title: Achromobacter species in cystic fibrosis: cross-infection caused by indirect patient-to-patient contact.
abstract: METHODS
  Achromobacter species leads to chronic infection in an increasing number of CF patients. We report 2 cases of Achromobacter ruhlandii cross-infection between patients after well-described indirect contact.
  
  
  RESULTS
  Both cases were young, stable, CF patients without chronic infections and with normal FEV1, but experienced clinical deterioration after visits to the home of a CF patient with A. ruhlandii infection and after sharing facilities with an A. ruhlandii infected CF patient on a skiing vacation, respectively. Both cases became positive for A. ruhlandii in airway secretions and were colonized with A. ruhlandii in their sinuses. Aggressive, long-term antibiotic treatment led to clinical stability. One of the cases developed chronic A. ruhlandii infection.
  
  
  CONCLUSIONS
  A. species can cause cross-infection even after a short period of indirect contact between infected and non-infected CF patients. Patients should be followed closely for several months before the possibility of cross-infection is ruled out.
authors.affiliation: Department of Pediatrics, Copenhagen CF Centre, University Hospital Rigshospitalet, Copenhagen, Denmark. Electronic address: christine.hansen@rh.regionh.dk.
authors.forename: C R
authors.initials: CR
authors.lastname: Hansen
authors.forename: T
authors.initials: T
authors.lastname: Pressler
authors.forename: W
authors.initials: W
authors.lastname: Ridderberg
authors.forename: H K
authors.initials: HK
authors.lastname: Johansen
authors.forename: M
authors.initials: M
authors.lastname: Skov
mesh_terms: D042402:Achromobacter / Q000145:classification / Q000302:isolation & purification; D000293:Adolescent; D015373:Bacterial Typing Techniques; D003550:Cystic Fibrosis / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000635:transmission*; D006801:Humans; D008297:Male; D058885:Multilocus Sequence Typing; D010256:Paranasal Sinuses / Q000382:microbiology; D013183:Sputum / Q000382:microbiology
keywords: Achromobacter xylosoxidans; Cross-infection; Pulmonary infection