Hello JoAnn - -
I can reply with very little info. It is known to colonize CF patients. It is a pretty "strong" bacteria, similar to Psuedomonas in that sense. It can actually live in alcohol.
I will post some things from the internet.
You may want to search not under achromobacter, but under alcaligenes xylosoxidans. It was historically under alcaligenes and you will probably find more information using that search info.
Here is the full link to some info listed below... <a target=_blank class=ftalternatingbarlinklarge href="http://www.cdc.gov/ncidod/eid/vol12no11/06-0143.htm
">http://www.cdc.gov/ncidod/eid/vol12no11/06-0143.htm
</a>
Achromobacter (formerly Alcaligenes) xylosoxidans is a newly emerging microorganism isolated with increased frequency from the lungs of patients with cystic fibrosis (CF), but information about its clinical relevance is limited (1). A. xylosoxidans is innately resistant to many antimicrobial drugs (2), except piperacillin, piperacillin-tazobactam, and imipenem, and moderately susceptible to ceftazidime (45% of susceptible isolates), which is widely used to treat infection due to Pseudomonas aeruginosa (3,4). The mechanisms involved in cases of high-level resistance to ceftazidime have not been described for A. xylosoxidans. Possible mechanisms for ceftazidime resistance among gram-negative bacilli are alterations in outer membrane proteins, overproduction of cephalosporinase, or production of an extended-spectrum ?-lactamase (ESBL). ESBLs are enzymes distributed worldwide (5) that hydrolyze oxyimino-cephalosporins and monobactams and are susceptible to ?-lactamase inhibitors such as clavulanic acid and tazobactam. We report on the isolation from a CF patient of A. xylosoxidans that produced the VEB-1 ESBL. This is the first report of ESBL production in A. xylosoxidans and the first report of a VEB-1 - producing isolate from a CF patient.
<b>Conclusions</b>
This finding of a VEB-1 - producing A. xylosoxidans from a CF patient enhances the scant information available to laboratorians and clinicians about ESBL production by isolates from CF patients. A very recent study reports 3 ESBL-positive isolates of P. aeruginosa from CF patients in New Delhi, but the ESBL has not been characterized (14). Resistance to expanded-spectrum cephalosporins mediated by ESBLs has never been described in A. xylosoxidans. The detection of the ESBL production was difficult in AX476; therefore, the frequency of A. xylosoxidans isolates that produce an ESBL might be underestimated. We recommend the use of BioRad combination disks, especially for isolates that are highly resistant to ceftazidime and susceptible to piperacillin or when synergy exists between ticarcillin and ticarcillin plus clavulanic acid.
The origin of the strain remains unclear. Because A. xylosoxidans is widely encountered in the environment, acquisition of AX476 by our patient may have resulted from poor adherence to handwashing, contamination of respiratory therapy equipment (nebulizer), or contaminated water. We can exclude nosocomial acquisition because our patient had never been hospitalized.
The location of blaVEB-1 on an easily transferable plasmid might represent a clinical threat if spread among other species widely encountered among CF patients, especially P. aeruginosa. Such a transfer would create serious therapeutic problems. Therefore, to prevent person-to-person transmission, our patient visits the physician on different days than the other CF patients. If he needs to be hospitalized, our patient may not share a room with immunocompromised patients or with other CF patients anywhere in the hospital, which is the recommendation for patients with other multidrug-resistant pathogens (15). In conclusion, this first finding of a VEB-1 - producing A. xylosoxidans from a CF patient emphasizes the need to study the mechanism(s) of resistance to ceftazidime among a wide collection of isolates originated from different centers. The sequence of the class 1 integron reported in this paper has been assigned GenBank accession no. DQ393569.
