Clinical, microbiological profile and treatment outcome of ocular infections caused by Achromobacter xylosoxidans

Cornea. 2009 Dec;28(10):1100-3. doi: 10.1097/ICO.0b013e3181a1658f.

Abstract

Purpose: To study the microbiological profile and outcome of ocular infections caused by Achromobacter xylosoxidans.

Methods: Medical and microbiology records of patients with A. xylosoxidans ocular infections managed between May 2007 and December 2007 were reviewed.

Results: The authors identified 10 patients whose eyes were infected by A. xylosoxidans during the study period. Of 10 patients, 8 had microbial keratitis, of whom 6 developed an infection after penetrating keratoplasty. The remaining 2 patients had endophthalmitis. The Gram-stained smear did not reveal any organism in 6 of 10 cases. In the 4 remaining cases, Gram-negative bacilli were reported. Out of 10 isolates, 9 were sensitive to ceftazidime, 7 to amikacin, 5 to ciprofloxacin, and 3 to ofloxacin, gatifloxacin, and chloramphenicol. Only one isolate was sensitive to moxifloxacin. Of the 6 patients with graft infection, 2 patients were lost to follow-up, infection was resolved in 3 patients, and the infection remained active in 1 patient. The two patients with endophthalmitis responded to antibacterial therapy and showed improved visual acuity. Infection was resolved in 2 patients with keratitis.

Conclusion: Although A. xylosoxidans ocular infections are rare, one should retain a high index of clinical suspicion in patients who present with slowly progressive disease characterized by a localized infiltration and show Gram-negative bacilli on smear examination.

MeSH terms

  • Achromobacter denitrificans*
  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Child, Preschool
  • Endophthalmitis / microbiology
  • Endophthalmitis / physiopathology
  • Eye Infections, Bacterial* / drug therapy
  • Eye Infections, Bacterial* / etiology
  • Female
  • Gram-Negative Bacterial Infections* / drug therapy
  • Gram-Negative Bacterial Infections* / etiology
  • Humans
  • Keratitis / microbiology
  • Keratoplasty, Penetrating / adverse effects
  • Male
  • Middle Aged
  • Treatment Outcome
  • Visual Acuity / drug effects
  • Young Adult

Substances

  • Anti-Bacterial Agents