Alcaligenes xylosoxidansBloodstream Infections in Outpatient Oncology Office

Abstract

In 2002, we investigated a cluster of patients with Alcaligenes xylosoxidans bloodstream infections by conducting a matched case-control study and a prospective study. Pulsed-fi eld gel electrophoresis (PFGE) was performed on blood culture isolates, and 1 explanted central venous catheter (CVC) was tested for biofi lm. We identifi ed 12 cases of A. xylosoxidans bloodstream infection. Case-patients were more likely than controls to have had a CVC (7/7 [100%] vs 4/47 [8.7%], respectively; p<0.0001). Ten case isolates were indistinguishable by PFGE analysis, and A. xylosoxidans biofi lm from the CVC matched the outbreak strain. We observed multiple breaches in infection control, which may have caused contamination of multidose vials used to fl ush the CVCs. Our study links A. xylosoxidans with CVC biofi lm and highlights areas for regulation and oversight in outpatient settings.

Towards diagnostic guidelines for biofilm-associated infections

“…, Gristina & Costerton (1985), Marrie & Costerton (1985) Endocarditis Stewart et al (1980) Device-related bacteremia is thought to be due primarily to erosion or sloughing of biofilm cells because of mechanical shear when flushing the catheter, which detaches microbial cells from a biofilm (Donlan, 2002) and results in cells or cell aggregates entering the bloodstream and leading to the signs and symptoms of blood stream infection. Indwelling catheters are frequently colonized with biofilm shortly after insertion (Donlan & Costerton, 2002), and Kim et al linked biofilm on a central venous catheter (CVC) to an outbreak of Alcaligenes xylosoxidans bloodstream infection (Kim et al, 2008b). Many others, including Raad et al, 1992, Yücel et al, 2004, Lorente et al, 2004, have noted that catheter colonization does not necessarily directly correlate with infection as measured by positive blood cultures.…”

“…Indwelling catheters are frequently colonized with biofilm shortly after insertion (Donlan & Costerton, ), and Kim et al . linked biofilm on a central venous catheter (CVC) to an outbreak of Alcaligenes xylosoxidans bloodstream infection (Kim et al ., ). Many others, including Raad et al ., , , Yücel et al ., , Lorente et al ., , have noted that catheter colonization does not necessarily directly correlate with infection as measured by positive blood cultures.…”

Biofilm formation of Achromobacter xylosoxidans on contact lens

“…Some studies showed that Achromobacter spp. can form biofilm on surfaces other than CL, such as central venous catheters and urinary catheters [15,16]. The presence of biofilms in sputum from cystic fibrosis (CF) patients infected with A. xylosoxidans was revealed in one study.…”

Successful renal transplantation in the setting of Alcaligenes xylosoxidans peritonitis treatment

“…xylosoxidans, also known as Achromobacter xylosoxidans, is a gram-negative aerobic organism with close relationship to pseudomonas [5] . This organism has been reported in immunosuppressed patients such as those with cystic fibrosis or indwelling hardware [3] . A. xylosoxidans peritonitis has a poor prognosis because of pathogen's virulence and a high rate of recurrence [1] .…”