title: Achromobacter respiratory infections.
abstract: Achromobacteria are ubiquitous environmental organisms that may also become opportunistic pathogens in certain conditions, such as cystic fibrosis, hematologic and solid organ malignancies, renal failure, and certain immune deficiencies. Some members of this genus, such as xylosoxidans, cause primarily nosocomially acquired infections affecting multiple organ systems, including the respiratory tract, urinary tract, and, less commonly, the cardiovascular and central nervous systems. Despite an increasing number of published case reports and literature reviews suggesting a global increase in achromobacterial disease, most clinicians remain uncertain of the organism's significance when clinically isolated. Moreover, effective treatment can be challenging due to the organism's inherent and acquired multidrug resistance patterns. We reviewed all published cases to date of non-cystic fibrosis achromobacterial lung infections to better understand the organism's pathogenic potential and drug susceptibilities. We found that the majority of these cases were community acquired, typically presenting as pneumonias (88%), and were most frequent in individuals with hematologic and solid organ malignancies. Our findings also suggest that achromobacterial lung infections are difficult to treat, but respond well to extended-spectrum penicillins and cephalosporins, such as ticarcillin, piperacillin, and cefoperazone.
authors.affiliation: 1 Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, University of Florida, Gainesville, Florida; and.
authors.forename: Colin E
authors.initials: CE
authors.lastname: Swenson
authors.forename: Ruxana T
authors.initials: RT
authors.lastname: Sadikot
mesh_terms: D042402:Achromobacter / Q000472:pathogenicity / Q000502:physiology*; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001987:Bronchiectasis / Q000453:epidemiology; D002438:Cefoperazone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology; D010406:Penicillins / Q000627:therapeutic use*; D010878:Piperacillin / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D013982:Ticarcillin / Q000627:therapeutic use; D037521:Virulence Factors
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D037521:Virulence Factors; D002438:Cefoperazone; D013982:Ticarcillin; D010878:Piperacillin
keywords: antimicrobial drug resistance; bacterial pneumonia; bronchiectasis; gram-negative bacteria; virulence factors