Structured surveillance of Achromobacter, Pandoraea and Ralstonia species from patients in England with cystic fibrosis

Coward, Amy; Kenna, D.; Woodford, Neil; Turton, Jane F.; Armstrong, Malcolm; Auckland, Cressida; Bowler, I.C.J.W.; Burns, Phillipa; Cargill, James S.; Carroll, Mary; Flight, W.G.; Graver, Michelle Angela; Green, Heather; Horner, Carolyne; Jones, Andrew M.; Jones, Graeme R.; Mayell, Sarah; Orendi, J M; Perry, Audrey; Robb, A.; Tucker, Natasha; Waine, D.J.; Winstanley, T. G.; Withers, Nick

doi:10.1016/j.jcf.2019.11.005

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…Nonetheless, as the publication of specific EUCAST breakpoints is recent, the vast majority of the published data is based on the CLSI breakpoints. Indeed, considering CLSI breakpoints, European studies on the antibiotic susceptibility of Achromobacter isolated from PWCF have shown similar results with a good susceptibility of piperacillin-tazobactam (85 to 89%), imipenem (79 to 88%) and meropenem (54 to 72%) [20][21][22]. Conversely, US studies showed a lower susceptibility (piperacillin-tazobactam (13 to 55%), imipenem (59% and meropenem (28 to 51%)) [23,24].…”

Section: Discussionmentioning

confidence: 88%

“…As Achromobacter, other non-fermenting Gram-negative bacilli, such as Stenotrophomonas maltophilia, Burkholderia cepacia complex, Pandoraea or Cupriavidus are increasingly isolated from the respiratory tract of PWCF and are characterised by their high resistance to antibiotics. For all these bacteria, SXT and tetracycline (minocycline) are among the most active antimicrobial agents [8,22,[34][35][36][37][38]. For most of them, carbapenems represent one of the most active antimicrobial agents except for S. maltophilia, which is intrinsically resistant due to a chromosomal carbapenemase.…”

Section: Discussionmentioning

confidence: 99%

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In Vitro Activity of 22 Antibiotics against Achromobacter Isolates from People with Cystic Fibrosis. Are There New Therapeutic Options?

Lamoureux

Mashi

Ramel³

et al. 2021

Microorganisms

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Bacteria belonging to the genus Achromobacter are increasingly isolated from respiratory samples of people with cystic fibrosis (PWCF). The management of this multidrug-resistant genus is challenging and characterised by a lack of international recommendations, therapeutic guidelines and data concerning antibiotic susceptibility, especially concerning the newer antibiotics. The objective of this study was to describe the antibiotic susceptibility of Achromobacter isolates from PWCF, including susceptibility to new antibiotics. The minimum inhibitory concentrations (MICs) of 22 antibiotics were determined for a panel of 23 Achromobacter isolates from 19 respiratory samples of PWCF. Two microdilution MIC plates were used: EUMDROXF® plate (Sensititre) and Micronaut-S Pseudomonas MIC® plate (Merlin) and completed by a third method if necessary (E-test® or UMIC®). Among usual antimicrobial agents, the most active was imipenem (70% susceptibility). Trimethoprim-sulfamethoxazole, piperacillin and tigecycline (65%, 56% and 52% susceptibility, respectively) were still useful for the treatment of Achromobacter infections. Among new therapeutic options, β-lactams combined with a β-lactamase-inhibitor did not bring benefits compared to β-lactam alone. On the other hand, cefiderocol appeared as a promising therapeutic alternative for managing Achromobacter infections in PWCF. This study provides the first results on the susceptibility of clinical Achromobacter isolates concerning new antibiotics. More microbiological and clinical data are required to establish the optimal treatment of Achromobacter infections.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

In Vitro Activity of 22 Antibiotics against Achromobacter Isolates from People with Cystic Fibrosis. Are There New Therapeutic Options?

Lamoureux

Mashi

Ramel³

et al. 2021

Microorganisms

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“…There has been concern of potential spread of M. abscessus infection between patients at CF centres in the United States and UK [10,11], although not all studies have uncovered evidence that healthcare associated transmission is the source of acquisition of M. abscessus infection [12][13][14]. Shared strains of other lower prevalence CF pathogens, including Achromobacter and Pandoraea species, have also been described, again with epidemiology implicating possible patient-to-patient spread in some but not all such studies [15][16][17][18]. In summary, over the years there have been reports of cross-infection with strains of an expanding number of different CF pathogens, although most of these reports involve relatively small number of patients.…”

Section: Evolving Literature Of Specific Pathogensmentioning

confidence: 99%

Infection control in cystic fibrosis: evolving perspectives and challenges

Jones¹

2022

Current Opinion in Pulmonary Medicine

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Purpose of reviewThis article reviews the impact of some of the most recent changes in clinical care management in cystic fibrosis on infection prevention practice and advice for people with cystic fibrosis. Recent findingsPeople with cystic fibrosis (CF) consistently highlight infection control as one of their major concerns. Infection prevention guidance and practice has facilitated successful decreases in rates of many transmissible CF pathogens. The coronavirus disease 2019 pandemic highlighted the clinical significance of respiratory viral infections and has accelerated the implementation of remote monitoring and telemedicine consultations as standard practice in CF. The continued improvement in health of the CF population is being further augmented by the introduction of new therapies, in particular cystic fibrosis transmembrane conductance regulator modulators. Infection prevention will remain pertinent to CF care, but these recent changes in clinical practice will have ongoing implications for infection prevention guidance in CF. SummaryRecent changes in CF clinical care have implications that will lead to further evolution of infection control practice and advice.

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“…Unusual Gram-negative (GN) pathogens, including Achromobacter spp., Alcaligenes spp., Aeromonas spp., Burkholderia spp., and other genera, are primarily opportunistic pathogens that can cause serious infections ( 1 – 3 ). Achromobacter spp., particularly A. xylosoxidans , have been isolated from cystic fibrosis (CF) patients, and the incidence has increased recently ( 4 – 6 ). Aeromonas spp.…”

Section: Introductionmentioning

confidence: 99%

Minocycline Activity against Unusual Clinically Significant Gram-Negative Pathogens

Shortridge

Arends

Streit

et al. 2021

Antimicrob Agents Chemother

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The minocycline susceptibility of 3,856 isolates including Burkholderia , Achromobacter , Alcaligenes, Aeromonas , and Stenotrophomonas maltophilia from the SENTRY surveillance (2014-2019) were analyzed. The susceptibilities of these species (number; %S) were Achromobacter spp. (n=411; 92.6%), Burkholderia cepacia species complex (n=199; 85.9%), Aeromonas spp. (n=127; 99.2%), Chryseobacterium spp (n=59; 94.9%), Alcaligenes faecalis (n=42; 88.1%) and S. maltophilia (n=2,287; 99.5%). These data suggest that minocycline may be a useful treatment option for infections caused by unusual gram-negative pathogens.

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Structured surveillance of Achromobacter, Pandoraea and Ralstonia species from patients in England with cystic fibrosis

Cited by 13 publications

References 19 publications

In Vitro Activity of 22 Antibiotics against Achromobacter Isolates from People with Cystic Fibrosis. Are There New Therapeutic Options?

In Vitro Activity of 22 Antibiotics against Achromobacter Isolates from People with Cystic Fibrosis. Are There New Therapeutic Options?

Infection control in cystic fibrosis: evolving perspectives and challenges

Minocycline Activity against Unusual Clinically Significant Gram-Negative Pathogens

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