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Microorganisms
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Achromobacter spp: New Insights in Epidemiology, Pathogenicity, and Antimicrobial Therapy
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Achromobacter spp: New Insights in Epidemiology, Pathogenicity, and Antimicrobial Therapy

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (30 December 2021) | Viewed by 7886

Special Issue Editor

Dr. Lucie Amoureux

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Guest Editor
Department of Bacteriology, University Hospital of Dijon, 21000 Dijon, France
Interests: Achromobacter; epidemiology; resistance mechanisms; reservoirs; antibiotics; antimicrobial resistance; cystic fibrosis; medical bacteriology

Special Issue Information

Dear Colleagues,

Achromobacter spp. are multidrug-resistant, non-fermenting Gram-negative bacilli increasingly being reported worldwide as opportunistic pathogens in patients with underlying conditions, especially cystic fibrosis (CF). The pathogenicity of these bacteria remains controversial among CF patients, and there are limited data concerning intrinsic or acquired resistance mechanisms and therapeutic options. Taxonomic studies describe a great diversity of species within the genus, with more than 20 species whose correct identification requires specific techniques not usually performed by the laboratories.

The aim of this Special Issue is to expand the current knowledge on the role of Achromobacter spp. in human health: sources of contamination and pathogenicity of the various species for CF or non-CF patients, intrinsic and acquired resistance mechanisms, and therapeutic options, including new antibiotics.

Dr. Lucie Amoureux
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Achromobacter spp.
  • epidemiology
  • identification
  • reservoirs
  • virulence
  • resistance
  • antimicrobial therapy

Published Papers (4 papers)

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Research

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9 pages, 956 KiB  
Communication
Achromobacter Species: An Emerging Cause of Community-Onset Bloodstream Infections
by Burcu Isler, David L. Paterson, Patrick N. A. Harris, Weiping Ling, Felicity Edwards, Claire M. Rickard, Timothy J. Kidd, Ian Gassiep and Kevin B. Laupland
Microorganisms 2022, 10(7), 1449; https://doi.org/10.3390/microorganisms10071449 - 18 Jul 2022
Cited by 5 | Viewed by 1469
Abstract
Background: Case reports and small series indicate that Achromobacter species bloodstream infection (BSI) is most commonly a complication of hospitalization among patients with chronic lung disease. The aim of the present study was to determine the incidence, risk factors, and outcomes of Achromobacter [...] Read more.
Background: Case reports and small series indicate that Achromobacter species bloodstream infection (BSI) is most commonly a complication of hospitalization among patients with chronic lung disease. The aim of the present study was to determine the incidence, risk factors, and outcomes of Achromobacter sp. BSI in an Australian population. Methods: Retrospective, laboratory-based surveillance was conducted in Queensland, Australia (population ≈ 5 million) during 2000–2019. Clinical and outcome data were obtained by linkage to state hospital admissions and vital statistics databases. BSI diagnosed within the community or within the first two calendar days of stay in hospital were classified as community-onset. Community-onset BSIs were grouped into community-associated and healthcare-associated. Results: During more than 86 million person-years of surveillance, 210 incidents of Achromobacter sp. BSI occurred among 195 individuals for an overall age-and sex-standardized annual incidence of 2.6 per million residents. Older individuals and males were at highest risk (2.9 vs. 2.0 per million, IRR for males 1.5; 95% CI, 1.1–1.9; p = 0.008). Most (153; 73%) cases were of community-onset of which 100 (48%) and 53 (25%) were healthcare- and community-associated, respectively. An increasing proportion of community-onset cases were observed during twenty years of surveillance. Underlying medical illnesses were common with median (interquartile range) Charlson Comorbidity Index (CCI) scores of 3 (1–5). CCI scores of 0, 1, 2, and 3+ were observed in 37 (18%), 27 (13%), 40 (19%), and 105 (50%) of cases, respectively. All but one of the cases were admitted to hospital for a median (interquartile range) length of stay of 12 (5–34) days. All-cause case–fatality rates in hospital by day 30 and by day 90 were 30 (14%), 28 (13%), and 42 (20%), respectively. The 90-day case–fatality rate increased with increasing comorbidity and was 3% (1/37), 11% (3/27), 25% (10/40), and 27% (28/105) among those with Charlson Comorbidity Indices of 0, 1, 2, and 3+, respectively (p = 0.004). Conclusions: Although comorbidity is an important determinant of risk, most Achromobacter sp. BSI are of community-onset and one-fifth of cases occur in patients without significant underlying chronic co-morbidities. This study highlights the value of population-based methodologies to define the epidemiology of an infectious disease. Full article
(This article belongs to the Special Issue Achromobacter spp: New Insights in Epidemiology, Pathogenicity, and Antimicrobial Therapy)
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8 pages, 658 KiB  
Article
Induction of Broad β-lactam Resistance in Achromobacter ruhlandii by Exposure to Ticarcillin Is Primarily Linked to Substitutions in Murein Peptide Ligase Mpl
by Camilla Andersen, Migle Gabrielaite and Niels Nørskov-Lauritsen
Microorganisms 2022, 10(2), 420; https://doi.org/10.3390/microorganisms10020420 - 11 Feb 2022
Cited by 1 | Viewed by 1244
Abstract
Achromobacter species are emerging pathogens in cystic fibrosis with inherent resistance to several classes of antimicrobial agents. We exposed strains with wild-type antimicrobial susceptibility to ticarcillin and generated mutants with broad β-lactam resistance. Within the detection limit of the assay, the capability to [...] Read more.
Achromobacter species are emerging pathogens in cystic fibrosis with inherent resistance to several classes of antimicrobial agents. We exposed strains with wild-type antimicrobial susceptibility to ticarcillin and generated mutants with broad β-lactam resistance. Within the detection limit of the assay, the capability to develop mutational resistance was strain-specific and reproducible. Mutational resistance was observed for all three tested strains of Achromobacter ruhlandii, for one of seven strains of Achromobacter xylosoxidans, and for none of five strains of Achromobacter insuavis. All mutants were resistant to piperacillin-tazobactam, while minimal inhibitory concentration of several other β-lactams increased 4–32-fold. Whole genome sequencing identified 1–4 non-synonymous mutations in known genes per mutant. All mutants encoded amino acid substitutions in cell wall recycling proteins, primarily Mpl, and the observed resistance is probably caused by hyperproduction of OXA-114-like β-lactamases. Related, but not identical substitutions were detected in clinical strains expressing acquired antimicrobial resistance. Full article
(This article belongs to the Special Issue Achromobacter spp: New Insights in Epidemiology, Pathogenicity, and Antimicrobial Therapy)
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11 pages, 302 KiB  
Article
In Vitro Activity of 22 Antibiotics against Achromobacter Isolates from People with Cystic Fibrosis. Are There New Therapeutic Options?
by Clémence Beauruelle, Claudie Lamoureux, Arsid Mashi, Sophie Ramel, Jean Le Bihan, Thomas Ropars, Anne Dirou, Anandadev Banerjee, Didier Tandé, Hervé Le Bars and Geneviève Héry-Arnaud
Microorganisms 2021, 9(12), 2473; https://doi.org/10.3390/microorganisms9122473 - 30 Nov 2021
Cited by 8 | Viewed by 2541
Abstract
Bacteria belonging to the genus Achromobacter are increasingly isolated from respiratory samples of people with cystic fibrosis (PWCF). The management of this multidrug-resistant genus is challenging and characterised by a lack of international recommendations, therapeutic guidelines and data concerning antibiotic susceptibility, especially concerning [...] Read more.
Bacteria belonging to the genus Achromobacter are increasingly isolated from respiratory samples of people with cystic fibrosis (PWCF). The management of this multidrug-resistant genus is challenging and characterised by a lack of international recommendations, therapeutic guidelines and data concerning antibiotic susceptibility, especially concerning the newer antibiotics. The objective of this study was to describe the antibiotic susceptibility of Achromobacter isolates from PWCF, including susceptibility to new antibiotics. The minimum inhibitory concentrations (MICs) of 22 antibiotics were determined for a panel of 23 Achromobacter isolates from 19 respiratory samples of PWCF. Two microdilution MIC plates were used: EUMDROXF® plate (Sensititre) and Micronaut-S Pseudomonas MIC® plate (Merlin) and completed by a third method if necessary (E-test® or UMIC®). Among usual antimicrobial agents, the most active was imipenem (70% susceptibility). Trimethoprim-sulfamethoxazole, piperacillin and tigecycline (65%, 56% and 52% susceptibility, respectively) were still useful for the treatment of Achromobacter infections. Among new therapeutic options, β-lactams combined with a β-lactamase-inhibitor did not bring benefits compared to β-lactam alone. On the other hand, cefiderocol appeared as a promising therapeutic alternative for managing Achromobacter infections in PWCF. This study provides the first results on the susceptibility of clinical Achromobacter isolates concerning new antibiotics. More microbiological and clinical data are required to establish the optimal treatment of Achromobacter infections. Full article
(This article belongs to the Special Issue Achromobacter spp: New Insights in Epidemiology, Pathogenicity, and Antimicrobial Therapy)

Review

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15 pages, 743 KiB  
Review
Achromobacter spp. Surgical Site Infections: A Systematic Review of Case Reports and Case Series
by Eve Ronin, Christian Derancourt, André Cabié and Karine Marion-Sanchez
Microorganisms 2021, 9(12), 2471; https://doi.org/10.3390/microorganisms9122471 - 30 Nov 2021
Cited by 6 | Viewed by 1768
Abstract
Achromobacter species are isolated from rare but severe healthcare-associated infections, including surgical site infections. They are considered to preferentially infect immunocompromised patients but so far with limited evidence. We conducted a systematic review on Achromobacter spp. surgical site infections (SSIs) to determine if [...] Read more.
Achromobacter species are isolated from rare but severe healthcare-associated infections, including surgical site infections. They are considered to preferentially infect immunocompromised patients but so far with limited evidence. We conducted a systematic review on Achromobacter spp. surgical site infections (SSIs) to determine if such infections were indeed more commonly associated with immunocompromised patients. The secondary objective was to describe the characteristics of infected patients. Eligible articles had to be published before 30 September 2020 and to report Achromobacter spp. SSIs across all surgical specialties excluding ophthalmology. Analyses were performed on individual data without meta-analysis. Cases were divided into 2 subgroups: one group which had either prosthesis or implant and the other group which did not. A first selection led to a review of 94 articles, of which 37 were analyzed. All were case reports or case series and corresponded to 49 infected patients. Most of the patients were under 65 years of age and had undergone a heart or digestive surgery followed by deep infection with no co-infecting pathogens. Nine out of the 49 cases were immunocompromised, with similar distribution between the two subgroups (16.6% and 20%, respectively). This review suggests that Achromobacter spp. SSIs do not preferentially target immunocompromised patients. Full article
(This article belongs to the Special Issue Achromobacter spp: New Insights in Epidemiology, Pathogenicity, and Antimicrobial Therapy)
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