Infect Chemother.  2016 Mar;48(1):47-50. 10.3947/ic.2016.48.1.47.

A Case of Septic Shock caused by Achromobacter xylosoxidans in an Immunocompetent Female Patient after Extracorporeal Shock Wave Lithotripsy for a Ureteral Stone

• Lee JH
• Lee SY
• Park IY
• Park SY
• Lee JS
• Kang G
• Kim JS
• Eom JS

• KMID: 2170517
• DOI: http://doi.org/10.3947/ic.2016.48.1.47

Abstract

Achromobacter xylosoxidans can cause various types of infections, but its infection in humans is rare. A. xylosoxidans has been reported as a rare etiological agent of infections including primary bacteremia, catheter-related bloodstream infection, endocarditis, otitis, and pneumonia, particularly in immunocompromised hosts. We encountered a case of septic shock caused by A. xylosoxidans in a 52-year-old, immunocompetent woman with no underlying disease, who received extracorporeal shock wave lithotripsy to remove a left upper ureteral stone. She was treated with antibiotics to which the organism was susceptible but died as a result of septic shock.

Keyword

Achromobacter xylosoxidans; Septic shock; Immunocompetent

MeSH Terms

Achromobacter denitrificans*
Achromobacter*
Anti-Bacterial Agents
Bacteremia
Endocarditis
Female*
Humans
Immunocompromised Host
Lithotripsy*
Middle Aged
Otitis
Pneumonia
Shock*
Shock, Septic*
Ureter*
Anti-Bacterial Agents

Reference

1. Yabuuchi E, Oyama A. Achromobacter xylosoxidans n. sp. from human ear discharge. Jpn J Microbiol. 1971; 15:477–481.

2. Mandell WF, Garvey GJ, Neu HC. Achromobacter xylosoxidans bacteremia. Rev Infect Dis. 1987; 9:1001–1005.

3. Eshwara VK, Mukhopadhyay C, Mohan S, Prakash R, Pai G. Two unique presentations of Achromobacter xylosoxidans infections in clinical settings. J Infect Dev Ctries. 2011; 5:138–141.

4. Weitkamp JH, Tang YW, Haas DW, Midha NK, Crowe JE Jr. Recurrent Achromobacter xylosoxidans bacteremia associated with persistent lymph node infection in a patient with hyper-immunoglobulin M syndrome. Clin Infect Dis. 2000; 31:1183–1187.

5. Tena D, González-Praetorius A, Pérez-Balsalobre M, Sancho O, Bisquert J. Urinary tract infection due to Achromobacter xylosoxidans: report of 9 cases. Scand J Infect Dis. 2008; 40:84–87.

6. Aisenberg G, Rolston KV, Safdar A. Bacteremia caused by Achromobacter and Alcaligenes species in 46 patients with cancer (1989-2003). Cancer. 2004; 101:2134–2140.

7. Amoureux L, Bador J, Siebor E, Taillefumier N, Fanton A, Neuwirth C. Epidemiology and resistance of Achromobacter xylosoxidans from cystic fibrosis patients in Dijon, Burgundy: first French data. J Cyst Fibros. 2013; 12:170–176.

8. Duggan JM, Goldstein SJ, Chenoweth CE, Kauffman CA, Bradley SF. Achromobacter xylosoxidans bacteremia: report of four cases and review of the literature. Clin Infect Dis. 1996; 23:569–576.

9. Gómez-Cerezo J, Suárez I, Ríos JJ, Peña P, García de Miguel MJ, de José M, Monteagudo O, Linares P, Barbado-Cano A, Vázquez JJ. Achromobacter xylosoxidans bacteremia: a 10-year analysis of 54 cases. Eur J Clin Microbiol Infect Dis. 2003; 22:360–363.

10. Molina-Cabrillana J, Santana-Reyes C, González-García A, Bordes-Benítez A, Horcajada I. Outbreak of Achromobacter xylosoxidans pseudobacteremia in a neonatal care unit related to contaminated chlorhexidine solution. Eur J Clin Microbiol Infect Dis. 2007; 26:435–437.

11. Shie SS, Huang CT, Leu HS. Characteristics of Achromobacter xylosoxidans bacteremia in northern Taiwan. J Microbiol Immunol Infect. 2005; 38:277–282.

12. Tena D, Carranza R, Barberá JR, Valdezate S, Garrancho JM, Arranz M, Sáez-Nieto JA. Outbreak of long-term intravascular catheter-related bacteremia due to Achromobacter xylosoxidans subspecies xylosoxidans in a hemodialysis unit. Eur J Clin Microbiol Infect Dis. 2005; 24:727–732.

13. Turel O, Kavuncuoglu S, Hosaf E, Ozbek S, Aldemir E, Uygur T, Hatipoglu N, Siraneci R. Bacteremia due to Achromobacter xylosoxidans in neonates: clinical features and outcome. Braz J Infect Dis. 2013; 17:450–454.

14. Turgutalp K, Kiykim A, Ersoz G, Kaya A. Fatal catheter-related bacteremia due to Alcaligenes (Achromobacter) xylosoxidans in a hemodialysis patient. Int Urol Nephrol. 2012; 44:1281–1283.

15. Saiman L, Chen Y, Gabriel PS, Knirsch C. Synergistic activities of macrolide antibiotics against Pseudomonas aeruginosa, Burkholderia cepacia, Stenotrophomonas maltophilia, and Alcaligenes xylosoxidans isolated from patients with cystic fibrosis. Antimicrob Agents Chemother. 2002; 46:1105–1107.

16. Vay CA, Almuzara MN, Rodríguez CH, Pugliese ML, Lorenzo Barba F, Mattera JC, Famiglietti AM. 'In vitro' activity of different antimicrobial agents on Gram-negative nonfermentative bacilli, excluding Pseudomonas aeruginosa and Acinetobacter spp. Rev Argent Microbiol. 2005; 37:34–45.