2295. Clinical Characteristics of Achromobacter Xylosoxidans Infections in a Korean Teaching Hospital

Abstract

Background Achromobacter species are non-fermentous Gram-negative bacilli that are primarily found in contaminated soil or water, but is rare in human. Although their low virulence, Achromobacter xylosoxidans is considered one of the emerging nosocomial agents in immunocompromised patients, including those with hematologic malignancy, diabetes, and renal failure. This organisms can cause pneumonia, catheter-related blood stream infection, urinary tract infection, and meningitis. We investigated the clinical manifestations and outcomes associated with A. xylosoxidans infection in a mid-sized community-based hospital in Korea.MethodsWe retrospectively analyzed all consecutive episodes of A. xylosoxidans in a mid-sized community-based hospital from October 2015 to April 2019.ResultsA total 181 clinical isolates of A. xylosoxidans were obtained from 123 patients. Of these, 117 (95%) had nosocomial infection that mostly received previous antibiotic therapy. A. xylosoxidans was isolated from respiratory tract (68%, 84/123), peritoneal fluid (11%, 13/123), urine (8%, 10/123) and blood (6%, 7/123). Seven cases of A. xylosoxidans bacteremia was associated with intravenous catheter sepsis. Seventy-eight cases (63%) had polymicrobial infection; P. aeruginosa (n = 21) was most commonly coisolates organisms, followed by S. maltophilia (n = 20) and methicillin-resistant S. aureus (n = 15). The main underlying diseases were neurologic disease (41%), diabetes mellitus (36%), and solid cancer (25%). Of these, 53 patients (43%) were categorized as in an immunocompromised state. The in-hospital mortality rate was 23%. Based on multivariate analysis, neurologic disease (hazard ratio [HR]: 1.23, 95% confidence interval [CI]: 0.08–0.67; P = 0.007) and the age-adjusted Charlson comorbidity score (HR: 1.31% CI: 1.038–1.65; P = 0.02) were associated with increased mortality.ConclusionWe concludes that, though rare, A. xylosoxidans could be pathogenic in immunocompromised patients who are in hospital. A. xylosoxidans can cause nosocomial infection and bacteremia is mostly originating from intravenous catheter. The potential impact on the clinical outcome, further investigations are required to delineate the role of A. xylosoxidans. Disclosures All authors: No reported disclosures.