Abstract
Achromobacter spp. are intrinsically multidrug-resistant environmental microorganisms which are known to cause opportunistic, nosocomial, and sometimes chronic infections. The existing literature yields scarcely any larger datasets, especially with regard to the incidence in patient groups other than those with cystic fibrosis. The aim of this study was to fill this gap. We present a retrospective analysis of 314 clinical and 130 screening isolates detected in our diagnostic unit between 2004 and 2021, combined with patients’ demographic and clinical information (ward type and length of hospitalization), and the results of routine diagnostic antibiotic MIC determination. We found the apparent increase in prevalence in our diagnostic unit, in which cystic fibrosis patients are an underrepresented group, in large part to be attributable to an overall increase in the number of samples and, more importantly, changes in the diagnostic setting, such as the introduction of rigorous screening for Gram-negative multidrug-resistant pathogens. We found these Achromobacter spp. to be most commonly detected in urine, stool, wounds and airway samples, and found the resistance rates to vary strongly between different sample types. Intestinal carriage is frequently not investigated, and its frequency is likely underestimated. Isolates resistant to meropenem can hardly be treated.
Highlights
Achromobacter spp. are non-fermenting, oxidase- and catalase-positive, motile Gramnegative bacilli that are widespread in nature, especially in moist soils and water sources and in plants
From a human health perspective, A. xylosoxidans especially is considered an emerging nosocomial pathogen capable of causing a wide range of different human infections and morbidities [1]. These typically occur in cystic fibrosis patients [2,3] but are not limited to these, and can range from urinary tract and eye infections to infections of the endocardium, mediastinum, lower respiratory tract, and even the central nervous system and the bloodstream [4,5,6,7,8,9,10,11]. This bacterial species can survive in adverse environments such as ultrasound gels, dialysis fluids, and hospital surfaces and equipment, predisposing it to emerge as an important nosocomial pathogen
The prevalence rates of Achromobacter spp. isolates from respiratory samples of cystic fibrosis patients have been reported as increasing in recent years, which has been attributed to selection pressure from antibiotic therapy and the longer survival of cystic fibrosis patients [15]
Summary
Achromobacter spp. are non-fermenting, oxidase- and catalase-positive, motile Gramnegative bacilli that are widespread in nature, especially in moist soils and water sources and in plants. These typically occur in cystic fibrosis patients [2,3] but are not limited to these, and can range from urinary tract and eye infections to infections of the endocardium, mediastinum, lower respiratory tract, and even the central nervous system and the bloodstream [4,5,6,7,8,9,10,11] This bacterial species can survive in adverse environments such as ultrasound gels, dialysis fluids, and hospital surfaces and equipment, predisposing it to emerge as an important nosocomial pathogen.
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