Achromobacter xylosoxidans in cystic fibrosis: Prevalence and clinical relevance

Baets, Frans De; Schelstraete, Petra; daele, Sabine Van; Haerynck, Filomeen; Vaneechoutte, Mario

doi:10.1016/j.jcf.2006.05.011

Cited by 147 publications

(160 citation statements)

References 10 publications

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“…The cumulative prevalence of Achromobacter isolation of 11% in our center is comparable to those previously reported for small centers, which ranged from 5 to 29% (11,12), although this spans 3 decades, making the incidence of infection very low. While others have reported that older patients and patients with greater lung disease burden appear to be predisposed to infection with Achromobacter species (11, 18), we did not observe any correlation between age, nutritional status, CF comorbidities, baseline lung status, or home oxygen use and incident infection.…”

Section: Discussionsupporting

confidence: 86%

“…Studies have attributed persistent Achromobacter infections predominantly to A. xylosoxidans (2,11,12,18), with a few exceptions, including A. insuavis and A. dolens (5,6). We now know that this may represent a broader species distribution.…”

Section: Discussionmentioning

confidence: 98%

“…Rates of chronic infection have typically ranged from 3 to 12% of incident Achromobacter infections (5,24,25), again with the risk factors of older age and the burden of lung disease (11,26). Coinfection with P. aeruginosa (2,17,19,27) is common due to increased exposure to antibiotics for chronic infection (26).…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and Outcomes of Achromobacter Species Infections in Adults with Cystic Fibrosis: a North American Cohort Study

et al. 2017

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Achromobacter species are increasingly being detected in cystic fibrosis (CF) patients, with an unclear epidemiology and impact. We studied a cohort of patients attending a Canadian adult CF clinic who had positive sputum cultures for Achromobacter species in the period from 1984 to 2013. Infection was categorized as transient or persistent (Ն50% positive cultures for 1 year). Those with persistent infection were matched 2:1 with age-, sex-, and time-matched controls without a history of Achromobacter infection, and mixed-effects models were used to assess pulmonary exacerbation (PEx) frequency and lung function decline. Isolates from a biobank were retrospectively assessed, identified to the species level by nrdA sequencing, and genotyped using pulsed-field gel electrophoresis (PFGE). Thirty-four patients (11% of those in our clinic), with a median age of 24 years (interquartile range [IQR], 20.3 to 29.8 years), developed Achromobacter infection. Ten patients (29%) developed persistent infection. Persistence did not denote permanence, as most patients ultimately cleared infection, often after years. Patients were more likely to experience PEx at incident isolation than at prior or subsequent visits (odds ratio [OR], 2.7 [95% confidence interval {CI}, 1.2 to 6.7]; P ϭ 0.03). Following persistent infection, there was no difference in annual lung function decline (Ϫ1.08% [95% CI, Ϫ2.73 to 0.57%] versus Ϫ2.74% [95% CI, Ϫ4.02 to 1.46%]; P ϭ 0.12) or the odds of PEx (OR, 1.21 [95% CI, 0.45 to 3.28]; P ϭ 0.70). Differential virulence among Achromobacter species was not observed, and no cases of transmission occurred. We demonstrated that incident Achromobacter infection was associated with a greater risk of PEx; however, neither transient nor chronic infection was associated with a worsened long-term prognosis. Large, multicenter studies are needed to clarify the clinical impact, natural history, and transmissibility of Achromobacter.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 98%

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Prevalence and Outcomes of Achromobacter Species Infections in Adults with Cystic Fibrosis: a North American Cohort Study

et al. 2017

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“…Decline in lung function was assessed using the variable annual percentage loss of FEV 1 . Informed consent for compassionate use was obtained from all individual participants.…”

Section: Methodsmentioning

confidence: 99%

“…Achromobacter xylosoxidans is a gram-negative non-fermentative rod that is increasingly cultured in sputum from adult cystic fibrosis (CF) patients with moderate to severe lung compromise [1,2]. Its clinical implications are still to be determined [3] and therefore there is limited evidence on specific treatment.…”

Section: Introductionmentioning

confidence: 99%

Experience with Aerosolized Imipenem in Patients with Cystic Fibrosis and Achromobacter xylosoxidans

Marcos¹,

Espinosa²,

Pérez³

et al. 2017

J Infect Dis Ther

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Achromobacter xylosoxidans is a gram negative non-fermentative rod that infects adult cystic fibrosis patients with moderate to severe lung compromise. Its clinical implications are still to be determined. The aim of this study was to analyze the impact of inhaled imipenem on forced expired volume in 1 sec (FEV 1 ) and number of exacerbations in adult cystic fibrosis patients. Patients colonized by A. xylosoxidans with more than two intravenous antibiotic cycles and/or ≥ 5% FEV 1 impairment during the last year were included.We included six patients with a mean age of 24.8 years. At the beginning of treatment FEV 1 was 1.18 l (52%) with a mean of 3.4 exacerbations in the previous 12 months and 2.24 (p=0.04) the following 12 months. There was a significant difference between the initial FEV 1 value and three months after treatment (p=0.005).

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Achromobacter xylosoxidansinduced bronchiolitis obliterans in cystic fibrosis

et al. 2013

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Achromobacter xylosoxidans in cystic fibrosis: Prevalence and clinical relevance

Cited by 147 publications

References 10 publications

Prevalence and Outcomes of Achromobacter Species Infections in Adults with Cystic Fibrosis: a North American Cohort Study

Prevalence and Outcomes of Achromobacter Species Infections in Adults with Cystic Fibrosis: a North American Cohort Study

Experience with Aerosolized Imipenem in Patients with Cystic Fibrosis and Achromobacter xylosoxidans

Achromobacter xylosoxidansinduced bronchiolitis obliterans in cystic fibrosis

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