Legrand C, Anaissie E
Department of Medical Specialities, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Clin Infect Dis. 1992 Feb;14(2):479-84. doi: 10.1093/clinids/14.2.479.
Bacteremia due to Achromobacter xylosoxidans is rare, and little information on treatment is available. Between 1983 and 1988, A. xylosoxidans was recovered from 26 cultures of blood from 10 patients with cancer and clinical signs of infection, including one patient with septic shock and two with pneumonia. Neutropenia did not seem to be a predisposing factor. The infection may have been catheter related in four patients and associated with gastrointestinal pathology in four others. Probable cause was not determined in the remaining two. In vitro studies of susceptibility showed that the isolates were susceptible to trimethoprim-sulfamethoxazole (TMP-SMZ), the antipseudomonal penicillins, ceftazidime, cefoperazone, and imipenem; moderately susceptible to ciprofloxacin; and resistant to ceftriaxone, cefotaxime, cefoxitin, ceftizoxime, aztreonam, and amikacin. All patients receiving therapy recovered, including those six who received TMP-SMZ or a beta-lactam antibiotic as a single agent. A. xylosoxidans bacteremia is a significant infection and may be catheter related or associated with gastrointestinal pathology. The infection usually responds to therapy with TMP-SMZ or an appropriate beta-lactam antibiotic.
木糖氧化无色杆菌引起的菌血症较为罕见，关于其治疗的信息也很少。1983年至1988年间，从10例患有癌症且有感染临床症状的患者的26份血培养物中分离出木糖氧化无色杆菌，其中1例患者发生感染性休克，2例患有肺炎。中性粒细胞减少似乎不是一个易感因素。4例患者的感染可能与导管相关，另外4例与胃肠道病变有关。其余2例的可能病因未确定。体外药敏研究表明，分离菌株对复方新诺明（TMP-SMZ）、抗假单胞菌青霉素、头孢他啶、头孢哌酮和亚胺培南敏感；对环丙沙星中度敏感；对头孢曲松、头孢噻肟、头孢西丁、头孢唑肟、氨曲南和阿米卡星耐药。所有接受治疗的患者均康复，包括6例接受TMP-SMZ或β-内酰胺类抗生素单药治疗的患者。木糖氧化无色杆菌菌血症是一种严重感染，可能与导管相关或与胃肠道病变有关。该感染通常对TMP-SMZ或适当的β-内酰胺类抗生素治疗有反应。
