RESUMO
BACKGROUND: Achromobacter xylosoxidans is an emerging pathogen in cystic fibrosis (CF). Although the rate of colonization by this microorganism is variable, prevalence is increasing in CF units. METHODS: A microbiological/clinical study was conducted on of adult CF patients harboring A. xylosoxidans. Identification and susceptibility testing were performed using MicroScan (Siemens). Decline in lung function was assessed using the variable, annual percentage loss of FEV1 (forced expiratory volume in 1 s). RESULTS: A. xylosoxidans was isolated in 18 (19.8%) of 91 patients over a 14-year period. Mean age was 26.6 years (18-39 years). Nine patients (9.8%) were chronically colonized. Piperacillin/tazobactam and imipenem were the most active antibiotics. Mean annual decline in lung function in chronically colonized patients was 2.49%. CONCLUSIONS: A. xylosoxidans is a major pathogen in CF. A decreased lung function was observed among patients who were chronically colonized by A. xylosoxidans. Antibiotic therapy should be started early in order to prevent chronic colonization by this microorganism
INTRODUCCIÓN: Achromobacter xylosoxidans es un patógeno emergente en fibrosis quística (FQ). Aunque la tasa de colonización por este microorganismo es variable, la prevalencia está aumentando en las unidades de FQ. MÉTODOS: Llevamos a cabo un estudio clínico-microbiológico de los pacientes adultos con FQ portadores de A. xylosoxidans. La identificación y sensibilidad fueron realizadas usando MicroScan (Siemens). La pérdida de función pulmonar fue evaluada por la variable porcentaje anual de pérdida de FEV1. RESULTADOS: A. xylosoxidans fue aislado en 18 (19.8%) de 91 pacientes, en un periodo de 14 años. La edad media fue 26.6 años (18-39 años). Nueve pacientes (9.8%) presentaban colonización crónica. Piperacilina/tazobactam e imipenem fueron los antibióticos más activos. La media anual de pérdida de función pulmonar en los pacientes colonizados de forma crónica fue 2.6%. CONCLUSIONES: A. xylosoxidans es un importante patógeno en FQ. Observamos pérdida de la función pulmonar en los pacientes colonizados de forma crónica por A. xylosoxidans. El tratamiento antibiótico debe iniciarse lo más rápido posible para prevenir la colonización crónica por este microorganismo
Assuntos
Humanos , Achromobacter denitrificans/patogenicidade , Infecções por Bactérias Gram-Negativas/microbiologia , Fibrose Cística/complicações , Testes de Função Respiratória , Antibacterianos/uso terapêutico , Estudos RetrospectivosRESUMO
BACKGROUND: Achromobacter xylosoxidans is an emerging pathogen in cystic fibrosis (CF). Although the rate of colonization by this microorganism is variable, prevalence is increasing in CF units. METHODS: A microbiological/clinical study was conducted on of adult CF patients harboring A. xylosoxidans. Identification and susceptibility testing were performed using MicroScan (Siemens). Decline in lung function was assessed using the variable, annual percentage loss of FEV1 (forced expiratory volume in 1s). RESULTS: A. xylosoxidans was isolated in 18 (19.8%) of 91 patients over a 14-year period. Mean age was 26.6 years (18-39 years). Nine patients (9.8%) were chronically colonized. Piperacillin/tazobactam and imipenem were the most active antibiotics. Mean annual decline in lung function in chronically colonized patients was 2.49%. CONCLUSIONS: A. xylosoxidans is a major pathogen in CF. A decreased lung function was observed among patients who were chronically colonized by A. xylosoxidans. Antibiotic therapy should be started early in order to prevent chronic colonization by this microorganism.