Pérez Barragán E, Sandino Pérez J, Corbella L, Orellana M A, Fernández-Ruiz M
Mario Fernández Ruiz. Unidad de Enfermedades Infecciosas. Hospital Universitario "12 de Octubre". Centro de Activi-dades Ambulatorias, planta 2ª, bloque D. Avda. de Córdoba, s/n. 28041 (Madrid). Spain.
Rev Esp Quimioter. 2018 Jun;31(3):268-273. Epub 2018 May 23.
The treatment of Achromobacter xylosoxidans bacteremia is challenged by antimicrobial resistance and the paucity of data. We aimed at offering a contemporary description of this uncommon entity.
Retrospective case series of 13 episodes of A. xylosoxidans bacteremia diagnosed over a 10-year period (November 2007 to May 2017) in our tertiary care center.
Solid organ cancer and heart failure were the most common comorbidities (4/13 [30.7%]). All but one episodes were hospital-acquired. Most patients had received previous antibiotic therapy (7/13 [53.8%]) and had a central venous catheter in place (6/13 [46.1%]). Primary and intravascular catheter were the most common sources (4/13 [30.7%] each). Meropenem was the agent with best in vitro activity (92.3% [12/13] of susceptible isolates). All-cause 30-day mortality (overall 23.1%) was higher in patients with primary bacteremia (50.0% vs. 11.1%; P-value=0.203) and prior chemotherapy (66.7% vs. 10.0%; P-value=0.108).
Bacteremia due to A. xylosoxidans constitutes a serious infection among immunocompromised hosts. Carbapenem-based therapy may be appropriate in most cases.
木糖氧化无色杆菌菌血症的治疗因耐药性和数据匮乏而面临挑战。我们旨在对这一罕见病症进行当代描述。
回顾性病例系列，涵盖了我们三级医疗中心在10年期间（2007年11月至2017年5月）诊断出的13例木糖氧化无色杆菌菌血症病例。
实体器官癌症和心力衰竭是最常见的合并症（4/13 [30.7%]）。除1例之外，所有病例均为医院获得性感染。大多数患者此前接受过抗生素治疗（7/13 [53.8%]）且留置了中心静脉导管（6/13 [46.1%]）。原发部位和血管内导管是最常见的感染源（各占4/13 [30.7%]）。美罗培南是体外活性最佳的药物（92.3% [12/13] 的敏感分离株）。原发性菌血症患者（50.0% 对11.1%；P值 = 0.203）和先前接受过化疗的患者（66.7% 对10.0%；P值 = 0.108）的全因30天死亡率（总体为23.1%）更高。
木糖氧化无色杆菌所致菌血症在免疫功能低下宿主中构成严重感染。大多数情况下基于碳青霉烯类的治疗可能是合适的。
