Achromobacter xylosoxidans is a nonfermenting, oxidase-positive, gram-negative rod that prefers aqueous environmental reservoirs. A variety of such sources have been implicated in epidemic and sporadic A xylosoxidans infections, including the deionized water of a hemodialysis system, a swimming pool chlorhexidine solutions, intravascular pressure transducers and distilled water. Nuclear medicine tracer material prepared at our institution was implicated in a 1978 outbreak that involved four hospitals. Fourteen patients developed proven or suspected A xylosoxidans bacteremia following intravenous injection with this tracer for lung, liver and bone scans. Contaminated non-bacteriostatic saline used as a diluent for the radioactive material was the likely source.
A xylosoxidans has been isolated from many different body sites, including the bloodstream, urinary tract, central nervous system, peritoneum, respiratory tract, biliary tree; bowel, eyes, ears, pharynx and surgical wounds. Many infected individuals have had compromised host defenses of varying types. Serious infections with this organism may be fatal, perhaps, in part, because of its resistance to multiple antibiotics.