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Volume 25, Number 11—November 2019
Letter

Achromobacter xylosoxidans Infections after Prostate Biopsies, France, 2014

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To the Editor: We read with interest the article by Haviari et al. concerning a health care–associated outbreak of Achromobacter xylosoxidans infections after prostate biopsies (1). Although noteworthy, the description lacks some data.

First, the isolates of Achromobacter cannot be referred to as A. xylosoxidans from just the method used in this study, API 20 NE mass spectrometry (bioMérieux, https://www.biomerieux.com). Since 2012, a total of 18 species have been defined in the genus Achromobacter (2). Only multilocus sequence typing or sequencing 765 bp of the housekeeping gene nrdA enables the identification of the isolates to the species level (3). To date, in the few studies available, a great variety of species have been detected in clinical samples, with A. xylosoxidans the most predominant (4,5). Correct identification of the isolates involved in all types of infection is necessary to help understand the epidemiology, pathogenicity, and resistance pattern of the various species.

Second, the antimicrobial drug resistance profiles are not given (except for ceftriaxone, which is an intrinsic resistance, and ofloxacin) but again are valuable epidemiologic data. This information might help in detecting the emergence of new cases in the unit or in other hospitals, as well as in discussing the therapeutic options.

Finally, all the bacteria recovered in the container belonged to environmental waterborne genera frequently encountered in wet sites in hospitals. As discussed by the authors, these microorganisms have been involved in contamination of antiseptic solutions containing quaternary ammonium compounds or chlorhexidine. Unfortunately, the authors did not mention which disinfectants were used in the biopsy room (for hands, sinks, surfaces, or containers) and did not investigate for these potential sources of contamination. In the absence of identification of any reservoir and despite the new measures adopted, new cases might still occur.

In conclusion, these missing data are needed for other hospitals to identify epidemiogenic Achromobacter isolates. Complete information would help in implementing control measures to contain and prevent outbreaks.

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Lucie AmoureuxComments to Author , Julien Bador, and Catherine Neuwirth

Author affiliations: University Hospital of Dijon, Dijon, France

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References

  1. Haviari  S, Cassier  P, Dananché  C, Hulin  M, Dauwalder  O, Rouvière  O, et al. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi infections after prostate biopsies, France, 2014. Emerg Infect Dis. 2016;22:14129. DOIPubMed
  2. Haviari  S, Cassier  P, Dananché  C, Hulin  M, Dauwalder  O, Rouvière  O, et al. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi infections after prostate biopsies, France, 2014. Emerg Infect Dis. 2016;22:14129. DOIPubMed
  3. Vandamme  PA, Peeters  C, Inganas  E, Cnockaert  M, Houf  K, Spilker  T, et al. Taxonomic dissection of Achromobacter denitrificans Coenye et al. 2003 and proposal of Achromobacter agilis sp. nov., nom. rev., Achromobacter pestifer sp. nov., nom. rev., Achromobacter kerstersii sp. nov. and Achromobacter deleyi sp. nov. Int J Syst Evol Microbiol. 2016;66:370817.
  4. Spilker  T, Vandamme  P, Lipuma  JJ. Identification and distribution of Achromobacter species in cystic fibrosis. J Cyst Fibros. 2013;12:298301. DOIPubMed
  5. Amoureux  L, Bador  J, Verrier  T, Mjahed  H, DE Curraize  C, Neuwirth  C. Achromobacter xylosoxidans is the predominant Achromobacter species isolated from diverse non-respiratory samples. Epidemiol Infect. 2016;144:352730. DOIPubMed
  6. Coward  A, Kenna  DT, Perry  C, Martin  K, Doumith  M, Turton  JF. Use of nrdA gene sequence clustering to estimate the prevalence of different Achromobacter species among Cystic Fibrosis patients in the UK. J Cyst Fibros. 2016;15:47985. DOIPubMed

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Cite This Article

DOI: 10.3201/eid2511.161487

Original Publication Date: 9/26/2019

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Table of Contents – Volume 25, Number 11—November 2019

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Please use the form below to submit correspondence to the authors or contact them at the following address:

Lucie Amoureux, Hôpital Universitaire Laboratoire de Bactériologie, Plateau Technique de Biologie, BP 37013, 21070, Dijon, CEDEX, France

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Page created: October 15, 2019
Page updated: October 15, 2019
Page reviewed: October 15, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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