Alcaligenes xylosoxidans bacteremia: clinical features and microbiological characteristics of isolates.
Bacteremia caused by Alcaligenes xylosoxidans is rare. Between 1999 and 2002, 12 cases of bacteremia caused by A. xylosoxidans were diagnosed at a tertiary referral center in central Taiwan. The clinical features of these patients and the antimicrobial susceptibilities and pulsed-field gel electrophoresis (PFGE) pattern of their blood isolates were studied. All infections were acquired nosocomially. All of the adult patients had underlying diseases, and 10 (83%) had undergone an invasive procedure. The clinical syndrome included primary bacteremia in 7 patients (58%), and catheter-associated bacteremia, surgical wound infection, pneumonia, urinary tract infection, and empyema in 1 each. Polymicrobial bacteremia was found in 1 patient. The case-fatality rate was 17% (2/12). All isolates were susceptible to piperacillin and ceftazidime and resistant to aminoglycoside, ciprofloxacin and cefepime. Susceptibility to imipenem (67%), ampicillin-sulbactam (75%) and trimethoprim-sulfamethoxazole (92%) was variable. Genetic fingerprints obtained by PFGE showed identical pattern in the isolates from 2 neonates, indicating the epidemiologic relatedness of these infections. We conclude that A. xylosoxidans isolates are multi-resistant and A. xylosoxidans bacteremia should be considered as a possible etiology of infection after invasive procedures in patients with underlying diseases. Strict infection control is needed to prevent this infection.
Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Ren-Wen
RW
Tsay
Li-Chen
LC
Lin
Chien-Shun
CS
Chiou
Jui-Cheng
JC
Liao
Chang-Hua
CH
Chen
Chun-Eng
CE
Liu
Tzuu-Guang
TG
Young
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000421:Alcaligenes / Q000145:classification / Q000187:drug effects / Q000235:genetics; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged
D000900:Anti-Bacterial Agents