Skin and soft tissue infection caused by Achromobacter xylosoxidans: report of 14 cases

Abstract

Background: Skin and soft tissue infections (SSTIs) caused by Achromobacter xylosoxidans are very infrequent. The aim of the present study was to investigate the clinical and microbiological characteristics of this infection. Methods: We carried out a retrospective review of 14 cases of SSTI due to A. xylosoxidans that occurred at the University Hospital of Guadalajara (Spain) from January 2007 to December 2012. Results: The infection was secondary to vascular diseases, trauma, and recent surgery in 12 patients (85.7%). The most frequent clinical presentation was infection of a vascular ulcer (5 cases). The infection was monomicrobial in 7 patients (50%) and 9 cases were community-acquired (64.2%). The clinical outcome of the patients was uniformly good after antibiotic treatment, except in 4 patients who suffered recurrence of the infection. Conclusion: A. xylosoxidans should be considered a potential pathogen in patients with SSTIs, especially in patients with vascular diseases or after surgery or trauma. A history of contact with water should be investigated in all cases. Treatment can be difficult due to the high level of antibiotic resistance. Trimethoprim–sulfamethoxazole may be useful for treatment in outpatients with community-acquired infections.

Keywords::

• Skin infection
• soft tissue infection
• wound infection
• surgical site infection
• Achromobacter xylosoxidans
• Achromobacter denitrificans
• Alcaligenes species

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.