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Urinary tract infection due to Achromobacter xylosoxidans: Report of 9 cases 

Authors: Daniel Tenaa; Alejandro Gonzaacutelez-Praetoriusa; Mercedes Peacuterez-Balsalobreb; Oliva Sanchoc; Julia Bisquerta
Affiliations:   a From the Section of Microbiology, University Hospital of Guadalajara, Guadalajara, Spain
b Medical Centre of Cabanillas del Campo, Guadalajara, Spain
c Medical Centre 'El Balconcillo', Guadalajara, Spain
DOI: 10.1080/00365540701558714
Publication Frequency: 10 issues per year
Published in: journal Scandinavian Journal of Infectious Diseases, Volume 40, Issue 2 2008 , pages 84 - 87
First Published: 2008
Formats available: HTML (English) : PDF (English)
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Abstract

Urinary tract infection (UTI) due to Achromobacter xylosoxidans is rare. The aims were to know the frequency and clinical characteristics of this infection in our area. We performed a retrospective analysis of 9 patients with UTI caused by this organism diagnosed over a period of 13 y. The mean age was 63.1 y. All patients had underlying diseases or urological abnormalities. The most frequent underlying diseases were solid or hematological malignancies (3 cases). Seven patients (77.7%) had urological abnormalities. Eight patients had symptoms of cystitis and 1 remained asymptomatic. Seven patients had community acquired UTIs. Clinical outcome was favourable in 5 patients after antibiotic treatment and recurrence occurred in 3 patients who had urological abnormalities. All isolates were susceptible to imipenem and piperacillin-tazobactam, 88.8% were susceptible to ceftazidime and 77.7% were susceptible to trimethoprim-sulfamethoxazole. High frequencies of resistance to ampicillin (100%), amoxicillin/clavulanic acid (78%), cefuroxime (100%), cefotaxime (67%), norfloxacin (89%), ciprofloxacin (78%), nitrofurantoin (89%) and gentamicin (67%) were observed. UTI due to A. xylosoxidans was predominantly observed in elderly patients with predisposing factors, especially urological abnormalities, malignancies and immunosuppression. Treatment can be difficult due to the high level of antibiotic resistance. Trimethoprim-sulfamethoxazole may be useful for treatment, particularly in outpatients with community acquired infections.
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