Marked increase in incidence of Achromobacter xylosoxidans infections caused by sporadic acquisition from the environment.

An increased incidence of Achromobacter xylosoxidans infections has been observed at the Cystic Fibrosis Centre at Aarhus University Hospital, as the proportion of patients colonised with A. xylosoxidans increased from 6 to 10% from 2005 to 2009. Pulsed field gel electrophoresis (PFGE) was used to type isolates of A. xylosoxidans. Four patients infected for 2-7 years were part of a larger epidemic spread involving both Danish CF centres, while 11 patients carried strains with unique genotypes. Longitudinal analysis of isolates from ten patients with multiple preserved isolates showed that each patient persistently carried isolates of a single genotype. Following lung transplantation, two patients showed re-colonisation of the lung grafts with the pre-transplant A. xylosoxidans strain. A. xylosoxidans has been transmitted between patients from our clinic, but the recent increase in incidence is not caused by cross infections.

Ridderberg W ，Bendstrup KE ，Olesen HV ，Jensen-Fangel S ，Nørskov-Lauritsen N ... -  《-》

Epidemiology and resistance of Achromobacter xylosoxidans from cystic fibrosis patients in Dijon, Burgundy: first French data.

Achromobacter xylosoxidans is an emerging pathogen in cystic fibrosis (CF) patients recognised as causal agent of inflammation. The prevalence of infection or colonisation is variable among CF centres. We report here the first epidemiological data about A. xylosoxidans in a French CF centre: Dijon, Burgundy. All isolates recovered from the patients affiliated with our centre in 2010 since their first visit were included. Antimicrobial susceptibility was determined by disk diffusion method and E-test. Molecular epidemiology was performed by Pulsed Field Gel Electrophoresis (PFGE) and compared with repetitive sequence-based PCR (rep-PCR, DiversiLab®). We also sequenced the constitutive bla-oxa-114 gene. Out of 120 patients, 21 (17.5%) had at least one positive culture with A. xylosoxidans since they started to receive routine care in our CF centre (447 isolates). Median age at first positive culture was 16 years (range 3-34 years). Most patients were colonised by their own strain, cross-contamination was very rare. We observed two cases of intra-family spread. DiversiLab® is a useful tool as efficient as PFGE to compare isolates recovered simultaneously from different patients when an outbreak is suspected. However, PFGE remains the reference method for long-term survey of chronically colonised patients. We detected new OXA-114 variants and the new oxacillinase OXA-243 (88% amino acid identity with OXA-114). Acquired resistance to ciprofloxacin, ceftazidime and carbapenems was frequent. In 2010, 7 patients harboured strains resistant to ceftazidime, 6 patients strains with decreased susceptibility to carbapenems (especially meropenem) and 12 patients strains resistant to ciprofloxacin. In our centre, the high prevalence of colonisation is not due to cross-contamination. Our main concern is the high rate of antimicrobial resistance.

Amoureux L ，Bador J ，Siebor E ，Taillefumier N ，Fanton A ，Neuwirth C ... -  《-》

Achromobacter xylosoxidans in cystic fibrosis: prevalence and clinical relevance.

De Baets F ，Schelstraete P ，Van Daele S ，Haerynck F ，Vaneechoutte M ... -  《Journal of Cystic Fibrosis》

Inflammation in Achromobacter xylosoxidans infected cystic fibrosis patients.

Hansen CR ，Pressler T ，Nielsen KG ，Jensen PØ ，Bjarnsholt T ，Høiby N ... -  《-》

Epidemic Achromobacter xylosoxidans strain among Belgian cystic fibrosis patients and review of literature.

Cools P ，Ho E ，Vranckx K ，Schelstraete P ，Wurth B ，Franckx H ，Ieven G ，Van Simaey L ，Van Daele S ，Verhulst S ，De Baets F ，Vaneechoutte M ... -  《BMC MICROBIOLOGY》