Effect of respiratory Achromobacter spp. infection on pulmonary function in patients with cystic fibrosis

Recio, Raúl; Brañas, Patricia; Martínez, María Teresa; Cháves, Fernando; Orellana, María Ángeles

doi:10.1099/jmm.0.000763

Cited by 31 publications

(46 citation statements)

References 25 publications

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“…The Ac-Ax assay demonstrated good sensitivity and specificity for achromobacterial identification from polymicrobial specimens, with 4/33 (12%) adult CF sputa being Ac PCR-positive. This rate falls within the 3 to 30% Achromobacter prevalence rates reported in CF centres worldwide (13, 15, 42). Of the four positive sputa, one patient was found to harbour a non- A. xylosoxidans achromobacterial infection (Table 3).…”

Section: Discussionsupporting

confidence: 78%

“…Achromobacter spp. are becoming increasingly common in people with the life-shortening disease, CF, being present in up to 30% of adult CF airways (13, 15, 42). Although historically considered of low pathogenic potential, there is mounting evidence that CF infections caused by Achromobacter spp.…”

Section: Discussionmentioning

confidence: 99%

“…Although historically considered of low pathogenic potential, there is mounting evidence that CF infections caused by Achromobacter spp. are associated with adverse clinical presentations and outcomes, especially in immunocompromised individuals (9, 13-15). Therefore, their rapid identification is essential for guiding appropriate therapeutic treatments and improving patient prognosis (43).…”

Section: Discussionmentioning

confidence: 99%

“…in disease pathogenesis has been unclear; however, recent studies have shown that CF patients with an Achromobacter spp. infection are in fact at greater risk of experiencing a pulmonary exacerbation (9), and patients with chronic infections exhibit severe airway obstruction and more rapid lung function decline (13-15). Further, these pathogens can cause a range of serious diseases such as pneumonia, meningitis, osteomyelitis, urinary tract infections, and ocular infection in non-CF patients (16).…”

Section: Introductionmentioning

confidence: 99%

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Duplex real-time PCR assay for the simultaneous detection ofAchromobacter xylosoxidansandAchromobacterspp

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23Several members of the Gram-negative environmental bacterial genus, Achromobacter, are 24 associated with serious infections in immunocompromised individuals, of which 25Achromobacter xylosoxidans is the most common. Despite their pathogenic potential, 26comparatively little is understood about these intrinsically drug-resistant bacteria and their role 27 in disease, leading to suboptimal diagnosis and management of Achromobacter infections. 28Here, we performed comparative genomics of 158 Achromobacter spp. genomes to robustly 29 identify species boundaries, to reassign several incorrectly speciated taxa, and to identify 30 genetic sequences specific for the Achromobacter genus and for A. xylosoxidans. Next, we 31 developed a Black Hole Quencher probe-based duplex real-time PCR assay, Ac-Ax, for the 32 rapid and simultaneous detection of Achromobacter spp. and A. xylosoxidans from both 33 purified colonies and polymicrobial clinical specimens. Ac-Ax was tested on 119 isolates 34 identified as Achromobacter spp. using phenotypic or genotypic methods. In comparison to 35 these routine diagnostic methods, the duplex assay showed superior identification of 36 Achromobacter spp. and A. xylosoxidans, with five Achromobacter isolates failing to amplify 37with Ac-Ax confirmed to be different genera according to 16S rRNA gene sequencing. Ac-Ax 38 quantified both Achromobacter spp. and A. xylosoxidans down to ~110 genome equivalents, 39 and detected down to ~12 and ~1 genome equivalent/s, respectively. In silico analysis, and 40 laboratory testing of 34 non-Achromobacter isolates and 38 adult CF sputa, confirmed duplex 41 assay specificity and sensitivity. We demonstrate that the Ac-Ax duplex assay provides a 42 robust, sensitive, and cost-effective method for the simultaneous detection of all 43Achromobacter spp. and A. xylosoxidans, and will facilitate the rapid and accurate diagnosis 44 of this important group of pathogens. 45

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Duplex real-time PCR assay for the simultaneous detection ofAchromobacter xylosoxidansandAchromobacterspp

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Arango

Kidd

et al. 2020

Preprint

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“…Achromobacter spp. are becoming increasingly common in people with CF, being cultured in up to 30 % of CF airways [9][10][11]. Although historically considered to be of low pathogenic potential, there is mounting evidence that CF infections caused by Achromobacter spp.…”

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confidence: 99%

Duplex real-time PCR assay for the simultaneous detection of Achromobacter xylosoxidans and Achromobacter spp.

et al. 2020

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Several members of the Gram-negative environmental bacterial genus Achromobacter are associated with serious infections, with Achromobacter xylosoxidans being the most common. Despite their pathogenic potential, little is understood about these intrinsically drug-resistant bacteria and their role in disease, leading to suboptimal diagnosis and management. Here, we performed comparative genomics for 158 Achromobacter spp. genomes to robustly identify species boundaries, reassign several incorrectly speciated taxa and identify genetic sequences specific for the genus Achromobacter and for A. xylosoxidans . Next, we developed a Black Hole Quencher probe-based duplex real-time PCR assay, Ac-Ax, for the rapid and simultaneous detection of Achromobacter spp. and A. xylosoxidans from both purified colonies and polymicrobial clinical specimens. Ac-Ax was tested on 119 isolates identified as Achromobacter spp. using phenotypic or genotypic methods. In comparison to these routine diagnostic methods, the duplex assay showed superior identification of Achromobacter spp. and A. xylosoxidans , with five Achromobacter isolates failing to amplify with Ac-Ax confirmed to be different genera according to 16S rRNA gene sequencing. Ac-Ax quantified both Achromobacter spp. and A. xylosoxidans down to ~110 genome equivalents and detected down to ~12 and ~1 genome equivalent(s), respectively. Extensive in silico analysis, and laboratory testing of 34 non- Achromobacter isolates and 38 adult cystic fibrosis sputa, confirmed duplex assay specificity and sensitivity. We demonstrate that the Ac-Ax duplex assay provides a robust, sensitive and cost-effective method for the simultaneous detection of all Achromobacter spp. and A. xylosoxidans and will facilitate the rapid and accurate diagnosis of this important group of pathogens.

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An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

et al. 2020

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Stenotrophomonas maltophilia, Burkholderia cepacia complex, Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., and Alcaligenes spp. are less‐common non–lactose‐fermenting bacteria that have emerged as important opportunistic pathogens. Patients at the highest risk for these infections include the immunocompromised, those with cystic fibrosis, and the critically ill. These opportunistic pathogens are frequently drug resistant through the expression of β‐lactamases, multidrug efflux pumps, aminoglycoside‐modifying enzymes, and target site alterations discussed in detail throughout this review. As a result, treatment is extremely challenging. For each pathogen, this review will examine the epidemiology, mechanisms of resistance, and in vitro and in vivo data including that for novel β‐lactam/β‐lactamase inhibitors and cefiderocol. Treatment recommendations are provided based on the available literature.

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Effect of respiratory Achromobacter spp. infection on pulmonary function in patients with cystic fibrosis

Abstract: The Achromobacter spp. status in CF shows a trend towards more severe airflow obstruction and an association with accelerated decline in lung function parameters.

Cited by 31 publications

References 25 publications

Duplex real-time PCR assay for the simultaneous detection ofAchromobacter xylosoxidansandAchromobacterspp

Duplex real-time PCR assay for the simultaneous detection ofAchromobacter xylosoxidansandAchromobacterspp

Duplex real-time PCR assay for the simultaneous detection of Achromobacter xylosoxidans and Achromobacter spp.

An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

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