Purpose Acromobacter xylosidans is a multidrug resistant gram-negative rod that has been recently described to colonize or infect the airways of 10-29% of cystic fibrosis (CF) patients. We describe our single center experience of CF lung transplant recipients colonized with this bacterium prior to transplantation. Methods and Materials CF patients who were transplanted between 1995-2011 at our institution were reviewed. Patients with pre-transplant A. xylosidans colonization (ACH) were compared to those who did not harbor this pathogen (non-ACH). Variables collected included: time to positive ACH culture post-transplant, duration of intravenous (IV) antibiotics, number of inpatient days, and survival. Duration of IV antibiotics and the number of inpatient days were analyzed by a Mann-Whitney U test, while survival was compared using Kaplan-Meier analysis. Results 48 of 474 patients had a CF diagnosis; 10 (21%) were colonized with ACH prior to transplantation. All 10 grew the organism after transplantation at a median of 125 days (3-1055 days) as detected by bronchoalveolar lavage performed during surveillance bronchoscopy. The ACH group was hospitalized a greater number of days after transplantation ( Table 1 ) and required significantly longer courses of IV antibiotics compared to the non-ACH group (p=0.048). ACH patients also showed a trend towards worse survival (p = 0.085) with separation between the groups noted three years after transplantation. Conclusions Longer post-operative hospital stays, a prolonged antibiotic course, and the possibility of poor mid-term survival when compared to non-ACH-CF transplant recipients, suggests a negative impact by the presence of ACH in CF transplant recipients. ACH (n=10) Non-ACH (n=38) P value Inpatient days, median (range) 87 (37-171) 50 (12-250) 0.084 Weeks of IV antibiotics, median (range) 12 (3-42) 7.5 (2-25) 0.049