PMID- 28446570
OWN - NLM
STAT- MEDLINE
DCOM- 20180312
LR  - 20181113
IS  - 1098-660X (Electronic)
IS  - 0095-1137 (Print)
IS  - 0095-1137 (Linking)
VI  - 55
IP  - 7
DP  - 2017 Jul
TI  - Prevalence and Outcomes of Achromobacter Species Infections in Adults with Cystic 
      Fibrosis: a North American Cohort Study.
PG  - 2074-2085
LID - 10.1128/JCM.02556-16 [doi]
AB  - Achromobacter species are increasingly being detected in cystic fibrosis (CF) 
      patients, with an unclear epidemiology and impact. We studied a cohort of 
      patients attending a Canadian adult CF clinic who had positive sputum cultures 
      for Achromobacter species in the period from 1984 to 2013. Infection was 
      categorized as transient or persistent (>/=50% positive cultures for 1 year). Those 
      with persistent infection were matched 2:1 with age-, sex-, and time-matched 
      controls without a history of Achromobacter infection, and mixed-effects models 
      were used to assess pulmonary exacerbation (PEx) frequency and lung function 
      decline. Isolates from a biobank were retrospectively assessed, identified to the 
      species level by nrdA sequencing, and genotyped using pulsed-field gel 
      electrophoresis (PFGE). Thirty-four patients (11% of those in our clinic), with a 
      median age of 24 years (interquartile range [IQR], 20.3 to 29.8 years), developed 
      Achromobacter infection. Ten patients (29%) developed persistent infection. 
      Persistence did not denote permanence, as most patients ultimately cleared 
      infection, often after years. Patients were more likely to experience PEx at 
      incident isolation than at prior or subsequent visits (odds ratio [OR], 2.7 [95% 
      confidence interval CI, 1.2 to 6.7]; P = 0.03). Following persistent infection, 
      there was no difference in annual lung function decline (-1.08% [95% CI, -2.73 to 
      0.57%] versus -2.74% [95% CI, -4.02 to 1.46%]; P = 0.12) or the odds of PEx (OR, 
      1.21 [95% CI, 0.45 to 3.28]; P = 0.70). Differential virulence among 
      Achromobacter species was not observed, and no cases of transmission occurred. We 
      demonstrated that incident Achromobacter infection was associated with a greater 
      risk of PEx; however, neither transient nor chronic infection was associated with 
      a worsened long-term prognosis. Large, multicenter studies are needed to clarify 
      the clinical impact, natural history, and transmissibility of Achromobacter.
CI  - Copyright (c) 2017 American Society for Microbiology.
FAU - Edwards, B D
AU  - Edwards BD
AD  - Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - Greysson-Wong, J
AU  - Greysson-Wong J
AD  - Department of Microbiology, Immunology and Infectious Diseases, University of 
      Calgary, Calgary, Alberta, Canada.
FAU - Somayaji, R
AU  - Somayaji R
AD  - Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - Waddell, B
AU  - Waddell B
AD  - Department of Microbiology, Immunology and Infectious Diseases, University of 
      Calgary, Calgary, Alberta, Canada.
FAU - Whelan, F J
AU  - Whelan FJ
AD  - Department of Biochemistry and Biomedical Sciences, the Farncombe Family 
      Digestive Health Research Institute, McMaster University, Hamilton, Ontario, 
      Canada.
FAU - Storey, D G
AU  - Storey DG
AD  - Department of Microbiology, Immunology and Infectious Diseases, University of 
      Calgary, Calgary, Alberta, Canada.
AD  - Department of Biological Sciences, University of Calgary, Calgary, Alberta, 
      Canada.
FAU - Rabin, H R
AU  - Rabin HR
AD  - Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
AD  - Department of Microbiology, Immunology and Infectious Diseases, University of 
      Calgary, Calgary, Alberta, Canada.
FAU - Surette, M G
AU  - Surette MG
AD  - Department of Microbiology, Immunology and Infectious Diseases, University of 
      Calgary, Calgary, Alberta, Canada.
AD  - Department of Medicine, the Farncombe Family Digestive Health Research Institute, 
      McMaster University, Hamilton, Ontario, Canada.
AD  - Department of Biochemistry and Biomedical Sciences, the Farncombe Family 
      Digestive Health Research Institute, McMaster University, Hamilton, Ontario, 
      Canada.
FAU - Parkins, M D
AU  - Parkins MD
AD  - Department of Medicine, University of Calgary, Calgary, Alberta, Canada 
      Michael.parkins@me.com.
AD  - Department of Microbiology, Immunology and Infectious Diseases, University of 
      Calgary, Calgary, Alberta, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170426
PL  - United States
TA  - J Clin Microbiol
JT  - Journal of clinical microbiology
JID - 7505564
SB  - IM
MH  - Achromobacter/classification/genetics/*isolation & purification
MH  - Adolescent
MH  - Adult
MH  - Cystic Fibrosis/*complications
MH  - Female
MH  - Follow-Up Studies
MH  - Gram-Negative Bacterial Infections/*epidemiology/pathology
MH  - Humans
MH  - Male
MH  - North America/epidemiology
MH  - Prevalence
MH  - Respiratory Function Tests
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5483909
OTO - NOTNLM
OT  - Achromobacter xylosoxidans
OT  - emerging infections
OT  - epidemiology
OT  - eradication
OT  - infection control
OT  - infection transmission
OT  - inhaled corticosteroids
OT  - multilocus sequence typing
OT  - pulsed-field gel electrophoresis
OT  - whole-genome sequencing
EDAT- 2017/04/28 06:00
MHDA- 2018/03/13 06:00
PMCR- 2018/01/01
CRDT- 2017/04/28 06:00
PHST- 2017/01/08 00:00 [received]
PHST- 2017/03/20 00:00 [accepted]
PHST- 2017/04/28 06:00 [pubmed]
PHST- 2018/03/13 06:00 [medline]
PHST- 2017/04/28 06:00 [entrez]
PHST- 2018/01/01 00:00 [pmc-release]
AID - JCM.02556-16 [pii]
AID - 02556-16 [pii]
AID - 10.1128/JCM.02556-16 [doi]
PST - ppublish
SO  - J Clin Microbiol. 2017 Jul;55(7):2074-2085. doi: 10.1128/JCM.02556-16. Epub 2017 
      Apr 26.