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Other Gram-Negative Bacteria Achromobacter xylosoxidans A. xylosoxidans (previously Alcaligenes xylosoxidans) is probably part of the endogenous intestinal flora and has been isolated from water sources. Immunocompromised hosts, including patients with cancer and post- chemotherapy neutropenia, cirrhosis, and chronic renal failure, are at increased risk. Nosocomial outbreaks of A. xylosoxidans infection have been attributed to contaminated fluids, and clinical illness has been associated with isolates from many sites, including blood (often in the setting of intravascular devices). Community-acquired bacteremia with A. xylosoxidans usually occurs in the setting of pneumonia. Metastatic skin lesions are present in one-fifth of cases. The reported mortality rate is. | Chapter 140. Infections Due to the HACEK Group and Miscellaneous Gram-Negative Bacteria Part 3 Other Gram-Negative Bacteria Achromobacter xylosoxidans A. xylosoxidans previously Alcaligenes xylosoxidans is probably part of the endogenous intestinal flora and has been isolated from water sources. Immunocompromised hosts including patients with cancer and postchemotherapy neutropenia cirrhosis and chronic renal failure are at increased risk. Nosocomial outbreaks of A. xylosoxidans infection have been attributed to contaminated fluids and clinical illness has been associated with isolates from many sites including blood often in the setting of intravascular devices . Community-acquired bacteremia with A. xylosoxidans usually occurs in the setting of pneumonia. Metastatic skin lesions are present in one-fifth of cases. The reported mortality rate is 67 a figure similar to rates for other bacteremic gram-negative pneumonias. Achromobacter xylosoxidans Infections Treatment Treatment is based on in vitro susceptibility testing of all clinically relevant isolates. Aeromonas Species More than 85 of Aeromonas infections are caused by A. hydrophila A. caviae and A. veronii biovar sobria. Aeromonas proliferates in potable and fresh water and in soil. It remains controversial whether Aeromonas is a cause of bacterial gastroenteritis asymptomatic colonization of the intestinal tract with Aeromonas occurs frequently. However rare cases of hemolytic-uremic syndrome following bloody diarrhea have been shown to be secondary to the presence of Aeromonas. Aeromonas causes sepsis and bacteremia in infants with multiple medical problems and in immunocompromised hosts particularly those with cancer or hepatobiliary disease. Aeromonas infection and sepsis can occur in patients with trauma including severe trauma with myonecrosis and in burn patients exposed to Aeromonas by environmental freshwater or soil contamination of their wounds. Reported mortality rates range from 25 among .
