[Bacteremia caused by Alcaligenes (Achromobacter) xylosoxidans. Description of 3 cases and review of the literature].
BACKGROUND
Alcaligenes (Achromobacter) xylosoxidans occasionally cause infections, mainly in immunocompromised hosts.


METHODS
Three cases of bacteremia due to A. xylosoxidans observed at the Fundación Jiménez Díaz between 1985-1994 were described. Moreover, 38 single cases of bacteremia due to A. xylosoxidans and 21 episodes associated with outbreak were reviewed by using computerized bibliography data base MEDLINE (1970-december 1994).


RESULTS
From 41 patients with bacteremia (including our 3 cases) reviewed, 27 were immunosuppressed hosts (twenty had neoplasia disease). The most common clinical presentation was primary bacteremia (11 cases, 27%) and pneumonia (10, 24%), followed by catheter-associated bacteremia (8, 20%), meningitis (4), bacteremia from abdominal cavity (4), endocarditis (3) and pyelonephritis (1). The mortality rate was higher (39%), specially in patients whom were a intensive care unit acquisition (87%), and illness with endocarditis (100%). No patient with catheter-related bacteremia died. All of 21 outbreak episodes of bacteremia had a autolimited form and low mortality (4.8%).


CONCLUSIONS
A. xylosoxidans is a microorganism with demonstrated capacity of cause bacteremia, mainly in immunocompromised hosts, with high mortality rates. Sometimes, it causes outbreaks of bacteremia with low mortality.
Ramos
J M
JM
Departamento de Microbiología Médica, Fundación Jiménez Díaz, Madrid.
Domine
M
M
Ponte
M C
MC
Soriano
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000421:Alcaligenes / Q000302:isolation & purification*; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D001943:Breast Neoplasms / Q000150:complications; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002648:Child; D003428:Cross Infection / Q000453:epidemiology; D004196:Disease Outbreaks; D017809:Fatal Outcome; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D006689:Hodgkin Disease / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D011183:Postoperative Complications / Q000382:microbiology; D011379:Prognosis; D015996:Survival Rate