Contamination of burn wounds by Achromobacter Xylosoxidans followed by severe infection: 10-year analysis of a burn unit population.

Gram-negative infections predominate in burn surgery. Until recently, Achromobacter species were described as sepsis-causing bacteria in immunocompromised patients only. Severe infections associated with Achromobacter species in burn patients have been rarely reported. We retrospectively analyzed all burn patients in our database, who were treated at the Intensive Care Burn Unit (ICBU) of the Cologne Merheim Burn Centre from January 2006 to December 2015, focusing on contamination and infection by Achromobacter species.We identified 20 patients with burns contaminated by Achromobacter species within the 10-year study period. Four of these patients showed signs of infection concomitant with detection of Achromobacter species. Despite receiving complex antibiotic therapy based on antibiogram and resistogram typing, 3 of these patients, who had extensive burns, developed severe sepsis. Two patients ultimately died of multiple organ failure. In 1 case, Achromobacter xylosoxidans was the only isolate detected from the swabs and blood samples taken during the last stage of sepsis. Achromobacter xylosoxidans contamination of wounds of severely burned immunocompromised patients can lead to systemic lethal infection. Close monitoring of burn wounds for contamination by Achromobacter xylosoxidans is essential, and appropriate therapy must be administered as soon as possible.