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: 3.99). 08/2011; 49(10):3649-51. DOI: 10.1128/JCM.05283-11
Source: PubMed


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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    • "Isolates from a patient attending the Aarhus University Hospital (Denmark) were also included in this study. Chronic colonization (CC) was defined as Pthree positive cultures per year separated by a minimum of one-month intervals, for at least 2 years (Pereira et al., 2011). Sputum cultures were conducted according to national recommendations. "
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    ABSTRACT: Achromobacter spp. are increasingly identified in Cystic Fibrosis (CF) patients and their ability to persistently colonize the CF respiratory tract (CFRT) suggests that Achromobacter species possess adaptive characteristics. We studied genome dynamics in 118 isolates recovered from 13 patients with Achromobacter chronic colonization (5-26 isolates per patient recovered over 13-61 months). Isolates were identified to species level by nrdA gene sequencing, subjected to Pulsed-Field Gel Electrophoresis (PFGE) and multiplex rep-PCR (MR-PCR), and rrs intragenomic diversity was studied by PCR-Temporal Temperature Gel Electrophoresis (TTGE). Intrapatient diversity was assessed: i) from dynamics of XbaI and/or SpeI-based pulsotypes, ii) from comparison of MR-PCR profiles, and iii) by longitudinal analysis of rrs intragenomic diversity. Patients were chronically colonized by Achromobacter xylosoxidans (n=10), Achromobacter dolens (n=1) or Achromobacter insuavis (n=2). All strains displayed genomic diversification over time but A. insuavis showed higher pulsotype diversity compared to other species. Intragenomic rrs heterogeneity was found in strains from 6 of 13 patients and may be persistently observed. Achromobacter genome evolution observed during chronic colonization of the CFRT warrants further investigation of the adaptation features of the different species, as well as of the selective forces driving this adaptation in the CFRT. Copyright © 2015. Published by Elsevier B.V.
    Full-text · Article · Mar 2015 · Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases
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    • "Recently, a Brazilian study reported a prevalence of 21.8% (Pereira et al., 2011). Infection is frequently transient, although approximately 2.3% of CF patients are chronically infected (Tan et al., 2002). "
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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.
    Full-text · Article · Apr 2014 · Frontiers in Microbiology
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    • "Again, this increase in incidence was not caused by cross infections , but interestingly, following lung transplantation, two patients showed re-colonization of the lung grafts with the pre-transplant A. xylosoxidans strain. In contrast, a Brazilian series investigating 122 A. xylosoxidans positive isolates taken over a 5-year period from 39 cystic fibrosis patients, detected only the subtype G in 22 cases (56Á4%), suggesting patientto-patient transmission (Pereira et al, 2011). Like in other localizations, pulmonary MALT lymphoma usually follows an indolent clinical course, thus giving the potential therapeutic option of an antimicrobial eradication treatment as a therapy with fewer side effects than radiation, surgery, or chemotherapy. "
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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.
    Full-text · Article · Dec 2013 · British Journal of Haematology
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