Scleral buckle infection with Alcaligenes xylosoxidans.

We describe a rare case of extraocular inflammation secondary to scleral buckle infection with Alcaligenes xylosoxidans. A 60‑year‑old female with a history of retinal detachment repair with open‑book technique of scleral buckling presented with purulent discharge and irritation in the right eye that had begun 4 weeks earlier and had been treated ineffectively at another hospital. Conjunctival erosion with exposure of the scleral buckle was noted. The scleral buckle was removed and cultured. The explanted material grew gram‑negative rod later identified as A. xylosoxidans. On the basis of the susceptibility test results, the patient was treated by subconjunctival injection and fortified topical ceftazidime. After 4 weeks of treatment, the infection resolved.

Infección respiratoria causada por Alcaligenes xylosoxidans en un paciente con síndrome de Mounier-Kuhn / Case report: respiratory infection due to Alcaligenes xylosoxidans in a patient with Mounier-Kuhn syndrome

Mounier-Kuhn syndrome is a rare entity characterized by abnormal dilatation of the trachea and main bronchi (tracheobronchomegaly). Alcaligenes xylosoxidans is a non fermenting gram-negative pathogen common in extra-and intra-hospital environment, which may be related to immunosuppression states. We describe the case of a 75 years old male, ex-smoker with moderate functional obstruction, chronic respiratory failure and chronic colonization by Pseudomonas aeuriginosa. He had an infectious exacerbation of his disease, reason that previously required several hospital admissions. The patient was treated with antibiotics and his evolution was favourable with negativization in cultures of the pathogen. This is the first description of the isolation of Alcaligenes xylosoxidans as a cause of respiratory infection in a patient with Mounier-Kuhn syndrome.

A Case of Peritonitis Due to Achromobacter xylosoxidans subsp. xylosoxidans in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) / 대한신장학회지

Bacterial peritonitis is a well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. Achromobacter xylosoxidans subsp. xylosoxidans is a catalase and oxidase positive, motile, nonfermentative and gram-negative rod bacterium that is a rare pathogen in humans and has rarely been reported as an opportunistic human pathogen. We present a case of peritonitis due to unusual pathogens, Achromobacter xylosoxidans subsp. xylosoxidans. A 49-year-old diabetic man undergoing CAPD for 90 days developed the first peritonitis due to Achromobacter xylosoxidans subsp. xylosoxidans. A. xylosoxidans was detected from a culture of peritoneal fluid. Susceptible antibiotic treatment was provided.

A Case of Alcaligenes xylosoxidans Keratitis in a Soft Contact Lens Wearer

PURPOSE: To report a case of corneal ulcer due to Alcaligenes xylosoxidans in a soft contact lens wearer. CASE SUMMARY: A 20-year-old female patient presented with a corneal ulcer. The patient had been wearing soft contact lenses over 6 months. The ulcer had a typical appearance, similar to that of immune infiltration due to contact lenses. However, the corneal scraping and culture yielded Alcaligenes xylosoxidans, which is susceptible to ceftazidime and levofloxacine in the antibiotic susceptibility test. After treatment with topical antibiotics, her eye improved, with only a mild corneal scar remaining. CONCLUSIONS: Alcaligenes xylosoxidans should be considered as a potential causal pathogen of keratitis upon wearing soft contact lenses. Additionally, any lesion should be suspected as a bacterial corneal ulcer, even if appearing as an immune infiltration due to contact lenses.

Thiry-nine Types of Resistant-related Genes in a Pan-resistant Alcaligenes xylosoxidans subsp xylosoxidans in Sputum from a Severe Chronic Hepatitis Patient / 中华医院感染学杂志

OBJECTIVE To study 39 kinds of resistant-related genes in a pan-resistant Alcaligenes xylosoxidans subsp xylosoxidans(AXXxx) in the sputum isolated from a severe hepatitis B patient.METHODS The susceptibility to antimicrobial agents were detected by MIC.16S rRNA and 39 resistant-related genes including 29 ?-lactamases genes,6 aminoglycoside-modifying enzymes(AMEs)genes,1 chlorhexidine-sulfadiazine resistant gene(qacE△1-sul1)and 3 intergron genes separated(intⅠ1,2,3) an AXXxx strain in the sputum of a severe hepatitis B patient were measured by PCR,and verified by DNA sequencing.RESULTS Among the strains,7 kinds of resistant-related genes(blaTEM-116,blaCARB-8,aac(6′)-Ⅱ,aac(3)-Ⅱ,ant(3″)-Ⅰ,qacE△1-sul1,and intI1)detected out.But other 27 kinds of ?-lactamases genes,3 kinds of AMEs(aac(6′)-Ⅰb,aac(3)-Ⅰ,ant(2″)-Ⅰ) genes,and 2 kinds of intⅠ(intⅠ2 and intⅠ3) genes were negative.CONCLUSIONS The pan-resistant A.xylosoxidans,mainly relates to 7 kinds of resistant-related genes(blaTEM-116,blaCARB-8,aac(6′)-Ⅱ,aac(3)-Ⅱ,ant(3″)-Ⅰ,qacE△1-sul1,and intⅠ1).

Two Cases of Pulmonary Infection due to A. xylosoxidans Infection in an Immunocompentent Patient / 결핵및호흡기질환

lcaligenes xylosoxidans is a catalase and oxidase positive, motile, nonfermentative and gram-negative rod bacterium. A. xylosoxidans infection is a rare cause of pulmonary infection and little information concerning treatment is available. The majority of patients that develop A. xylosoxidans infection belong to a high-risk group due to an immunocompromised condition or due to pulmonary cystic fibrosis. We report two rare cases of immunocompentent patients that developed a pulmonary infection due to A. xylosoxidans. A 77-year-old man was admitted with a lung abscess. The patient denied having any prior medical illness. A culture of bronchial washing fluid showed the presence of A. xylosoxidans. Despite appropriate antibiotic treatment, the patient died from acute respiratory distress syndrome (ARDS). Another patient, a 61-year-old man without an underlying disease, was admitted with empyema. Under the condition of a closed thoracostomy, a high fever persisted and the empyema was also aggravated. A. xylosoxidans was detected from a culture of pleural fluid. Susceptible antibiotic treatment was provided and surgical intervention was performed. We report these cases with a review of the literature.

Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS

The purpose of the present work was to inform about the first case of meningitis associated to the bacteria Alcaligenes xylosoxidans in a patient with HIV/AIDS. The patient was a 46-year-old male, with the antecedent of have been diagnosed for HIV/ AIDS, who attended in the Hospital Universitario de Colima, Mexico, with fever, shock and meningismus. The study of the cerebrospinal fluid showed pleocytosis, elevated protein levels and hypoglycorrhachia. The culture yielded the presence of Alcaligenes xylosoxidans with sensitivity to ciprofloxacin. After 14 days of treatment with this antibiotic, the patient showed neurologic improvement and was able to continue with his outpatient antiretroviral treatment. The present case shows the importance of the inclusion of this bacterium in the differential diagnosis of the neurological infections in HIV/AIDS patients and emphasizes the importance of considering the bacterial meningitis in this population.

Nosocomial Alcaligenes xylosoxidans Infection / 中华医院感染学杂志

OBJECTIVE To investigate the clinical distribution and resistance of Alcaligenes xylosoxidans,discussing risk factors of nosocomial infection and measures of prevention and treatment.METHODS We retrospectively analyzed 1323 isolated strains of Al.xylosoxidans in our hospital from Sep 2004 to Aug 2006.RESULTS For specimen from which Al.xylosoxidans was examined,sputum accounted for 99.85%,being the highest percentage.Al.xylosoxidans was especially distributed at respiratory ward(46.94%) and intensive care unit(ICU) ward(12.77%).Then was cardiovascular ward,endocrinology ward and hematology ward.The antibiotic drugs which had the high drug-resistance rate(i.e.more than 98%) were aminoglycoside(amikacin and gentamicin),quinolone(ciprofloxacin) and cefepime.But the drug-resistance rate to carbapenems,?-lactam/?-lactamase inhibitor combinations and the third generation cepholosporins(cefoperazone and ceftazidime) was less than 5%.CONCLUSIONS It is important for clinic to strengthen the disinfection for hospital environment and to use antibiotic drugs reasonably in order to control colonization and spread of Al.xylosoxidans in hospital.

Drug Resistance of Alcaligenes xylosoxidans / 中华医院感染学杂志

OBJECTIVE To investigate the distribution and the antimicrobial resistance of Alcaligenes xylosoxidans and to provide the guidance of rational use of antibiotics.METHODS A.xylosoxidans was isolated and identified through VITEK-AMS all-automatic microbiology analysis system and its G~-bacilli identification cards(GNI) and drug sensitivity cards(GNS-KI/121) were also analyzed.Drug-resistance was tested by Kirby-Bauer disk(sensitivity) method((Bio-Merieux) and Oxoid products).RESULTS The drug-resistance rates to the 1st to 4th((except) CAZ) generation cephalosporins were more than 77%.The drug-resistance rate to the aminoglycosides was more than 76%,and to(ampicillin,) amoxicillin/CA,ampicillin/sulbactam,cefoxitin and cefuroxime were all 100%;but to(aztreonam) was 92.86%;66.67% and 44.44% strains were resistant to ciprofloxacin and(levofloxacin).(CONCLUSIONS) The detection rates of the multidrug resistant A.xylosoxidans have the tendency to increase yearly.The antibiotics should be used reasonably according to the results of drug sensitivity test in clinic.

A Case of Alcaligenes xylosoxidans Endophthalmitis after Cataract Extraction

PURPOSE: To report a case of Alcaligenes xylosoxidans endophthalmitis following cataract extraction and IOL implantation. In Korea, Alcaligenes xylosoxidans endophthalmitis has not been reported. METHODS: The patient was transferred for endophthalmitis at 6 days after cataract extraction and IOL implantation. Alcaligenes xylosoxidans was founded in culture. We performed pars plana vitrectomy with removal of IOL and lens capsule, and then we supplied systemic IV antibiotics with fortified topical antibiotics. RESULTS: Sixty-four days after vitrectomy, corrected visual acuity was 1.0 and anterior segment showed no inflammatory cell.

A Case of Epidemic Keratoconjunctivitis Complicated by Alcaligenes Xylosoxidans Infection

PURPOSE: To report a case of epidemic keratoconjunctivitis complicated by Alcaligenes xylosoxidans. METHODS: A 37-year-old man suffered epidemic keratoconjunctivitis in both eyes. Eleven days later, he developed a corneal ulcer in his left eye. Bacterial staining, culture, and antibiotics sensitivity test were performed from a corneal scrape. RESULTS: The cultures revealed a growth of Alcaligenes xylosoxidans, and the patient was treated with ceftazidime and levofloxacin, based on the sensitivity test results. After 21 days of treatment, the infection was resolved with mild scaring and final vision in the left eye of 20/20. CONCLUSIONS: Alcaligenes xylosoxidans should be considered a rare but potential pathogen able to produce corneal ulcer complication in epidemic keratoconjunctivitis.