993, 19: 480.
Cieslak TJ, Raszka WV: Catheter-associated sepsis due toAlcaligenes xylosoxidans in a child with AIDS. Clinical Infectious Diseases 1993, 16: 592–593.
Gradon JD, Mayrer AR, Hayes J: Pulmonary abscess associated withAlcaligenes xylosoxidans in a patient with AIDS. Clinical Infectious Diseases 1993, 17: 1071–1072.
Taylor P, Fischbein L: Prosthetic knee infection due toAchromobacter xylosoxidans. Journal of Rheumatology 1992, 19: 992–993.
Ezzedine H, Mourad M, Van Ossel C, Logghe C, Squifflet JP, Renault F, Wauters G, Gigi J, Wilmotte L, Haxhe JJ: An outbreak ofOchrobactrum anthropi bacteraemia in five organ transplant patients. Journal of Hospital Infection 1994, 27: 35–42.
Alnor D, Frimodt-Moller N, Espersen F, Fredicksen W: Infections with the unusual human pathogensAgrobacterium species andOchrobactrum anthropi. Clinical Infectious Diseases 1994, 18: 914–920.
Hoffkes HG, Schmid EN: Nosocomial infection byAlcaligenes xylosoxidans in neutropenic patients. Presse Medicale 1995, 24: 1180.
Bénaoudia F, François M, Brahimi N, Narcy P, Bingen E:Alcaligenes xylosoxidans-associated infection in an infant with cholesteatoma. Pediatric Infectious Disease Journal 1995, 14: 637–638.
Ramos JM, Fernandez-Roblas R, Garcia Ruiz P, Soriano F: Meningitis caused byAlcaligenes (Achromobacter) xylosoxidans associated with epidural catheter. Infection 1995, 23: 395–396.
Haditsch M, Binder L, Tschurtschenthaler G, Watschinger R, Zauner G, Mittermayer H: Bacteremia caused byOchrobactrum anthropi in an immunocompromised child. Infection 1994, 22: 291–292.
Mastroianni A, Coronado O, Nanetti A, Manfredi R, Chiodo F:Agrobacterium radiobacter pneumonia in a patient with HIV infection. European Journal of Clinical Microbiology & Infectious Diseases 1996, 15: 960–963.
Mofredj A, Baraka D: Infection àAlcaligenes denitrificans subsp.xylosoxidans chez une patiente insuffisante respiratoire chronique corticodependante. Presse Medicale 1996, 25: 306.
Wintermeyer SM, Nahata MC:Alcaligenes xylosoxidans in children with chronic otorrhea. Otolaryngology — Head and Neck Surgery 1996, 114: 332–334.
Knippschild M, Schmid EN, Uppenkamp M, König E, Meusers P, Brittinger G, Hoffkes HG: Infection byAlcaligenes xylosoxidans subsp.xylosoxidans in neutropenic patients. Oncology 1996, 53: 258–262.
Chang HJ, Christenson JC, Pavia AT, Bobrin BD, Bland LA, Carson LA, Arduino MJ, Verma P, Aguero SM, Carroll K, Jenkins E, Daly JA, Woods ML, Jarvis WR:Ochrobactrum anthropi meningitis in pediatric pericardial allograft transplant recipients. Journal of Infectious Diseases 1996, 173: 656–660.
Martino R, Martinez C, Pericas R, Salazar R, Sola C, Brunet S, Sureda A, Domingo Albos A: Bacteremia due to glucose non-fermenting gram-negative bacilli in patients with hematological neoplasias and solid tumors. European Journal of Clinical Microbiology & Infectious Diseases 1996, 15: 610–615.
Duggan JM, Goldstein SJ, Chenowetz CE, Kauffman CA, Bradley SF:Achromobacter xylosoxidans bacteremia: report of four cases and review of the literature. Clinical Infectious Diseases 1996, 23: 569–676.
Cheron M, Abachin E, Guerot E, El Bez M, Simonet M: Investigation of hospital-acquired infections due toAlcaligenes denitrificans subsp.xylosoxidans by DNA restriction fragment length polymorphism. Journal of Clinical Microbiology 1994, 32: 1023–1026.
National Committee for Clinical Laboratory Standards: Performance standards for antimicrobial disk susceptibility tests. Approved standard M2-A6, NCCLS, Villanova, PA, 1997, 13: 1–26.
Bergogne-Berezin E, Decre D, Joly-Guillou ML: Opportunistic nosocomial multiply resistant bacterial infections. Their treatment and prevention. Journal of Antimicrobial Chemotherapy 1993, 32, Supplement A: 39–47.
Arpi M, Renneberg J, Andersen HK, Nielsen B, Larsen SO: Bacteremia at a Danish university hospital during a twenty-five-year period (1968–1992). Scandinavian Journal of Infectious Diseases 1995, 27: 245–251.
Vu Thien H, Moissenet D, Valcin M, Dulot C, Tournier G, Garbarg-Chenon A: Molecular epidemiology ofBurkholderia cepacia, Stenotrophomonas maltophilia, andAlcaligenes xylosoxidans in a cystic fibrosis center. European Journal of Clinical Microbiology & Infectious Diseases 1996, 15: 876–879.
Bernard E, Carles M, Pradier C, Ozouf N, Dellamonica P: Septicémies communautaires et nosocomiales chez le patient infecté par le virus de l'immunodéficience humaine. Presse Medicale 1996, 25: 746–750.
Kovacs A, Leaf HL, Simberkoff MS: Bacterial infections. Medical Clinics of North America 1997, 81: 319–343.
Rolston K, Messer M: Thein vitro susceptibility ofAlcaligenes denitrificans subsp.xylosoxidans to 40 antimicrobial agents. Journal of Antimicrobial Chemotherapy 1990, 26: 857–860.
Glupczynski Y, Hansen W, Freney J, Yourassonisky E:In vitro susceptibility ofAlcaligenes denitrificans subsp.xylosoxidans to 24 antimicrobial agents. Antimicrobial Agents and Chemotherapy 1988, 32: 276–278.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Manfredi, R., Nanetti, A., Ferri, M. et al. Bacteremia and respiratory involvement byAlcaligenes xylosoxidans in patients infected with the human immunodeficiency virus. Eur. J. Clin. Microbiol. Infect. Dis. 16, 933–938 (1997). https://doi.org/10.1007/BF01700563
Issue Date:
DOI: https://doi.org/10.1007/BF01700563