Comparison of nutrient-rich and limited media in the production of biosurfactant by Achromobacter xylosoxidans BP(1)5

Aims@#This study aims to produce Achromobacter biosurfactant in nutrient-rich and nutrient-limited media.@*Methodology and results@#This study conducted fermentation on nutrient-rich and nutrient-limited media using a minimal salt medium (MSM). Dextrose and sodium citrate were used as sole carbon supplemented with 0.5% yeast extract for nutrient-rich media, while nutrient-limited media used molasses and rice straw hydrolysate (RSH) at variations of concentrations of 100 ppm and 200 ppm. The research was performed over 120 h and evaluated from growth response, surface tension and emulsification activity. The study revealed that the best surface tension value was when 2% (w/v) sodium citrate was used as C-source and 0.5% (w/v) yeast extract as N-source, after 72 h upon incubation at 30 °C/120 rpm having 45.45 ± 2.19 mN/m with emulsification activity 24.54 ± 3.42%. Whereas the best result of the nutrient-limited medium was obtained by RSH at a concentration of 200 ppm having 48.86 ± 5.36 mN/m.@*Conclusion, significance and impact of study@#The experiment showed that nutrient-limited medium from rice straw hydrolysate could compete with the nutrient-rich medium. The use of rice straw will contribute to the reduction of biosurfactant production costs and valorisation of agricultural waste.

Recurrent Endophthalmitis Caused by Achromobacter xylosoxidans: Importance of Aggressive Surgical Removal of Capsular Bag

No abstract available.

Achromobacter xylosoxidans Bacteremia in a Child with Neutropenia

Achromobacter xylosoxidans is a non-fermentative, aerobic, oxidase, and catalase-positive Gram-negative rod similar to Pseudomonas species. This organism colonizes aquatic environments and can cause nosocomial infections, especially in patients with immune deficiency such as human immunodeficiency virus infection, cancer, cystic fibrosis, neutropenia, and immunoglobulin M deficiency. Infections are found as bacteremia, pneumonia, meningitis, urinary tract infection, abscess formation, and osteomyelitis. It is known that most effective antibiotics are piperacillin/tazobactam, meropenem, and trimethoprim/sulfamethoxazol. But there is no optimal antibiotic therapy so far. We present a case of Achromobacter xylosoxidans bacteremia in a 13-month-old Korean girl who had past history of neutropenia.

Clinical impact of Achromobacter xylosoxidans colonization/infection in patients with cystic fibrosis

The rate of diagnosis of colonization/infection of the airways with Achromobacter xylosoxidans has increased in cystic fibrosis patients, but its clinical significance is still controversial. This retrospective, case-control study aimed to evaluate the clinical impact of A. xylosoxidans colonization/infection in cystic fibrosis patients. Individuals who were chronically colonized/infected (n=10), intermittently colonized/infected (n=15), and never colonized/infected with A. xylosoxidans (n=18) were retrospectively evaluated during two periods that were 2 years apart. Demographic characteristics, clinical data, lung function, and chronic bacterial co-colonization data were evaluated. Of the total study population, 87% were pediatric patients and 65.1% were female. Individuals chronically colonized/infected with A. xylosoxidans had decreased forced expiratory volume in 1 s (51.7% in the chronic colonization/infection group vs 82.7% in the intermittent colonization/infection group vs 76% in the never colonized/infected group). Compared with the other two groups, the rate of co-colonization with methicillin-resistant Staphylococcus aureus was higher in individuals chronically colonized/infected with A. xylosoxidans (P=0.002). Changes in lung function over 2 years in the three groups were not significant, although a trend toward a greater decrease in lung function was observed in the chronically colonized/infected group. Compared with the other two groups, there was a greater number of annual hospitalizations in patients chronically colonized/infected with A. xylosoxidans (P=0.033). In cystic fibrosis patients, there was an increased frequency of A. xylosoxidans colonization/infection in children, and lung function was reduced in patients who were chronically colonized/infected with A. xylosoxidans. Additionally, there were no differences in clinical outcomes during the 2-year period, except for an increased number of hospitalizations in patients with A. xylosoxidans.

Persistent Bordetella petrii Infection Related to Bone Fractures

No abstract available.

A Case of Septic Shock caused by Achromobacter xylosoxidans in an Immunocompetent Female Patient after Extracorporeal Shock Wave Lithotripsy for a Ureteral Stone / 감염과화학요법

Achromobacter xylosoxidans can cause various types of infections, but its infection in humans is rare. A. xylosoxidans has been reported as a rare etiological agent of infections including primary bacteremia, catheter-related bloodstream infection, endocarditis, otitis, and pneumonia, particularly in immunocompromised hosts. We encountered a case of septic shock caused by A. xylosoxidans in a 52-year-old, immunocompetent woman with no underlying disease, who received extracorporeal shock wave lithotripsy to remove a left upper ureteral stone. She was treated with antibiotics to which the organism was susceptible but died as a result of septic shock.

Achromobacter xylosoxidans Infection Following Total Knee Arthroplasty / 대한정형외과학회잡지

Achromobacter xylosoxidans is an opportunistic organism, mainly causing infection in immune compromised hosts, such as patients on dialysis. However, review of the medical literature showed that few cases of A. xylosoxidans infections following total knee arthroplasty have been reported. This organism has not been reported in prosthetic joint infections of patients who are not immune compromised. Here, a case of periprosthetic infection with A. xylosoxidans following total knee arthroplasty in a man with no medical history of immune suppression is reported.

Bacteremia due to Achromobacter xylosoxidans in neonates: clinical features and outcome

OBJECTIVE: We report an outbreak of Achromobacter xylosoxidans at a neonatal intensive care unit. We aimed to present clinical, laboratory and treatment data of the patients. Materials and METHODS: All consecutive episodes of bacteremia due to A. xylosoxidans at our neonatal intensive care unit, beginning with the index case detected at November 2009 until cessation of the outbreak in April 2010, were evaluated retrospectively. RESULTS: Thirty-four episodes of bacteremia occurred in 22 neonates during a 6-month period. Among the affected, 90% were preterm newborns with gestational age of 32 weeks or less and 60% had birth weight of 1000 g or less. Endotracheal intubation, intravenous catheter use, total parenteral nutrition and prolonged antibiotic therapy were the predisposing conditions. Presenting features were abdominal distention, thrombocytopenia and neutropenia. The mortality rate was 13.6% and the majority of isolates were susceptible to piperacillin-tazobactam, carbapenems and trimethoprim-sulfametoxazole, and resistant to gentamycin. More than half were breakthrough infections. Despite intensive efforts to control the outbreak by standard methods of hand hygiene, patient screening and isolation, containment could be achieved only after the neonatal intensive care unit was relocated. The investigation was not able to single out the source of the outbreak. CONCLUSION: A. xylosoxidans has the potential to cause serious infections in premature babies. More studies are needed to determine the importance of different sources of infection in hospital units.

Brote hospitalario de Achromobacter denitrificans relacionado con el uso de clorhexidina contaminada / Achromobacter denitrificans hospital outbreak associated with the use of contaminated chlorhexidine

El objetivo de este artículo es describir una serie de casos de pacientes con pseudobacteriemia causada por Achromobacter denitrificans, germen aislado a partir de los hemocultivos de 14 pacientes hospitalizados en una institución de alta complejidad de Medellín. Los casos estuvieron asociados con el uso de clorhexidina al 4 % en jabón contaminado. Todos los pacientes recibieron antibióticos con resultados favorables, posiblemente debido a la baja virulencia de este microorganismo y a las medidas oportunas adoptadas por el Grupo de Control de Infecciones del hospital.

The aim of this paper is to describe a case series of pseudobacteremia caused by Achromobacter denitrificans, isolated from blood cultures from 14 hospitalized patients in a tertiary care institution in Medellín. The cases were associated with the use of contaminated 4% chlorhexidine soap. All patients received antibiotic treatment and had favorable results, possibly because of the low virulence of this organism and the timely measures taken by the hospital infections control group.

Achromobacter xylosoxidans Keratitis after Contact Lens Usage

To report on Achromobacter xylosoxidans keratitis in two healthy patients who had worn contact lenses foran extended period of time. A 36-year-old female and a 21-year-old female visited our hospital with ocular pain and blurred vision. Both patients had a history of wearing soft contact lenses for over fve years with occasional overnight wear. At the initial presentation, a slit lamp examination revealed corneal stromal infiltrations and epithelial defects with peripheral neovascularization in both patients. Microbiological examinations were performed from samples of corneal scrapings, contact lenses, contact lens cases, and solution. The culture resulting from the samples taken from the contact lenses, contact lens cases, and solution were all positive for Achromobacter xylosoxidans. Confrming that the direct cause of the keratitis was the contact lenses, the frst patient was prescribed ceftazidime and amikacin drops sensitive to Achromobacter xylosoxidans. The second patient was treated with 0.3% gatifoxacin and fortifed tobramycin drops. After treatment, the corneal epithelial defects were completely healed, and subepithelial corneal opacity was observed. Two cases of Achromobacter xylosoxidans keratitis were reported in healthy young females who wore soft contact lenses. Achromobacter xylosoxidans should be considered a rare but potentially harmful pathogen for lens-induced keratitis in healthy hosts.

Avaliação do perfil de sensibilidade a antimicrobianos de Stenotrophomonas maltophilia, Complexo Burkholderia cepacia, Burkholderia gladioli e Achromobacter xylosoxidans subsp. xylosoxidans obtidos de amostras respiratórias de pacientes portadores de fibrose cística / Evaluation of antibiotic susceptibility of Stenotrophomonas maltophilia, Burkholderia cepacia complex, Burkholderia gladioli and Achromobacter xylosoxidans subsp. xylosoxidans recovered from respiratory samples from cystic fibrosis patients

Fibrose Cística (FC) é uma doença autossômica recessiva causada por mutações no canal de cloreto CFTR e caracterizada por uma extensa gama de sinais e sintomas clínicos. Devido a alterações na composição eletrolítica da camada de líquido periciliar, uma série de fatores converge para o estabelecimento de infecção e inflamação pulmonar crônicas. Stenotrophomonas matophilia (SM), Complexo Burkholderia cepacia (CBc), Burkholderia gladioli (Bg) e Achromobacter xylosoxidans subsp. xylosoxidans (Ax) são bacilos Gram-negativos não fermentadores frequentemente isolados de culturas de amostras respiratórias de pacientes com FC e intrinsecamente resistentes a diversas classes de antimicrobianos. O presente estudo buscou avaliar o perfil de sensibilidade destes microrganismos isolados de amostras respiratórias de pacientes fibrocísticos atendidos no Instituto da Criança do HC-FMUSP. Um total de 781 amostras foi obtido entre junho de 2003 a junho de 2004 e setembro de 2006 a setembro de 2007. Deste total, foram isoladas 57 cepas (7,3%) de SM (23 no primeiro e 34 no segundo períodos), 34 cepas (4,4%) de CBc (22 no primeiro e 12 no segundo períodos), 8 cepas (1%) de Bg (5 no primeiro e 3 no segundo períodos) e 23 ( 2,9%) de Ax (17 no primeiro e 6 no segundo períodos). Os isolados foram submetidos ao teste de disco-difusão (DD) frente a 22 anitimicrobianos. A verificação da Concentração Inibitória Mínima (CIM) foi realizada pelo método da diluição em ágar e teste epsilométrico. Pesquisou-se, fenotipicamente, a produção de beta-lactamases do tipo Beta-Lactamase de Espectro Estendido (ESBL) e Metalo-Beta-Lactamase (MBL). Minociclina foi a droga mais ativa, inibindo 100% das cepas estudadas. Sulfametoxazol-trimetoprim ainda apresenta um bom desempenho contra SM, porém, verificou-se resistência de 10,5%. Levofloxacina inibiu 96% das cepas de SM. Piperacilina-tazobactam foi ativa contra 100% das cepas do gênero Burkholderia e Ax. Notou-se diferenças importantes entre...

Bacteriologia da fibrose cística / Cystic fibrosis bacteriology

O exame bacteriológico é um dos principais parâmetros que auxiliam o diagnóstico e manuseio da infecção respiratória dos pacientes com Fibrose Cística (FC). Os microrganismos que colonizam e infectam o paciente fibrocístico determinam o tratamento, a qualidade de vida, as perspectivas para o transplante e a sua sobrevida global. A identificação precisa de patógenos respiratórios é essencial para o tratamento da infecção, seja como guia para o uso adequado de antibióticos por longos períodos para os pacientes com infecção bacteriana crônica ou para a aplicação adequada de medidas de controle de infecção. Embora exista um espectro limitado de patógenos respiratórios classicamente associados à doença respiratóriana FC, um número crescente de microrganismos vem sendo reconhecido como potenciais agentes patogênicos. O espectro de patógenos em FC varia com a idade do paciente, mas, de uma forma geral, é bem estabelecido na literatura que existem quatro bactérias “clássicas”: Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa e o complexo B. cepacia (CBC)...

The bacteriological culture is one of the main parameters that support the diagnosis and management of the respiratoryinfection in patients with cystic fibrosis (CF). The microorganisms that colonize and infect CF patients determine the treatment,quality of life, the lung transplant possibility and their overall survival. The accurate identification of respiratory pathogensis essential for the treatment of infection, either to guide the appropriate use of antibiotics for long periods to patientswith chronic bacterial infection or to the proper implementation of infection control measures. Although there is a limitedspectrum of respiratory pathogens classically associated with the respiratory disease in CF, an increasing number of microorganismshas been recognized as potential pathogens. The spectrum of pathogens in CF varies with the patients age but,in general, it is well established in the literature that there are four "classic" pathogens: Staphylococcus aureus, Haemophilusinfluenzae, Pseudomonas aeruginosa and the B. cepacia complex (Bcc)...

A Case of Chronic Dacryocystitis Caused by Achromobacter Xylosoxidans

PURPOSE: To report a case of chronic dacryocystitis caused by Achromobacter xylosoxidans. CASE SUMMARY: A 73-year-old female was referred to our clinic for management of chronic dacryosyctitis from which she did not to recover despite empirical therapy. A. xylosoxidans was isolated from purulent discharge. Based on the results of susceptibility testing, therapy was changed to fortified ceftazidime eye-drop 6 times a day and intravenous tazocin 4.5 g/20 ml (piperacillin 2 g/tazobactam 0.25 g) 3 times a day. All symptoms were resolved after treatment with sensitive antibiotics and external dacryocystorhinostomy. CONCLUSIONS: To our knowledge, this is the first report of A. xylosoxidans dacryocystitis. A. xylosoxidans are rare but potential pathogens which cause dacryocystitis. The cultures and sensitivity test were collected and processed to detect the presence of unusual pathogens in a case with persistent infection despite conventional treatment.

Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis Caused by Achromobacter xylosoxidans: A Case Report and Comprehensive Literature Review / 감염과화학요법

Achromobacter xylosoxidans is an uncommon cause of peritonitis in patients on maintenance continuous ambulatory peritoneal dialysis (CAPD). CAPD peritonitis caused by Achromobacter xylosoxidans carries high mortality and recurrence rates because of its virulence and resistance to most antimicrobial agents. We experienced a case of CAPD peritonitis caused by Achromobacter xylosoxidans in a patient with hypertension, diabetes mellitus, and end stage renal disease. The patient was treated with intravenous imipenem/cilastatin, and the CAPD catheter was removed. However, the patient died by aspiration pneumonia on the 34th day of hospitalization.

Peritonitis by Achromobacter xylosoxidans in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis(CAPD): A Case Report / 대한신장학회지

Peritonitis is a major cause of morbidity in continuous ambulatory peritoneal dialysis (CAPD) patients. Achromobacter xylosoxidans is a rarely reported cause of peritonitis in CAPD patients. In this report, a peritonitis case due to Achromobacter xylosoxidans in a 60-year-old male patient with end-stage renal failure receiving CAPD for 7 years, has been reported. White blood cell (WBC) count in peritoneal fluid was 3,160/mm3 with 95% neutrophil. Gram staining of the peritoneal fluid yielded gram negative rod. Empirical antibiotic therapy with ceftriaxone was initiated intraperitoneally. But drug sensitivity test revealed these regimens were resistant. On fourth hospital day, Achromobacter xylosoxidans was cultured from peritoneal effluent, the antibiotic regimen was switched to piperacillin/tazobactam intraperitoneally. The patient rapidly recovered and the WBC count of the peritoneal effluent decreased. The therapy was continued for 14 days and then the patient was discharged. The peritoneal catheter was not removed.

A Case of Achromobacter Xylosoxidans Keratitis

PURPOSE: To report a case of corneal ulcer caused by Achromobacter xylosoxidans in a farmer. CASE SUMMARY: A previously healthy 68-year-old man presented with unilateral redness and irritation after his eye was grazed by a cow's tail. The patient had previously been treated in a local clinic for four days without improvement. Bacterial staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of A. xylosoxidans. The patient was treated with moxifloxacin and ceftazidime eyedrops. After three months of treatment, the infection was resolved with mild scarring. CONCLUSIONS: Although it is a rare pathogen, A. xylosoxidans should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil or animal feces and having a slowly progressive disease and localized infiltrate but showing Gram-negative bacilli on smear examination.

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.

Molecular and Phenotypic Characteristics of 16S rRNA Methylase-producing Gram-negative Bacilli / 대한임상미생물학회지

BACKGROUND: Recently a novel plasmid-mediated resistant mechanism that conferred high-level resistance to aminoglycoside via methylation of 16S rRNA was reported. The aims of this study were to determine the prevalence of the 16S rRNA methylase genes and to characterize the coresistance to other antibiotics in Gram-negative bacilli. METHODS: Consecutive non-duplicate Gram-negative bacilli were isolated from clinical specimens at a Korean secondary- and tertiary-care hospital from July 2006 to June 2007. The antimicrobial susceptibility was tested by the CLSI agar dilution method,and PCR was performed to detect the 16S rRNA methylase genes in the arbekacin-resistant isolates. RESULTS: In Gram-negative bacilli, the proportions of 16S rRNA methylase gene-positive isolates were 5% (75/1,471) in the secondary-carehospital and 4% (48/1,251) in the tertiary-care hospital, and the positive rates by species were 1% Escherichiae coli 16% (10/1,062), Klebsiella pneumoniae 16% (75/460), K. oxytoca 2% (1/44), Citrobacter spp. 9% (7/82), Enterobacter spp. 2% (4/181), Serratia marcescens 6% (6/100), Proteus miriabilis 4% (2/57), Achromobacter xylosoxidans 20% (1/5), Pseudomonas aeruginosa < 1% (1/505), Acinetobacter spp. 10% (11/112), and Stenotrophomonas maltophilia 2% (1/66), respectively. Among 16S rRNA methylase-positive isolates from secondary- and tertiary-care hospitals, 93% (70/75) and 90% (43/48), respectively, were armA positive, and others, except one rmtA positive isolate, were positive for the rmtB gene, according to PCR results. The rates of ESBL-positive and cefoxitin-resistant K. pneumoniae were 59% and 92%,s respectively. In addition, 91% of 16S rRNA methylase-producing K. pneumoniae were positive for qnrB. There were no MBL producers among 16S rRNA methylase-producing Pseudomonas and Acinetobacter species. CONCLUSION: The novel aminoglycoside-resistant mechanisms involving16S rRNA methylase were prevalent and widely distributed among Gram-negative bacilli in Korea, and other resistance mechanisms were commonly associated with 16S rRNA methylase-mediated resistance in Korea.

Conjuntivite por Achromobacter xylosoxidans: relato de caso / Conjunctivitis due to Achromobacter xylosoxidans: case report

Relatamos um caso de conjuntivite ocasionada por Achromobacter xylosoxidans em paciente imunocompetente usuária de lentes de contato rígidas. A bactéria foi isolada da solução utilizada para a desinfecção das lentes bem como do raspado conjuntival. A. xylosoxidans tem sido descrita em infecções oportunistas em pacientes imunodeprimidos, contudo pode ser confundida com outros bacilos gram-negativos, principalmente Pseudomonas aeruginosa, isoladas de infecções oculares em pacientes imunocompetentes. Devido ao reduzido perfil de sensibilidade aos antimicrobianos demonstrado pelo A. xylosoxidans, torna-se importante a identificação deste agente etiológico em quadros de conjuntivite.

We report here a case of conjunctivitis in an immunocompetent patient due to Achromobacter xylosoxidans, which was associated with the use of rigid contact lenses. The bacteria were isolated from the scraped conjunctival swab as well as from the lens cleaning fluid. A. xylosoxidans is an opportunistic pathogen, especially in immunocompromised patients; however, in isolates of ocular infections, from immunocompetent patients, it may be confused with other gram-negative organisms, particularly Pseudomonas aeruginosa. Due to an increased resistance against different antimicrobial agents, A. xylosoxidans must be fully identified and differentiated from other gram-negative isolates from ocular infections.