Volume 22, Number 8—August 2016
Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014
|Date of biopsy||Aug 13||Sep 12||Sep 15||Sep 30||Sep 30||Oct 3||Oct 8||Oct 10|
|Patient age at onset, y||66||60||59||62||65||54||68||69|
|Days between biopsy and urinalysis||13||2||3||10||3||6||8||7|
|Highest fever level, °C||39||39||38.5||38.6||39.1||NR||39||38.3|
|Urine culture result||Negative||A. xyl||A. xyl||A. xyl||A. xyl||O. ant||A. xyl||O. ant|
|Blood culture result||O. ant||A. xyl||A. xyl||NA||A. xyl||NA||NA||NA|
|Curative antimicrobial treatment†||Yes||Yes||Yes||Yes||Yes||NR||Yes||No|
|Apyrexia without effective antimicrobial drug||Yes||No||Yes||No||Yes||NR||Yes||Yes|
*A. xyl, Achromobacter xylosoxidans; NA, cultures not requested; NR, not recorded; O. ant, Ochrobactrum anthropi.
†All patients received a single dose of 400 mg ofloxacin. Most received curative treatments: Patient 1, 2 g ceftriaxone/d intravenously for 3 d; then 200 mg ofloxacin/d orally for 10 d. Patient 2, ceftazidime, modalities unknown (treated outside the university hospital network). Patient 3, 2 g ceftriaxone 1× intravenously; then 200 mg ofloxacin 2×/d orally for 15 d. Patient 4, 2 g ceftriaxone/d intravenously for 3 d; then 1,200 mg amikacin 1× intravenously; then 800/160 mg co-trimoxazole 2×/d orally for 15 d. Patient 5, 2 g ceftriaxone/d intravenously for 3 d; then 4 g piperacillin 3×/d intravenously and 800/160 mg co-trimoxazole 3×/d orally for 4 d; then co-trimoxazole for 15 d. Patient 7, 1 g ceftriaxone/d intravenously for 2 d and 200 mg ofloxacin 2×/d orally for 21 d. Antibiogram of A. xylosoxidans for patients 2, 3, 4, 5, and 7 showed sensitivity to amoxicillin, ticarcillin, piperacillin (with or without β-lactamase inhibitors), ceftazidime, colistin, co-trimoxazole, and carbapenems and resistance to cefalotine, cefoxitine, cefotaxime, cefepime, aminoglycosides, quinolones, tigecyclin, fosfomycin, and rifampin. Antibiogram of O. anthropi for patient 1 showed sensitivity to carbapenems, aminoglycosides, ciprofloxacin, tigecyclin, rifampin, and co-trimoxazole and resistance to amoxicillin, ticarcillin, piperacillin (with or without β-lactamase inhibitors), cefalotine, cefoxitine, cefotaxime, ceftazidime, cefepime, aztreonam, norfloxacin, and fosfomycin. Antibiogram of O. anthropi for patient 8 was the same as for patient 1 except for sensitivity to norfloxacin. In hindsight, co-trimoxazole should probably have been used as first-line therapy.