User login

Enter your username and password here in order to log in on the website:

Forgot your password?

Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.

Alcaligenes / Achromobacter xylosoxidans

Dear expert team,
Is there any new knowledge / therapeutic strategies concerning this bacterium (last question/answer 18.09.04)?
The first identification of this bacterium was on the 15.02.03 and again on the 08.12.03. Almost at the same time Pseudomonas has been identified for the last time (30.01.04). Since then, Alcaligenes could be identified in the sputum during all controls – however not causing any problems (FEV1 = 87,2% / 24 years) – Pseudomonas could not be detected anymore since then. Do you probably see a connection between these two findings – does Alcaligenes probably cause such unfavourable circumstances that Pseudomonas can not / does not like to colonize anymore?
Alcaligenes is not treated – all oral antibiotics are not effective according to laboratory findings. In addition, the following bacteria can be identified in the sputum sample: staphylococcus again and again (cefuroxim sensitive) / aspergillus + hämophilus from time to time.
Many thanks in advance,
Yours sincerely, ….
New knowledge (since 2003) about Alcaligenes / Achromobacter xylosoxidans in CF

Dear questioner,
Our knowledge about the colonization of the airways with Alcaligenes / Achromobacter xylosoxidans in CF did improve a bit during the last years.

1.This humidity loving bacterium can be found in 2-3% of all CF patients chronically for several years, it is found in another 5% sporadically. In some CF hospitals Alcaligenes / Achromobacter xylosoxidans is found more often. Transmission of the bacterium from patient to patient is possible.

2. According to our knowledge now, CF patient-groups with or without Alcaligenes / Achromobacter xylosoxidans do not differ significantly in their clinical symptoms (e.g. the course of weightgain or pulmonary function).

3. A study from Belgium in the year 2007 however, draws the conclusion that the significance of colonisation of the airways with Alcaligenes / Achromobacter xylosoxidans in CF has been underestimated so far. The patient positive for Alcaligenes / Achromobacter xylosoxidans is typically an adult patient. The changes of the lung tissue are mostly more progressed compared to patients of the same age positive for Pseudomonas, who have never been positive for Alcaligenes / Achromobacter xylosoxidans so far.

4. In Denmark a high-risk group could be identified: in case the antibody-level against Alcaligenes / Achromobacter xylosoxidans raises rapidly as a sign of infection, you have to reckon on a worsening of the pulmonary function. For this high-risk group a treatment of the bacterium is recommended. As a rule an antibiotic therapy is not recommended for the colonisation with Alcaligenes / Achromobacter xylosoxidans because of the high rate of resistance to antibiotics.

Summary: The indication for an antibiotic therapy of colonisation of the airways with Alcaligenes / Achromobacter xylosoxidans has to be established according to the individual case.

Yours sincerely,
Prof. Dr. Dr. B. Tümmler