title: Epidemiology and resistance of Achromobacter xylosoxidans from cystic fibrosis patients in Dijon, Burgundy: first French data.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  In our centre, the high prevalence of colonisation is not due to cross-contamination. Our main concern is the high rate of antimicrobial resistance.
authors.affiliation: Department of Bacteriology, University Hospital of Dijon, BP 37013, 21070 Dijon Cedex, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Amoureux
authors.affiliation: Department of Bacteriology, University Hospital of Dijon, BP 37013, 21070 Dijon Cedex, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Bador
authors.affiliation: Department of Bacteriology, University Hospital of Dijon, BP 37013, 21070 Dijon Cedex, France.
authors.forename: Eliane
authors.initials: E
authors.lastname: Siebor
authors.affiliation: Department of Bacteriology, University Hospital of Dijon, BP 37013, 21070 Dijon Cedex, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Taillefumier
authors.affiliation: Department of Respiratory Medicine and Cystic Fibrosis Centre, University Hospital of Dijon, BP 37013, 21070 Dijon Cedex, France.
authors.forename: Annlyse
authors.initials: A
authors.lastname: Fanton
authors.affiliation: Department of Bacteriology, University Hospital of Dijon, BP 37013, 21070 Dijon Cedex, France. Electronic address: catherine.neuwirth@chu-dijon.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Neuwirth
mesh_terms: D042441:Achromobacter denitrificans / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005602:France / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction
chemical_list: D000900:Anti-Bacterial Agents