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Achromobacter xylosoxidans

Background:

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Non-fermenting Gram-negative bacilli   
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[cannot catabolize glucose and therefore are not able to ferment. Non-spore forming.]
>Acinetobacter baumannii
>Achromobacter xylosoxidans led
>Bordetella pertussis
>Burkholderia species:
     1] Burkholderia cepacia (also known as Pseudomonas cepacia) –  important
            pathogen of pulmonary infections in people with cystic fibrosis.
     2] Burkholderia pseudomallei (also known as Pseudomonas pseudomallei) 
>Elizabethkingia meningoseptica (Previously Chryseobacterium meningosepticum)
>Moraxella catarrhalis (formerly known as Branhamella catarrhalis)
>Pseudomonas aeruginosa
>Stenotrophomonas maltophilia (Initially classified as Pseudomonas maltophilia)

Achromobacter xylosoxidans

  • Gram-negative, aerobic, oxidase and catalase-positive, motile bacterium with peritrichous flagella, from the genus of Achromobacter which exist in water environment and was isolated from patients (pulmonary).
  • Achromobacter xylosoxidans can cause infections like bacteremia, especially for patients who suffer from cystic fibrosis.
  • The complete genome of Achromobacter xylosoxidans is sequenced.

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Therapy:

Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first. Listed dosages may need to be adjusted for renal dysfunction.  

Achromobacter xylosoxidans: Usually resistant to multiple antibiotics which complicates therapy.

  1. Cefepime 1-2 grams IV every 8-12 hours
  2. Bactrim Mild-moderate infection:  8 to 10 mg/kg/day (based on trimethoprim component)  IV divided in 2-4 doses.    Severe infection: 15 to 20 mg/kg/day (based on trimethoprim component)  IV, given in equally divided doses every 6 to 8 hours.
  3. Imipenem 500mg IV every 6 hours [Range: 250-1000 mg q6-8h]
  4. Meropenem 0.5 – 1 gram IV q8h
Achromobacter xylosoxidans