Achromobacter xylosoxidans, an Emergent Pathogen in Lung Infections

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Bacterial Pathogens".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 7840

Special Issue Editors

Department of Diagnostics and Public Health, University of Verona, Verona, Italy
Interests: microbiology of cystic fibrosis; molecular typing of bacterial strains; mouse models for lung inflammation studies; antibiotic and anti-inflammation molecules; beta-lactamases in veterinarian samples; antibiotic resistance in sexually transmitted pathogens; contrasting strategies against oral infections
Department of Diagnostics and Public Health, University of Verona, 37134 Verona, VR, Italy
Interests: cystic fibrosis; respiratory infections; bacterial pathogens
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Special Issue Information

Dear Colleagues,

Achromobacter xylosoxidans is a nonfermenting, oxidase- and catalase-positive, motile Gram-negative bacillus that can be found widely distributed in natural environments, mainly in moist soil and water sources but also in plants. From the human health point of view, A. xylosoxidans has been recently recognized as an emerging nosocomial pathogen. It potentially causes a wide range of different human infections typically in cystic fibrosis but also in non-CF patients, including endocarditis, pneumonia, catheter-associated bacteremia, meningitis, ocular infections, and urinary tract infections. This bacterial species is moreover considered an emerging threat for immunocompromised patients, primarily patients with hematological malignancies and lung cancer. A. xylosoxidans is often nosocomially acquired by transmission from patient to patient and is able to survive in adverse environments such disinfectants, ultrasound gels, dialysis fluids and surfaces and devices in hospitals. In some cases, A. xylosoxidans bacteremia results in high mortality rates (15–30%) arriving up to >50%.

The patients most frequently colonized and infected by A. xylosoxidans are those with CF lung disease and chronic bronchiectasis. A. xylosoxidans is capable of causing persistent respiratory tract infections in those patients but its pathogenic role in disease progression remains to be elucidated. Prevalence rates of Achromobacter spp. recovered from respiratory specimens have increased in recent years, mainly due to the selective pressure imposed by antibiotic therapy and the extended life survival of CF patients. Other Achromobacter species, namely A. ruhlandii, A. insuavis, A. dolens, A. aegrifaciens, A. denitrificans, and A. insolitus have also been isolated from CF patients but their epidemiology and clinical impact are still not completely understood and constitute a source of expanding interest.

The mechanisms that make Achromobacter species able to colonize and infect the respiratory tract are still unclear. Recent studies have expanded our knowledge on the genetics, organization, and expression of virulence factors and on the adaptive strategies set up in the lung such as hypermutation and pathoadaptative mutations.

However, the current literature on the field is still missing large studies on the progression and outcomes of Achromobacter lung colonization and other aspects of the Achromobacter pathogenesis. Among these, evaluation of the effectiveness of antibiotic treatments, the identification of the virulence factors which might be used as markers for colonization and infection, the mechanisms used by Achromobacter spp. to interact with other respiratory pathogens and to exchange mobile genetic elements.

All this information seems to be mandatory to establish the clinical role and impact of this emergent bacterial species in respiratory infections and other infectious pathologies, to improve the monitoring of disease evolution and for the application of an appropriate antimicrobial therapy.

This issue will focus on studies aiming to clarify the clinical role of Achromobacter in chronic pulmonary infections by referring to the following topics:

  • Achromobacter species epidemiology and clinical impact
  • Transmissibility of Achromobacter in CF and non CF-patients
  • Achromobacter xylosoxidans infections in immunocompromissed hosts and in the nosocomial environment
  • Presumptive diagnose of the risk of Achromobacter chonic lung infection and exacerbations on the basis of the virulence factors asssociated to the different species and strains
  • Interactions between Achromobacter and other bacterial species (P. aeruginosa, S, aureus, S, maltophilia) leading to more severe lung pathologies
  • Therapeutic protocols to be applied to prevent and solve the infection caused by Achromobacter

Dr. Maria M. Lleo
Dr. Angela Sandri
Guest Editors

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Keywords

  • Achromobacter xylosoxidans
  • Achromobacter species
  • Achromobacter virulence factors
  • Cystic fibrosis
  • Achromobacter infections in immunocompromissed patients
  • Emergent pathogens in infectious diseases
  • Chronic lung infection and exacerbations
  • Therapeutic protocols in cystic fibrosis

Published Papers (2 papers)

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Research

11 pages, 588 KiB  
Article
Achromobacter spp. in a Cohort of Non-Selected Pre- and Post-Lung Transplant Recipients
by Cornelia Geisler Crone, Omid Rezahosseini, Hans Henrik Lawaetz Schultz, Tavs Qvist, Helle Krogh Johansen, Susanne Dam Nielsen and Michael Perch
Pathogens 2022, 11(2), 181; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11020181 - 28 Jan 2022
Cited by 4 | Viewed by 2115
Abstract
Achromobacter is an opportunistic pathogen that mainly causes chronic lung infections in cystic fibrosis (CF) patients and is associated with increased mortality. Little is known about Achromobacter spp. in the lung transplant recipient (LTXr) population. We aimed at describing rates of Achromobacter spp. [...] Read more.
Achromobacter is an opportunistic pathogen that mainly causes chronic lung infections in cystic fibrosis (CF) patients and is associated with increased mortality. Little is known about Achromobacter spp. in the lung transplant recipient (LTXr) population. We aimed at describing rates of Achromobacter spp. infection in LTXr prior to, in relation to, and after transplantation, as well as all-cause mortality proportion in infected and uninfected LTXr. We included 288 adult LTXr who underwent lung transplantation (LTX) between 1 January 2010 and 31 December 2019 in Denmark. Bronchoalveolar lavage was performed at regular intervals starting two weeks after transplantation. Positive cultures of Achromobacter spp. were identified in nationwide microbiology registries, and infections were categorized as persistent or transient, according to the proportion of positive cultures. A total of 11 of the 288 LTXr had transient (n = 7) or persistent (n = 4) Achromobacter spp. infection after LTX; CF was the underlying disease in 9 out of 11 LTXr. Three out of the four patients, with persistent infection after LTX, also had persistent infection before LTX. The cumulative incidence of the first episode of infection one year after LTX was 3.8% (95% CI: 1.6–6.0). The incidence rates of transient and persistent infection in the first year after LTX were 27 (12–53) and 15 (5–37) per 1000 person-years of follow-up, respectively. The all-cause mortality proportion one year after LTX was 27% in the Achromobacter spp. infected patients and 12% in the uninfected patients (p = 0.114). Achromobacter spp. mainly affected LTXr with CF as the underlying disease and was rare in non-CF LTXr. Larger studies are needed to assess long-term outcomes of Achromobacter spp. in LTXr. Full article
(This article belongs to the Special Issue Achromobacter xylosoxidans, an Emergent Pathogen in Lung Infections)
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12 pages, 2603 KiB  
Article
Adaptive Interactions of Achromobacter spp. with Pseudomonas aeruginosa in Cystic Fibrosis Chronic Lung Co-Infection
by Angela Sandri, Janus Anders Juul Haagensen, Laura Veschetti, Helle Krogh Johansen, Søren Molin, Giovanni Malerba, Caterina Signoretto, Marzia Boaretti and Maria M. Lleo
Pathogens 2021, 10(8), 978; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens10080978 - 03 Aug 2021
Cited by 8 | Viewed by 2157
Abstract
In the lungs of patients with cystic fibrosis (CF), the main pathogen Pseudomonas aeruginosa is often co-isolated with other microbes, likely engaging in inter-species interactions. In the case of chronic co-infections, this cohabitation can last for a long time and evolve over time, [...] Read more.
In the lungs of patients with cystic fibrosis (CF), the main pathogen Pseudomonas aeruginosa is often co-isolated with other microbes, likely engaging in inter-species interactions. In the case of chronic co-infections, this cohabitation can last for a long time and evolve over time, potentially contributing to the clinical outcome. Interactions involving the emerging pathogens Achromobacter spp. have only rarely been studied, reporting inhibition of P. aeruginosa biofilm formation. To evaluate the possible evolution of such interplay, we assessed the ability of Achromobacter spp. isolates to affect the biofilm formation of co-isolated P. aeruginosa strains during long-term chronic co-infections. We observed both competition and cohabitation. An Achromobacter sp. isolate secreted exoproducts interfering with the adhesion ability of a co-isolated P. aeruginosa strain and affected its biofilm formation. Conversely, a clonal Achromobacter sp. strain later isolated from the same patient, as well as two longitudinal strains from another patient, did not show similar competitive behavior against its P. aeruginosa co-isolates. Genetic variants supporting the higher virulence of the competitive Achromobacter sp. isolate were found in its genome. Our results confirm that both inter-species competition and cohabitation are represented during chronic co-infections in CF airways, and evolution of these interplays can happen even at the late stages of chronic infection. Full article
(This article belongs to the Special Issue Achromobacter xylosoxidans, an Emergent Pathogen in Lung Infections)
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