Achromobacter xylosoxidans: Characterization of Strains in Brazilian Cystic Fibrosis Patients

Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciéncias Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Journal of clinical microbiology (Impact Factor: 4.23). 08/2011; 49(10):3649-51. DOI: 10.1128/JCM.05283-11
Source: PubMed

ABSTRACT We investigated the possibility of cross-infection among cystic fibrosis patients in two Brazilian reference centers. Achromobacter xylosoxidans isolates (n = 122) were recovered over a 5-year period from 39 patients. Isolates were genetically heterogeneous, but one genotype was present in 56% of the patients, suggesting that cross-infection may have occurred.

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    ABSTRACT: Achromobacter xylosoxidans is an aerobic non fermentative Gram-negative rod considered as an important emerging pathogen among Cystic Fibrosis (CF) patients worldwide and immunocompromised patients. This increased prevalence remains unexplained and to date none 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 have been collected in Dijon's University hospital, in healthy volunteers homes in Dijon's area and in outdoor environment in Burgundy (soils, waters, mud and plants). We designed a protocol to detect A. xylosoxidans in environmental samples based on a selective medium: MCXVAA (Mac Conkey agar supplemented with xylose, vancomycin, aztreonam and amphotericin B). Susceptibility testings, genotypic analysis by Pulsed-Field-Gel-Electrophoresis and blaOXA-114 sequencing were performed on the isolates. A total of 50 strains of A. xylosoxidans have been detected in hospital (33), domestic (9) and outdoor (8) samples, mainly in handwashing sinks, showers and waters. Most of them were resistant to ciprofloxacin (49 strains). Genotypic analysis and blaOXA-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 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.
    Applied and Environmental Microbiology 09/2013; DOI:10.1128/AEM.02293-13 · 3.95 Impact Factor
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    ABSTRACT: Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) comprises 7-8% of B-cell lymphomas and commonly originates from a background of long-standing chronic inflammation. An association with distinct bacteria species has been confirmed for several anatomical sites of MALT lymphoma. For pulmonary MALT lymphoma, however, a clear link with an infectious agent or autoimmune disorder has not yet been reported. Using a 16S rRNA gene-based approach, we have recently identified Achromobacter (Alcaligenes) xylosoxidans in eight of nine cases of pulmonary MALT lymphoma. A. xylosoxidans is a gram-negative betaproteobacterium with low virulence, but high resistance to antibiotic treatment. To further examine a potential association with A. xylosoxidans, 124 cases of pulmonary MALT lymphoma and 82 control tissues from six European countries were analysed using a specific nested PCR. Although prevalence rates for A. xylosoxidans varied significantly from country to country, they were consistently higher for MALT lymphoma as compared to controls. Overall, 57/124 (46%) pulmonary MALT lymphomas and 15/82 (18%) control tissues were positive for A. xylosoxidans (P = 0·004). Whether the significant association of A. xylosoxidans with pulmonary MALT lymphoma demonstrated in our study points to a potential causal role in the pathogenesis of this lymphoma will require further studies.
    British Journal of Haematology 12/2013; 164(6). DOI:10.1111/bjh.12703 · 4.94 Impact Factor
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    ABSTRACT: Cystic fibrosis (CF) patients have chronic airway infection and frequent exposure to antibiotics, which often leads to the emergence of resistant organisms. Achromobacter xylosoxidans is a new emergent pathogen in CF spectrum. From 2005 to 2010 we had an outbreak in A. xylosoxidans prevalence in our CF center, thus, the present study was aimed at deeply investigating virulence traits of A. xylosoxidans strains isolated from infected CF patients. To this purpose, we assessed A. xylosoxidans genome variability by randomly amplified polymorphic DNA (RAPD), biofilm production, antibiotic resistances, and motility. All A. xylosoxidans strains resulted to be biofilm producers, and were resistant to antibiotics usually employed in CF treatment. Hodge Test showed the ability to produce carbapenemase in some strains. Strains who were resistant to β-lactamics antibiotics, showed the specific band related to metal β-lactamase (blaIMP-1), and some of them showed to possess the integron1. Around 81% of A. xylosoxidans strains were motile. Multivariate analysis showed that RAPD profiles were able to predict Forced Expiratory Volume (FEV1%) and biofilm classes. A significant prevalence of strong biofilm producers strains was found in CF patients with severely impaired lung functions (FEV1% class 1). The outbreak we had in our center (prevalence from 8.9 to 16%) could be explained by an enhanced adaptation of A. xylosoxidans in the nosocomial environment, despite of aggressive antibiotic regimens that CF patients usually undergo.
    Frontiers in Microbiology 01/2014; 5:138. DOI:10.3389/fmicb.2014.00138 · 3.94 Impact Factor


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