Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing

Introduction: Achromobacter xylosoxidans has been reported in several countries; however, hospital-acquired pneumonia (HAP) due to this organism in elderly patients in China remains rare. Methodology: HAP due to Achromobacter xylosoxidans identified at the General Hospital of the People's Libe...

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Main Authors: Chao Liu, Jun Guo, Weifeng Yan, Yi Jin, Fei Pan, Xiangqun Fang, Long Qin, Changting Liu
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2017-01-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/8747
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author Chao Liu
Jun Guo
Weifeng Yan
Yi Jin
Fei Pan
Xiangqun Fang
Long Qin
Changting Liu
author_facet Chao Liu
Jun Guo
Weifeng Yan
Yi Jin
Fei Pan
Xiangqun Fang
Long Qin
Changting Liu
author_sort Chao Liu
collection DOAJ
description Introduction: Achromobacter xylosoxidans has been reported in several countries; however, hospital-acquired pneumonia (HAP) due to this organism in elderly patients in China remains rare. Methodology: HAP due to Achromobacter xylosoxidans identified at the General Hospital of the People's Liberation Army in Beijing from January 2008 to October 2011 was studied. Detailed clinical manifestations were collected. To study the clinical risk factors for the imipenem-resistant strain, patients were divided into two groups: imipenem-resistant (21 cases) and imipenem-nonresistant (20 cases). Univariate and multivariate logistic regression were used. Results: All patients were > 75 years of age, and 92.7% (38/41) were male. Nine patients died 30 days after infection. The mean acute physiology and chronic health evaluation (APACHE) II score and sequential organ failure assessment (SOFA) were 23.66 ± 7.71 and 6.93 ± 2.47, respectively. Almost all strains were resistant to aminoglycosides. However, the strains showed significant sensitivity to minocycline (MIN), piperacillin-tazobactam (PTZ), and cefoperazone-sulbactam (SCF). Compared with the imipenem-nonresistant group, more patients with imipenem-resistant infection had the following characteristics: use of an intubation, use of a proton-pump inhibitor (PPI), chronic obstructive pulmonary disease (COPD), and coronary artery disease (CHD). Among the four risk factors, COPD and CHD remained independent risk factors in the multivariate analysis. Conclusions: HAP due to Achromobacter xylosoxidans occurred in severely ill elderly patients with a long-term indwelling catheter and many underlying diseases. Effective treatment of imipenem-resistant organisms is challenging. SCF, PTZ, and MIN may be useful for imipenem-resistant Achromobacter xylosoxidans.
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publisher The Journal of Infection in Developing Countries
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spelling doaj-art-71afb77f6caf476ca4a97286a0df1aa52025-08-20T02:14:14ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802017-01-01110110.3855/jidc.8747Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in BeijingChao Liu0Jun Guo1Weifeng Yan2Yi Jin3Fei Pan4Xiangqun Fang5Long Qin6Changting Liu7Beijing Haidian Hospital, Beijing Haidian Section of Peking University Third Hospital, Beijing, ChinaBeijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing, ChinaBeijing Haidian Hospital, Beijing Haidian Section of Peking University Third Hospital, Beijing, ChinaBeijing Haidian Hospital, Beijing Haidian Section of Peking University Third Hospital, Beijing, ChinaChinese PLA General Hospital, Beijing, ChinaChinese PLA General Hospital, Beijing, ChinaBeijing Haidian Hospital, Beijing Haidian Section of Peking University Third Hospital, Beijing, ChinaChinese PLA General Hospital, Beijing, ChinaIntroduction: Achromobacter xylosoxidans has been reported in several countries; however, hospital-acquired pneumonia (HAP) due to this organism in elderly patients in China remains rare. Methodology: HAP due to Achromobacter xylosoxidans identified at the General Hospital of the People's Liberation Army in Beijing from January 2008 to October 2011 was studied. Detailed clinical manifestations were collected. To study the clinical risk factors for the imipenem-resistant strain, patients were divided into two groups: imipenem-resistant (21 cases) and imipenem-nonresistant (20 cases). Univariate and multivariate logistic regression were used. Results: All patients were > 75 years of age, and 92.7% (38/41) were male. Nine patients died 30 days after infection. The mean acute physiology and chronic health evaluation (APACHE) II score and sequential organ failure assessment (SOFA) were 23.66 ± 7.71 and 6.93 ± 2.47, respectively. Almost all strains were resistant to aminoglycosides. However, the strains showed significant sensitivity to minocycline (MIN), piperacillin-tazobactam (PTZ), and cefoperazone-sulbactam (SCF). Compared with the imipenem-nonresistant group, more patients with imipenem-resistant infection had the following characteristics: use of an intubation, use of a proton-pump inhibitor (PPI), chronic obstructive pulmonary disease (COPD), and coronary artery disease (CHD). Among the four risk factors, COPD and CHD remained independent risk factors in the multivariate analysis. Conclusions: HAP due to Achromobacter xylosoxidans occurred in severely ill elderly patients with a long-term indwelling catheter and many underlying diseases. Effective treatment of imipenem-resistant organisms is challenging. SCF, PTZ, and MIN may be useful for imipenem-resistant Achromobacter xylosoxidans. https://jidc.org/index.php/journal/article/view/8747Achromobacter xylosoxidanshospital-acquired pneumoniaimipenemelderly patientsresistance
spellingShingle Chao Liu
Jun Guo
Weifeng Yan
Yi Jin
Fei Pan
Xiangqun Fang
Long Qin
Changting Liu
Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing
Journal of Infection in Developing Countries
Achromobacter xylosoxidans
hospital-acquired pneumonia
imipenem
elderly patients
resistance
title Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing
title_full Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing
title_fullStr Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing
title_full_unstemmed Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing
title_short Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing
title_sort hospital acquired pneumonia due to achromobacter xylosoxidans in the elderly a single center retrospective study in beijing
topic Achromobacter xylosoxidans
hospital-acquired pneumonia
imipenem
elderly patients
resistance
url https://jidc.org/index.php/journal/article/view/8747
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