An Outbreak of Achromobacter Bacteremia in Pediatric Clinic 1 Tîrgu Mureș in 2010

Introduction: Achromobacter is a less common pathogen, with implications in patients with immune deficiency. The purpose of this paper is to evaluate the Achromobacter spp. bacteremia outbreaks in the hematology department of Pediatric Clinic I Tîrgu Mureș and to establish the involvement of this species as an etiologic agent of bacteremia/septicemia or solely as a contaminant of blood culture samples.
Material and methods: We analyzed an outbreak of Achromobacter infection from 2010’s summer-autumn season in Pediatric Clinic I. Bacteriological (blood culture, antibiotic susceptibility), laboratory (white cells count, inflammatory tests) and clinical aspects (underlying disease, body temperature, treatments, age, sex) were followed.
Results: A total of 26 blood cultures collected from nine children admitted in this period were positive for Achromobacter spp., other 28 were negative. In febrile patients with positive blood cultures, the leukocyte and neutrophil count was increased. In non-febrile patients with positive blood cultures, changes in the total number of leukocytes and granulocytes did not show significant variations. The antibiotic susceptibility test for Achromobacter strains identified a 100% resistance to ticarcillin, gentamicin, and trimethoprim-sulfamethoxazole, sensitivity to most classes of antibiotics, but an OXA-114 β-lactamase producing phenotype.
Conclusions: An association between the inflammatory syndrome and Achromobacter spp. bacteremia was established. Achromobacter spp. isolated from blood sampled through catheters is most likely a contaminant. The antibiotic susceptibility testing of Achromobacter spp. revealed sensitivity to most classes of antibiotics.

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