Highlights
- •Achromobacter species are emerging pathogens isolated from respiratory samples of patients with cystic fibrosis causing growing concerns in the CF community.
- •European CF society patient registry data was analysed for association between Achromobacter infection and demographic/clinical characteristics and outcomes.
- •Patient infected with Achromobacter had similar pulmonary function and BMI to patients infected with P. aeruginosa at all age groups.
- •Being infected with both bacteria was associated with significantly lower pulmonary function and BMI at all age groups.
Abstract
Background
Achromobacter species are emerging pathogens isolated from respiratory samples of Patients with
cystic fibrosis (pwCF) causing growing concerns in the CF community. The epidemiology and the clinical impact of Achromobacter in CF is unclear since data are restricted to small case control studies or selected
populations.
Aim
To characterize the effect of Achromobacter respiratory infection on CF lung disease.
Methods
European CF Society Patient Registry data was analysed for association between Achromobacter infection and demographic/clinical characteristics and outcomes of pwCF.
Results
Of eligible 38,795 patients, Achromobacter infection was reported in 2,093 (prevalence (95% CI) of 5.40% (5.17 - 5.62). The
prevalence varied significantly between the countries and increased with age peaking
at the age 20–30. Achromobacter infection was more prevalent in pwCF carrying class minimal function mutations, having
worse nutrition or lower pulmonary function, and more patients inhaled antibiotics
against P. aeruginosa. Patient infected with Achromobacter had similar pulmonary function and BMI to patients infected with P. aeruginosa at all age groups. Being infected with both bacteria was associated with significantly
lower pulmonary function and BMI at all age groups.
Conclusions
Achromobacter infection was associated with disease severity similar to infection with P. aeruginosa.
Being infected with both bacteria is associated with even more severe disease. This
suggests to study if eradication will improve the outcome of pwCF.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Cystic FibrosisAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Marked increase in incidence of Achromobacter xylosoxidans infections caused by sporadic acquisition from the environment.J Cyst Fibros. 2011; 10 (Dec): 466-469
- Genetic adaptation of Achromobacter sp. during persistence in the lungs of cystic fibrosis patients.PLoS ONE. 2015; 10e0136790
- Identification and distribution of Achromobacter species in cystic fibrosis.J Cyst Fibros. 2013; 12 (May): 298-301
- Alcaligenes infection in cystic fibrosis.Pediatr Pulmonol. 2002; 34 (Aug): 101-104
- Achromobacter xylosoxidans in cystic fibrosis: prevalence and clinical relevance.J Cyst Fibros. 2007; 6 (Jan): 75-78
- Achromobacter xylosoxidans respiratory tract infections in cystic fibrosis patients.APMIS. 2008; 116 (Sep): 837-841
- Achromobacter xylosoxidans respiratory tract infection in cystic fibrosis patients.Eur J Clin Microbiol Infect Dis. 2011; 30 (Aug): 973-980
- Clinical outcomes associated with Achromobacter.Ann Am Thorac Soc. 2017; 14: 1412-1418
- Emerging pathogens in cystic fibrosis: ten years of follow-up in a cohort of patients.Eur J Clin Microbiol Infect Dis. 2009; 28: 191-195
- Respiratory microbiology of patients with cystic fibrosis in the United States, 1995 to 2005.Chest. 2009; 136: 1554-1560
- Achromobacter xylosoxidans respiratory tract infections in cystic fibrosis patients.APMIS. 2008; 116: 837-841
- Molecular characterization of Achromobacter isolates from cystic fibrosis and non-cystic fibrosis patients in Madrid, Spain.J Clin Microbiol. 2013; 51: 1927-1930
- Microbiology of sputum from patients at cystic fibrosis centers in the United States.Clin Infect Dis. 1998; 27: 158-163
- Achromobacter xylosoxidans: characterization of strains in Brazilian cystic fibrosis patients.J Clin Microbiol. 2011; 49: 3649-3651
- Chronic infection with Achromobacter xylosoxidans in cystic fibrosis patients; a retrospective case control study.J Cyst Fibros. 2006; 5: 245-251
- Achromobacter xylosoxidans in cystic fibrosis: prevalence and clinical relevance.J Cyst Fibros. 2007; 6: 75-78
- Prevalence and outcomes of Achromobacter species infections in adults with cystic fibrosis: a north american cohort study.J Clin Microbiol. 2017; 55 (Jul): 2074-2085https://doi.org/10.1128/JCM.02556-16
Zolin, A., Orenti, A., Naehrlich, L., Jung, A., van Rens, J. et al. (2020) ECFSPR Annual Report 2018.
- Genotype -phenotype correlations in cystic fibrosis.Pediatr Pulmonol. 1996; 22: 387-395
- Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients.J Cyst Fibros. 2003; 2: 29-34
- Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations.Eur Respir J. 2012; 40: 1324-1343
- 2000 CDC growth charts for the United States: methods and development. National Centre for Health Statistics.Vital Health Stat. 2002; 11: 1-190
- Longitudinal data analysis using generalized linear models.Biometrika. 1986; 78: 13-22
https://www.cff.org/sites/default/files/2021-11/Patient-Registry-Annual-Data-Report.pdf, 2021.
- Impact of sustained eradication of new pseudomonas aeruginosa infection on long-term outcomes in cystic fibrosis.Clin Infect Dis. 2015; 61 (Sep 1): 707-715
- Decade-long bacterial community dynamics in cystic fibrosis airways.Proc Natl Acad Sci U S A. 2012; 109 (Apr 10Epub 2012 Mar 26. PMID: 22451929; PMCID: PMC3326496): 5809-5814https://doi.org/10.1073/pnas.1120577109
- Rapid detection of emerging pathogens and loss of microbial diversity associated with severe lung disease in cystic fibrosis.J Clin Microbiol. 2015; 53 (JulEpub 2015 Apr 15. PMID: 25878338; PMCID: PMC4473198): 2022-2029https://doi.org/10.1128/JCM.00432-15
- Severe Achromobacter xylosoxidans infection and loss of sputum bacterial diversity in an adult patient with cystic fibrosis.Paediatr Respir Rev. 2016; (Aug;20 SupplEpub 2016 Jun 15. PMID: 27374622): 27-29https://doi.org/10.1016/j.prrv.2016.06.011
Article info
Publication history
Published online: November 20, 2022
Accepted:
November 7,
2022
Received in revised form:
October 28,
2022
Received:
July 18,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
