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Haqqie SS, Roth M, Bailie GR. Unsuccessful Treatment of CAPD Peritonitis Caused by Alcaligenes xylosoxidans subsp. denitrificans. Ren Fail 2020. [DOI: 10.1080/0886022x.1995.12098272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Syed S. Haqqie
- Stratton VA Medical Center Albany, New York
- Albany Medical College Albany, New York
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2
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Melgosa M, Espinazo O, Alonso A, Perea AG, Navarro M. Dialysis-Associated Alcaligenes Xylosoxidans Peritonitis: A Pediatric Case. Perit Dial Int 2020. [DOI: 10.1177/089686080402400110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Marta Melgosa
- Paediatric Nephrology Unit Hospital La Paz, Madrid, Spain
| | - Oscar Espinazo
- Paediatric Nephrology Unit Hospital La Paz, Madrid, Spain
| | - Angel Alonso
- Paediatric Nephrology Unit Hospital La Paz, Madrid, Spain
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3
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Ledger S, Cordy P. Successful Treatment of Alcaligenes xylosoxidans in Automated Peritoneal Dialysis-Related Peritonitis. Perit Dial Int 2020. [DOI: 10.1177/089686080702700524] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- S.G. Ledger
- Pharmacy Service London Health Sciences Centre London, Ontario, Canada
| | - P. Cordy
- Division of Nephrology London Health Sciences Centre London, Ontario, Canada
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4
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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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5
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Barragán EP, Pérez JS, Corbella L, Orellana MÁ, Fernández-Ruiz M. Achromobacter xylosoxidans bacteremia: clinical and microbiological features in a 10-year case series. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2018; 31:268-273. [PMID: 29806765 PMCID: PMC6166261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The treatment of Achromobacter xylosoxidans bacteremia is challenged by antimicrobial resistance and the paucity of data. We aimed at offering a contemporary description of this uncommon entity. METHODS Retrospective case series of 13 episodes of A. xylosoxidans bacteremia diagnosed over a 10-year period (November 2007 to May 2017) in our tertiary care center. RESULTS Solid organ cancer and heart failure were the most common comorbidities (4/13 [30.7%]). All but one episodes were hospital-acquired. Most patients had received previous antibiotic therapy (7/13 [53.8%]) and had a central venous catheter in place (6/13 [46.1%]). Primary and intravascular catheter were the most common sources (4/13 [30.7%] each). Meropenem was the agent with best in vitro activity (92.3% [12/13] of susceptible isolates). All-cause 30-day mortality (overall 23.1%) was higher in patients with primary bacteremia (50.0% vs. 11.1%; P-value=0.203) and prior chemotherapy (66.7% vs. 10.0%; P-value=0.108). CONCLUSIONS Bacteremia due to A. xylosoxidans constitutes a serious infection among immunocompromised hosts. Carbapenem-based therapy may be appropriate in most cases.
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Affiliation(s)
- Edgar Pérez Barragán
- Unidad de Enfermedades Infecciosas, Hospital Universitario “12 de Octubre”. Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12). Facultad de Medicina, Universidad Complutense. Madrid, Spain
| | - Justo Sandino Pérez
- Servicio de Nefrología, Hospital Universitario “12 de Octubre”. Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12). Facultad de Medicina, Universidad Complutense. Madrid, Spain
| | - Laura Corbella
- Unidad de Enfermedades Infecciosas, Hospital Universitario “12 de Octubre”. Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12). Facultad de Medicina, Universidad Complutense. Madrid, Spain
| | - María Ángeles Orellana
- Servicio de Microbiología. Hospital Universitario “12 de Octubre”. Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12). Facultad de Medicina, Universidad Complutense. Madrid, Spain
| | - Mario Fernández-Ruiz
- Unidad de Enfermedades Infecciosas, Hospital Universitario “12 de Octubre”. Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12). Facultad de Medicina, Universidad Complutense. Madrid, Spain
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6
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Tsai JL, Tsai SF. Case report: The first case of Achromobacter xylosoxidans-related tunnel infection in a patient receiving peritoneal dialysis. Medicine (Baltimore) 2017; 96:e6654. [PMID: 28422870 PMCID: PMC5406086 DOI: 10.1097/md.0000000000006654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Achromobacter xylosoxidans infection is mostly reported in immunocompromised patients. Until now, it is still rarely reported in patients undergoing peritoneal dialysis. PATIENT CONCERNS This is the 1st case of A xylosoxidans infection due to tunnel infection of a Tenckhoff catheter. DIAGNOSIS The diagnosis was confirmed by the report of culture. INTERVENTIONS Risk factors for this infection in peritoneal dialysis include uremia with an immunocompromised state, contamination due to inexperienced skills, and aqueous environment of the dialysate. OUTCOME We believe that finding the source of A xylosoxidans contamination is the most important aspect of the overall treatment of the infection. LESSONS Environmental investigation of suspected source contamination is warranted in those with A xylosoxidans infection. Once the diagnosis is made, removal of the Tenckhoff catheter should not be delayed.
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Affiliation(s)
- Jun-Li Tsai
- Department of Family Medicine, Cheng Ching General Hospital
| | - Shang-Feng Tsai
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital
- Department of Life Science, Tunghai University, Taichung
- Department of Medicine, Nation Yang Ming University, Taipei, Taiwan
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7
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Cankaya E, Keles M, Gulcan E, Uyanik A, Uyanik H. A rare cause of peritoneal dialysis-related peritonitis: Achromobacter denitrificans. Perit Dial Int 2014; 34:135-7. [PMID: 24525606 DOI: 10.3747/pdi.2013.00063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- E Cankaya
- Department of Nephrology1 Department of Microbiology2 Faculty of Medicine Ataturk University Erzurum, Turkey
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8
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Oh TG, Baek JH, Jeong SJ, Chae YT, Ku NS, Chin BS, Han SH, Kim CO, Song YG, Lee HY, Kim JM, Choi JY. Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis Caused by Achromobacter xylosoxidans: A Case Report and Comprehensive Literature Review. Infect Chemother 2011. [DOI: 10.3947/ic.2011.43.3.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tak Geun Oh
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyeon Baek
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Su Jin Jeong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Tae Chae
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Nam Su Ku
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Bum Sik Chin
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Oh Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young Goo Song
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Yong Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - June Myung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
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9
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Abstract
AbstractAlcaligenes xylosoxidans is non-fermenting gram-negative bacilli found in soil and water. It is an aerobic bacterium in the genus Achromobacter. This bacterium is motile, oxidase positive, and catalase positive, which is isolated uncommonly from clinical specimens. In the present paper, we report a case of meningitis associated with A. xylosoxidans in a 38-year-old male patient post neurosurgery.
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10
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von Graevenitz A, Amsterdam D. Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis. Clin Microbiol Rev 1992; 5:36-48. [PMID: 1735094 PMCID: PMC358222 DOI: 10.1128/cmr.5.1.36] [Citation(s) in RCA: 93] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The process of continuous ambulatory peritoneal dialysis has provided a useful, relatively inexpensive, and safe alternative for patients with end-stage renal disease. Infectious peritonitis, however, has limited a more widespread acceptance of this technique. The definition of peritonitis in this patient population is not universally accepted and does not always include the laboratory support of a positive culture (or Gram stain). In part, the omission of clinical microbiological findings stems from the lack of sensitivity of earlier microbiological efforts. Peritonitis results from decreased host phagocytic efficiency with depressed phagocytosis and bactericidal capacity of peritoneal macrophages. During episodes of peritonitis, fluid movement is reversed, away from the lymphatics and peritoneal membrane and toward the cavity. As a result, bloodstream infections are rare. Most peritonitis episodes are caused by bacteria. Coagulase-negative staphylococci are the most frequently isolated organisms, usually originating from the skin flora, but a wide array of microbial species have been documented as agents of peritonitis. Clinical microbiology laboratories need to be cognizant of the diverse agents so that appropriate primary media can be used. The quantity of dialysate fluid that is prepared for culture is critical and should constitute at least 10 ml. The sensitivity of the cultural approach depends on the volume of dialysate, its pretreatment (lysis or centrifugation), the media used, and the mode of incubation. The low concentration of microorganisms in dialysate fluids accounts for negative Gram stain results. Prevention of infection in continuous ambulatory peritoneal dialysis patients is associated with the socioeconomic status of the patient, advances in equipment (catheter) technology, and, probably least important, the application of prophylactic antimicrobial agents.
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Affiliation(s)
- A von Graevenitz
- Institute for Medical Microbiology, University of Zurich, Switzerland
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11
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Mensah K, Philippon A, Richard C, Névot P. Susceptibility of Alcaligenes denitrificans subspecies xylosoxydans to beta-lactam antibiotics. Eur J Clin Microbiol Infect Dis 1990; 9:405-9. [PMID: 2387293 DOI: 10.1007/bf01979470] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The susceptibility of 56 clinical isolates and two reference strains of Alcaligenes denitrificans subsp. xylosoxydans to beta-lactam agents was tested and related to beta-lactamase activity of the strains. The MICs of 12 beta-lactams determined by an agar dilution method showed that all the strains were sensitive to imipenem and moxalactam. Forty-one cloxacillin-sensitive beta-lactamase producing strains were highly susceptible to azlocillin, piperacillin and ticarcillin, and less susceptible to several cephalosporins (cefamandole, cefoperazone, ceftazidime). The 17 remaining beta-lactamase-producing strains, which were sensitive to clavulanic acid and to a lesser extent cloxacillin, had variable resistance to the penicillins tested and synergy was obtained when these penicillins were combined with clavulanic acid or tazobactam. The choice of agents for treatment of infections with this organism must take into account the susceptibility phenotype of clinical isolates.
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Affiliation(s)
- K Mensah
- Service de Bactériologie, CHU Cochin, Paris, France
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12
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Mensah K, Philippon A, Richard C, Grimont P. Infections nosocomiales a Alcaligenes denitrificans subsp. xylosoxidans : Sensibilite de 41 souches a 38 antibiotiques. Med Mal Infect 1989. [DOI: 10.1016/s0399-077x(89)80253-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Van Horn KG, Gedris CA, Ahmed T, Wormser GP. Bacteremia and urinary tract infection associated with CDC group Vd biovar 2. J Clin Microbiol 1989; 27:201-2. [PMID: 2913028 PMCID: PMC267265 DOI: 10.1128/jcm.27.1.201-202.1989] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
A case of urinary tract infection and bacteremia caused by CDC group Vd biovar 2 in a 23-year-old woman with Hodgkin's disease is described. This is the first report of CDC group Vd biovar 2 isolated from a clinical specimen and considered as a pathogen. Detailed antimicrobial susceptibility data are presented.
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Affiliation(s)
- K G Van Horn
- Department of Clinical Pathology, Westchester County Medical Center, Valhalla, New York
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14
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Gahrn-Hansen B, Alstrup P, Dessau R, Fuursted K, Knudsen A, Olsen H, Oxhøj H, Petersen AR, Siboni A, Siboni K. Outbreak of infection with Achromobacter xylosoxidans from contaminated intravascular pressure transducers. J Hosp Infect 1988; 12:1-6. [PMID: 2905368 DOI: 10.1016/0195-6701(88)90115-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Achromobacter xylosoxidans contaminating transducers caused 15 cases of hospital infection. In the eight patients with bacteraemia the interval from inoculation to fever was an average of 6.6 days. All the infected patients recovered. Computerization of laboratory records allowed retrieval of previous isolates, and review of clinical records focused the problem on patients with cardiac and aortic diseases. The problem arose from the re-use of disposable equipment after disinfection with a benzalcone.
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Affiliation(s)
- B Gahrn-Hansen
- Department of Clinical Microbiology, Odense University Hospital, Denmark
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15
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Glupczynski Y, Hansen W, Freney J, Yourassowsky E. In vitro susceptibility of Alcaligenes denitrificans subsp. xylosoxidans to 24 antimicrobial agents. Antimicrob Agents Chemother 1988; 32:276-8. [PMID: 3163242 PMCID: PMC172153 DOI: 10.1128/aac.32.2.276] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The in vitro susceptibilities of 37 clinical isolates of Alcaligenes denitrificans subsp. xylosoxidans to 24 antimicrobial agents were determined. Imipenem was the only drug with consistent activity (MIC for 90% of isolates, 2 micrograms/ml). Piperacillin, ticarcillin-clavulanic acid, ceftazidime, and co-trimoxazole were active against most strains. All the isolates were resistant to ampicillin, cefazolin, cefuroxime, cefamandole, cefotetan, ceftriaxone, cefotaxime, aztreonam, amdinocillin, and temocillin. Most isolates were resistant to the aminoglycosides tested, including amikacin. Lack of activity was also observed for all new 4-quinolone antimicrobial agents.
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Affiliation(s)
- Y Glupczynski
- Department of Clinical Microbiology, Brugmann University Hospital, Brussels, Belgium
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16
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Arroyo JC, Jordan W, Lema MW, Brown A. Diversity of plasmids in Achromobacter xylosoxidans isolates responsible for a seemingly common-source nosocomial outbreak. J Clin Microbiol 1987; 25:1952-5. [PMID: 3667915 PMCID: PMC269374 DOI: 10.1128/jcm.25.10.1952-1955.1987] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Achromobacter xylosoxidans, an uncommon yet highly resistant opportunistic pathogen, was isolated from nine hospitalized patients during an 8-month period. It had been isolated from only seven patients with either nonfatal infection or colonization from 1981 to 1984. From June 1985 to January 1986, A. xylosoxidans was isolated 18 times from seven different sites (sputum, 7 times; urine, 4 times; blood, 3 times; and lung, pleural fluid, wound tissue, and tracheal aspirate, 1 time each). Four patients died, including the three with bacteremia. All but two patients had nosocomial infections and either were on the same ward or were cared for by the same staff members. Eleven A. xylosoxidans strains yielded eight distinct plasmids (8, 21, 23, 26, 38, 50, 51, and 64 megadaltons). Whole-cell peptide patterns of 10 of these strains were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Isolates from the same patient contained the same plasmids and had identical peptide patterns but differed from other strains in both parameters. Plasmids were absent from the two community-acquired isolates. Although nosocomial strains showed similar antibiotic resistance patterns (only moxalactam and ticarcillin-clavulanic acid were uniformly active) and cross-contamination was strongly suggested epidemiologically, results of plasmid and peptide analyses did not support the possibility of a single-strain outbreak.
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Affiliation(s)
- J C Arroyo
- Medical and Research Services, Dorn Veterans Administration Hospital, Columbia, South Carolina
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