title: Early treatment with inhaled antibiotics postpones next occurrence of Achromobacter in cystic fibrosis.
abstract: OBJECTIVE
  In this nationwide retrospective study, we analysed species distribution, antimicrobial susceptibility and time to next occurrence of Achromobacter in Danish cystic fibrosis (CF) patients from 2000 to 2011.
  
  
  METHODS
  Thirty-four primary isolates were identified to species level and subjected to antimicrobial susceptibility testing. Effectiveness of early antimicrobial treatment was assessed by a Kaplan-Meier estimation of time to recurrence.
  
  
  RESULTS
  Achromobacter xylosoxidans accounted for 13 (38%) of the isolates, and an unnamed species accounted for 11 (32%) of the isolates. Meropenem, piperacillin-tazobactam and trimethoprim-sulfamethoxazole were highly active against chemotherapy-naïve Achromobacter, while ceftazidime, colistin and tobramycin were judged adequate for inhalation therapy. Fifty-five percent of 25 patients treated with inhaled ceftazidime, colistin, or tobramycin remained free of Achromobacter three years after acquisition, in contrast to 17% of 22 patients who did not receive inhaled antibiotics (P<0.01).
  
  
  CONCLUSIONS
  Early treatment with inhaled antibiotics may prevent or postpone chronic infection with Achromobacter in CF patients.
authors.affiliation: Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Wang
authors.forename: W
authors.initials: W
authors.lastname: Ridderberg
authors.forename: C R
authors.initials: CR
authors.lastname: Hansen
authors.forename: N
authors.initials: N
authors.lastname: Høiby
authors.forename: S
authors.initials: S
authors.lastname: Jensen-Fangel
authors.forename: H V
authors.initials: HV
authors.lastname: Olesen
authors.forename: M
authors.initials: M
authors.lastname: Skov
authors.forename: L E
authors.initials: LE
authors.lastname: Lemming
authors.forename: T
authors.initials: T
authors.lastname: Pressler
authors.forename: H K
authors.initials: HK
authors.lastname: Johansen
authors.forename: N
authors.initials: N
authors.lastname: Nørskov-Lauritsen
mesh_terms: D042402:Achromobacter; D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D055502:Secondary Prevention; D013183:Sputum / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Achromobacter xylosoxidans; Cross-infections; Eradication; MLSA; Systemic therapy