New microbes and new infections · 2026
Epidemiology of Achromobacter in a French hospital over six years: sample types, species, and antibiotic resistance profiles.
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Cultrera Léa, Demeule Caroline, Neuwirth Catherine, Saussier Anne Claire, Varin Véronique, Amoureux Lucie, Magallon Arnaud
Аннотация
BACKGROUND: Achromobacter are non-fermenting-Gram-negative pathogens, mainly reported in cystic fibrosis (CF), but also responsible for opportunistic infections among immunocompromised patients or in case of healthcare-associated infections. Species identification techniques require specific methods not used in the routine diagnostic laboratories (nrdA-gene sequencing, MultiLocus Sequence Typing or matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry using in-house databases). As a result, epidemiological data are scarce, particularly outside the context of CF.
METHODS: In this descriptive, retrospective monocentric study, we included all Achromobacter isolates, identified at species-level with accurate reference methods, collected from our 1600-beds University Hospital (Dijon, France) during the period 2018-2023, from patients with (pwCF) or without CF (pw/oCF). Data about sample types, context of detection, culture characteristics (mono or polymicrobial), species distribution and antibiotic resistance profiles were collected.
RESULTS: In total, 651 Achromobacter strains from 274 patients (including 36 pwCF) were isolated from 570 samples. A wide variety of samples was found and mainly polymicrobial (46% of which associated with Pseudomonas aeruginosa). Among pw/oCF, Achromobacter spp. were mainly detected in respiratory samples (38.7%). More than 12 species were identified, A. xylosoxidans being the most frequent both in pwCF (44.4%) and pw/oCF (60.5%). Overall, piperacillin-tazobactam was the most effective antibiotic (96.5% susceptibility). In pwCF, resistance rates were significantly higher for meropenem, cotrimoxazole and ceftazidime but lower for imipenem compared with pw/oCF. A. xylosoxidans isolates appeared significantly more resistant to imipenem, ceftazidime and ciprofloxacin than non-xylosoxidans Achromobacter species isolates.
CONCLUSIONS: This study highlights the importance of accurate Achromobacter species identification and of CF status when elaborating treatment recommendations.
METHODS: In this descriptive, retrospective monocentric study, we included all Achromobacter isolates, identified at species-level with accurate reference methods, collected from our 1600-beds University Hospital (Dijon, France) during the period 2018-2023, from patients with (pwCF) or without CF (pw/oCF). Data about sample types, context of detection, culture characteristics (mono or polymicrobial), species distribution and antibiotic resistance profiles were collected.
RESULTS: In total, 651 Achromobacter strains from 274 patients (including 36 pwCF) were isolated from 570 samples. A wide variety of samples was found and mainly polymicrobial (46% of which associated with Pseudomonas aeruginosa). Among pw/oCF, Achromobacter spp. were mainly detected in respiratory samples (38.7%). More than 12 species were identified, A. xylosoxidans being the most frequent both in pwCF (44.4%) and pw/oCF (60.5%). Overall, piperacillin-tazobactam was the most effective antibiotic (96.5% susceptibility). In pwCF, resistance rates were significantly higher for meropenem, cotrimoxazole and ceftazidime but lower for imipenem compared with pw/oCF. A. xylosoxidans isolates appeared significantly more resistant to imipenem, ceftazidime and ciprofloxacin than non-xylosoxidans Achromobacter species isolates.
CONCLUSIONS: This study highlights the importance of accurate Achromobacter species identification and of CF status when elaborating treatment recommendations.