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Achromobacter xylosoxidans bacteremia.

W F Mandell¹, G J Garvey, H C Neu

¹Department of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York 10032.

Reviews of Infectious Diseases

|September 1, 1987

Summary

Achromobacter xylosoxidans is a rare cause of bacteremia, often seen in patients with underlying health issues. This case highlights a rare instance of pneumonia and bacteremia in a patient with tuberculosis, emphasizing treatment challenges.

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Area of Science:

Clinical microbiology and infectious diseases
Pulmonary medicine

Background:

Achromobacter xylosoxidans is an opportunistic pathogen, infrequently causing bacteremia.
Predisposing factors for Achromobacter bacteremia are diverse, with immunosuppression being uncommon.
Pulmonary tuberculosis represents a significant underlying condition that may predispose to infections.

Observation:

A case of community-acquired pneumonia and bacteremia caused by Achromobacter xylosoxidans is presented.
The patient had concomitant pulmonary tuberculosis, a less common comorbidity in Achromobacter bacteremia cases.
Detailed information on predisposing conditions was available for only seven prior patients with Achromobacter bacteremia.

Findings:

Achromobacter xylosoxidans demonstrated resistance to common antibiotics like ampicillin, cephalosporins, and aminoglycosides.
Antipseudomonal penicillins and trimethoprim-sulfamethoxazole showed inhibitory effects on most isolates.
The isolate exhibited multidrug resistance, complicating therapeutic decisions.

Implications:

This case underscores the importance of considering Achromobacter xylosoxidans in patients with severe pneumonia and bacteremia, especially those with comorbidities like tuberculosis.
The common multidrug resistance observed in Achromobacter necessitates careful antibiotic selection and susceptibility testing.
Optimal therapeutic strategies for Achromobacter bacteremia remain to be established, highlighting a need for further research.

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