Epidemiology and resistance of Achromobacter xylosoxidans from cystic fibrosis patients in Dijon, Burgundy: First French data

Amoureux, Lucie; Bador, Julien; Siébor, Eliane; Taillefumier, Nathalie; Fanton, Annlyse; Neuwirth, Catherine

doi:10.1016/j.jcf.2012.08.005

Cited by 73 publications

(81 citation statements)

References 29 publications

(39 reference statements)

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“…As previously reported, this species is innately resistant to cephalothin, cefoxitin, cefotaxime, aztreonam, and aminoglycosides (11,12). Acquired resistance to carbapenems, ceftazidime, and ciprofloxacin is frequent, dramatically limiting therapeutic choices (13,14).…”

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confidence: 78%

Detection of Achromobacter xylosoxidans in Hospital, Domestic, and Outdoor Environmental Samples and Comparison with Human Clinical Isolates

Amoureux

Bador

Fardeheb

et al. 2013

Appl Environ Microbiol

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Achromobacter xylosoxidans is an aerobic nonfermentative Gram-negative rod considered an important emerging pathogen among cystic fibrosis (CF) patients worldwide and among immunocompromised patients. This increased prevalence remains unexplained, and to date no environmental reservoir has been identified. The aim of this study was to identify potential reservoirs of A. xylosoxidans in hospital, domestic, and outdoor environments and to compare the isolates with clinical ones. From 2011 to 2012, 339 samples were collected in Dijon's university hospital, in healthy volunteers' homes in the Dijon area, and in the outdoor environment in Burgundy (soil, water, mud, and plants). We designed a protocol to detect A. xylosoxidans in environmental samples based on a selective medium: MCXVAA (MacConkey agar supplemented with xylose, vancomycin, aztreonam, and amphotericin B). Susceptibility testing, genotypic analysis by pulsed-field gel electrophoresis, and bla OXA-114 sequencing were performed on the isolates. A total of 50 strains of A. xylosoxidans were detected in hospital (33 isolates), domestic (9 isolates), and outdoor (8 isolates) samples, mainly in hand washing sinks, showers, and water. Most of them were resistant to ciprofloxacin (49 strains). Genotypic analysis and bla OXA-114 sequencing revealed a wide diversity among the isolates, with 35 pulsotypes and 18 variants of oxacillinases. Interestingly, 10 isolates from hospital environment were clonally related to clinical isolates previously recovered from hospitalized patients, and one domestic isolate was identical to one recovered from a CF patient. These results indicate that A. xylosoxidans is commonly distributed in various environments and therefore that CF patients or immunocompromised patients are surrounded by these reservoirs.

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confidence: 78%

Detection of Achromobacter xylosoxidans in Hospital, Domestic, and Outdoor Environmental Samples and Comparison with Human Clinical Isolates

Amoureux

Bador

Fardeheb

et al. 2013

Appl Environ Microbiol

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“…For example, WGS comparing longitudinally collected isolates of A. xylosoxidans and Achromobacter insuavis that were isolated from CF patients identified strain-specific mutations in genes mostly involved in general metabolism but also in virulence and antimicrobial resistance (17). Moreover, genome fingerprint diversity was a frequent finding during Achromobacter persistence (12 out of the 13 patients in the study by Dupont et al [15] and 10 out of the 14 patients in the study by Amoureux et al [14]). …”

Section: Discussionmentioning

confidence: 99%

“…Its ability to induce local inflammation, as done by P. aeruginosa, suggests its pathogenicity (13). Previous studies reporting longitudinal genetic and phenotypic variations of A. xylosoxidans during chronic colonization (14)(15)(16) prompt the assessment of the intraspecimen diversity of Achromobacter species populations by studying the genome fingerprint (pulsed-field gel electrophoresis [PFGE]) and antibiotic susceptibility profile variability.…”

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confidence: 99%

Impact of High Diversity of Achromobacter Populations within Cystic Fibrosis Sputum Samples on Antimicrobial Susceptibility Testing

et al. 2017

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Chronic colonization by opportunistic environmental bacteria is frequent in the airways of cystic fibrosis (CF) patients. Studies of Pseudomonas aeruginosa evolution during persistence have highlighted the emergence of pathoadaptive genotypes and phenotypes, leading to complex and diversified inpatient colonizing populations also observed at the intraspecimen level. Such diversity, including heterogeneity in resistance profiles, has been considered an adaptive strategy devoted to host persistence. Longitudinal genomic diversity has been shown for the emergent opportunistic pathogen Achromobacter, but phenotypic and genomic diversity has not yet been studied within a simple CF sputum sample. Here, we studied the genomic diversity and antimicrobial resistance heterogeneity of 132 Achromobacter species strains (8 to 27 strains of identical or distinct colonial morphotypes per specimen) recovered from the sputum samples of 9 chronically colonized CF patients. We highlighted the high within-sample and within-morphotype diversity of antimicrobial resistance (disk diffusion) and genomic (pulsed-field gel electrophoresis) profiles. No sputum sample included strains with identical pulsotypes or antibiotic susceptibility patterns. Differences in clinical categorization were observed for the 9 patients and concerned 3 to 11 antibiotics, including antibiotics recommended for use against Achromobacter. Within-sample antimicrobial resistance heterogeneity, not predictable from colonial morphology, suggested that it may represent a selective advantage against antibiotics in an Achromobacter persisting population and potentially compromise the antibiotic management of CF airway infections.KEYWORDS Achromobacter, antimicrobial susceptibility, cystic fibrosis, diversity, genome B acterial adaptation during persistence in the respiratory tract of cystic fibrosis (CF) patients has mainly been studied for Pseudomonas aeruginosa showing that pathoadaptation mechanisms are particularly efficient, leading to rare and hardly achievable P. aeruginosa eradication. Many studies have revealed a variety of phenotypic pathoadaptative traits during long-term colonization, such as auxotrophy and metabolic modifications, quorum-sensing alterations, biofilm production, loss of motility and virulence factors, emergence of mucoid colonies, and an increase of antibiotic resistance (for a review, see reference 1). Moreover, numerous genomic modifications, which were either directly related to phenotype or not, were observed (1, 2). Other species, such as the Burkholderia cepacia complex, Stenotrophomonas maltophilia, and

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“…nrdA gene sequencing was performed as previously described [11] on one selected isolate from each patient. Longitudinal analysis of multiple isolates has shown that each patient persistently carries isolates of a single genotype [3,6]. Therefore only one isolate per patient was included.…”

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confidence: 99%

Prevalence and species distribution of Achromobacter sp. cultured from cystic fibrosis patients attending the Aarhus centre in Denmark

Gade

Nørskov‐Lauritsen

Ridderberg

2017

Journal of Medical Microbiology

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Epidemiology and resistance of Achromobacter xylosoxidans from cystic fibrosis patients in Dijon, Burgundy: First French data

Abstract: In our centre, the high prevalence of colonisation is not due to cross-contamination. Our main concern is the high rate of antimicrobial resistance.

Cited by 73 publications

References 29 publications

Detection of Achromobacter xylosoxidans in Hospital, Domestic, and Outdoor Environmental Samples and Comparison with Human Clinical Isolates

Detection of Achromobacter xylosoxidans in Hospital, Domestic, and Outdoor Environmental Samples and Comparison with Human Clinical Isolates

Impact of High Diversity of Achromobacter Populations within Cystic Fibrosis Sputum Samples on Antimicrobial Susceptibility Testing

Prevalence and species distribution of Achromobacter sp. cultured from cystic fibrosis patients attending the Aarhus centre in Denmark

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