Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Japan.
J Infect Chemother. 2021 May;27(5):770-772. doi: 10.1016/j.jiac.2020.12.025. Epub 2021 Jan 16.
Achromobacter xylosoxidans (A. xylosoxidans) is an aerobic gram-negative bacillus and often isolated from aquatic environments. It is supposed to cause infections in patients with malignancy or immunodeficiency. It causes various healthcare-associated infections, but cellulitis is rare. Herein, we report the first case of sever cellulitis by A. xylosoxidans after allogeneic hematopoietic stem cell transplantation (HSCT). A 49-year-old man underwent allogeneic HSCT from 8/8 HLA-matched unrelated donor with myeloablative conditioning for relapsed acute myeloid leukemia. He developed skin chronic graft versus host disease 11 months after HSCT. During the prolonged treatment with prednisolone and cyclosporine, he developed cellulitis on his left leg and admitted to our hospital. Blood and exudate culture revealed A. xylosoxidans. Although empirical therapy with cefepime was ineffective, his symptoms were dramatically improved after administration of meropenem. To our knowledge, this is the first case of A. xylosoxidans cellulitis after allogeneic HSCT. A. xylosoxidans should be considered as a possible cause of cellulitis in post-allogeneic HSCT patients on prolonged immunosuppressive therapy.
木糖氧化无色杆菌（Achromobacter xylosoxidans，A. xylosoxidans）是一种需氧革兰氏阴性杆菌，通常从水生环境中分离出来。它被认为会导致恶性肿瘤或免疫功能低下患者的感染。它可引起各种与医疗保健相关的感染，但蜂窝织炎很少见。在此，我们报告首例异基因造血干细胞移植（HSCT）后由 A. xylosoxidans 引起的严重蜂窝织炎。一名 49 岁男性因复发性急性髓细胞白血病接受了 8/8 HLA 匹配的无关供体的清髓性 HSCT。他在 HSCT 后 11 个月出现皮肤慢性移植物抗宿主病。在长期接受泼尼松龙和环孢素治疗期间，他的左腿出现蜂窝织炎并入住我院。血液和渗出液培养显示为木糖氧化无色杆菌。尽管经验性头孢吡肟治疗无效，但使用美罗培南后他的症状显著改善。据我们所知，这是首例异基因 HSCT 后 A. xylosoxidans 蜂窝织炎。在长期接受免疫抑制治疗的异基因 HSCT 后患者中，应考虑 A. xylosoxidans 是蜂窝织炎的可能原因。
