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Volume 38, Number 3, June 2005

Alcaligenes xylosoxidans bacteremia: clinical features and microbiological characteristics of isolates


Ren-Wen Tsay, Li-Chen Lin, Chien-Shun Chiou, Jui-Cheng Liao, Chang-Hua Chen, Chun-Eng Liu, Tzuu-Guang Young
Division of Infectious Diseases, Department of Internal Medicine and Infection Control Committee, Changhua Christian Hospital, Changhua; and Center for Disease Control, Department of Health, Taipei, Taiwan

Received: August 23, 2004    Revised: September 29, 2004    Accepted: October 27, 2004   

 

Corresponding author:

Dr. Tzuu-Guang Young, Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua 500, Taiwan. E-mail: 59062@cch.org.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Methods:

Bacteremia caused by Alcaligenes xylosoxidans is rare. Between 1999 and 2002, 12 cases of bacteremia caused by A. xylosoxidans were diagnosed at a tertiary referral center in central Taiwan. The clinical features of these patients and the antimicrobial susceptibilities and pulsed-field gel electrophoresis (PFGE) pattern of their blood isolates were studied. All infections were acquired nosocomially. All of the adult patients had underlying diseases, and 10 (83%) had undergone an invasive procedure. The clinical syndrome included primary bacteremia in 7 patients (58%), and catheter-associated bacteremia, surgical wound infection, pneumonia, urinary tract infection, and empyema in 1 each. Polymicrobial bacteremia was found in 1 patient. The case-fatality rate was 17% (2/12). All isolates were susceptible to piperacillin and ceftazidime and resistant to aminoglycoside, ciprofloxacin and cefepime. Susceptibility to imipenem (67%), ampicillin-sulbactam (75%) and trimethoprim-sulfamethoxazole (92%) was variable. Genetic fingerprints obtained by PFGE showed identical pattern in the isolates from 2 neonates, indicating the epidemiologic relatedness of these infections. We conclude that A. xylosoxidans isolates are multi-resistant and A. xylosoxidans bacteremia should be considered as a possible etiology of infection after invasive procedures in patients with underlying diseases. Strict infection control is needed to prevent this infection.

 



 

Key words:

Alcaligenes xylosoxidans, antibacterial agents, bacteremia, pulsed-field gel electrophoresis



 



 

J Microbiol Immunol Infect 2005;38:194-199.