Cerebral ventriculitis associated with Achromobacter xylosoxidans

Area of Science:

• Neurosurgery
• Infectious Diseases
• Microbiology

Background:

• Ventriculitis is a serious infection of the brain's ventricles, often occurring post-neurosurgery.
• Achromobacter xylosoxidans is an opportunistic pathogen increasingly recognized in healthcare-associated infections.

Observation:

• Six patients in a neurosurgical ward developed ventriculitis caused by Achromobacter xylosoxidans following craniotomy or cranial trepanation.
• Isolates of A. xylosoxidans demonstrated resistance to common antibiotics including streptomycin, ampicillin, cephaloridine, gentamicin, and colistin.
• These strains also exhibited resistance to 2% chlorhexidine digluconate (Hibitane).

Findings:

• A survey of chlorhexidine solutions in the surgical ward revealed four strains of A. xylosoxidans.
• Importantly, A. xylosoxidans was not detected in chlorhexidine containers from the operating theatre.
• This suggests potential contamination or reduced efficacy of chlorhexidine in the ward environment.

Implications:

• The findings highlight the potential for Achromobacter xylosoxidans to cause severe infections in neurosurgical patients.
• Antibiotic and antiseptic resistance in these strains poses a significant treatment challenge.
• The presence of resistant strains in hospital chlorhexidine solutions warrants further investigation into disinfection protocols and environmental contamination control in healthcare settings.