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Published on: December 5, 2025
Treatment of Achromobacter Ventilator-Associated Pneumonia in Critically Ill Trauma Patients
G Christopher Wood1, Brittany L Jonap1, George O Maish1
11 University of Tennessee Health Science Center, Memphis, TN, USA.
Background:
Achromobacter sp are nonfermenting Gram-negative bacilli (NFGNB) that rarely cause severe infections, including ventilator-associated pneumonia (VAP). Data on the treatment of Achromobacter pneumonia are very limited, and the organism has been associated with a high mortality rate. Thus, more data are needed on treating this organism.
Objective:
To evaluate the treatment of Achromobacter VAP in critically ill trauma patients.
Methods:
This retrospective, observational study evaluated critically ill trauma patients who developed Achromobacter VAP. A previously published pathway for the diagnosis and management of VAP was used according to routine patient care. This included the use of quantitative bronchoscopic bronchoalveolar lavage cultures to definitively diagnose VAP.
Results:
A total of 37 episodes of Achromobacter VAP occurred in 34 trauma intensive care unit patients over a 15-year period. The most commonly used definitive antibiotics were imipenem/cilastatin, cefepime, or trimethoprim/sulfamethoxazole. The primary outcome of clinical success was achieved in 32 of 37 episodes (87%). This is similar to previous studies of other NFGNB VAP (eg, Pseudomonas, Acinetobacter) from the study center. Microbiological success was seen in 21 of 28 episodes (75%), and VAP-related mortality was 9% (3 of 34 patients).
Conclusions:
Achromobacter is a rare but potentially serious cause of VAP in critically ill patients. In this study, there was an acceptable success rate compared with other causes of NFGNB VAP in this patient population.
Insights
Achromobacter VAP in critically ill trauma patients showed an 87% clinical success rate with common antibiotics. This rare pathogen, Achromobacter, can be treated effectively, similar to other Gram-negative bacteria.
Area of Science:
- Critical care medicine
- Infectious diseases
- Microbiology
Background:
- Achromobacter species are rare causes of severe infections like ventilator-associated pneumonia (VAP).
- Limited data exist on treating Achromobacter pneumonia, which is associated with high mortality.
- Further research is needed to establish effective treatment strategies for Achromobacter VAP.
Purpose of the Study:
- To evaluate the treatment outcomes of Achromobacter VAP in critically ill trauma patients.
- To assess the efficacy of common antibiotic regimens against Achromobacter VAP.
- To compare treatment success rates with other nonfermenting Gram-negative bacilli (NFGNB) VAP.
Main Methods:
- Retrospective observational study of critically ill trauma patients with Achromobacter VAP.
- Diagnosis confirmed by quantitative bronchoscopic bronchoalveolar lavage cultures.
- Analysis of clinical success, microbiological success, and VAP-related mortality.
Main Results:
- 37 episodes of Achromobacter VAP occurred in 34 patients over 15 years.
- Common antibiotics included imipenem/cilastatin, cefepime, and trimethoprim/sulfamethoxazole.
- Clinical success was 87% (32/37), microbiological success was 75% (21/28), and VAP-related mortality was 9% (3/34).
Conclusions:
- Achromobacter is a rare but serious cause of VAP in critically ill patients.
- Treatment of Achromobacter VAP in this cohort achieved acceptable success rates.
- Outcomes were comparable to other NFGNB VAP cases, suggesting effective treatment options exist.
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