Alcaligenes  -- from chickens to humans

Prevalence of Alcaligenes faecalis in North Carolina Broiler Flocks and Its Relationship to Respiratory Disease
Herman A. Berkhoff, H. John Barnes, Sandra I. Ambrus, Michael D. Kopp, Gerald D. Riddle, David C. Kradel
Avian Diseases, Vol. 28, No. 4 (Oct. - Dec., 1984), pp. 912-920

In order to assess the role of Alcaligenes faecalis in respiratory disease of broilers, a study was conducted to
determine the prevalence of this bacterium in North Carolina broilers and to determine the relationship of A. faecalis
infection to clinical disease. Our studies showed that A. faecalis is prevalent in North Carolina commercial broilers
during the winter months. Bacteriological examination of turbinates and tracheas revealed that almost 40% of individual
birds between 35 and 45 days of age yielded positive cultures; 62% of tested flocks were infected. When present, A.
faecalis was usually the predominant bacterium isolated. Furthermore, because of a higher frequency of A. faecalis
isolation in broiler flocks with respiratory disease (75% vs. 29% in flocks without respiratory diseases), these studies
suggest a causal relationship between this bacterium and clinical respiratory disease. /// A fin de determinar la funcion
de Alcaligenes faecalis en la enfermedad respiratoria de los pollos de engorde se llevo a cabo un estudio para
determinar la prevalencia de esta bacteria en pollos de engorde de Carolina del Norte y para determinar la relacion
entre la infeccion con A. faecalis y la enfermedad clinica. Nuestros estudios han demostrado que A. faecalis es
prevalente en los pollos de engorde de Carolina del Norte durante los meses de invierno. El examen bacteriologico de
los cornetes nasales y de las traqueas demostro que casi el 40% de aves individuales entre 35 y 45 dias de edad
produjeron cultivos positivos y el 62% de las parvadas examinadas estaban infectadas. En los casos positivos, A.
faecalis fue generalmente la bacteria predominantemente aislada. Ademas, debido a la alta frecuencia de aislamientos
de A. faecalis en parvadas de engorde con enfermedad respiratoria (75% versus 29% en parvadas sin enfermedad
respiratoria), estos estudios sugieren una relacion de tipo causal entre esta bacteria y la enfermedad respiratoria

CAPD-Associated Peritonitis Caused by
Alcaligenes xylosoxidans sp. xylosoxidans

Alcaligenes xylosoxidans is an uncommon cause of peritonitis in patients on maintenance continuous ambulatory
peritoneal dialysis (CAPD). Peritonitis caused by A. xylosoxidans usually carries a poor prognosis because of the
pathogen's virulence and its universal resistance to most antimicrobial agents. Even after early Tenckhoff catheter
removal, the transport property of the peritoneum is often irreversibly damaged, leading to permanent technique
failure. We report 2 patients with CAPD-associated peritonitis due to A. xylosoxidans sp. xylosoxidans who were
successfully cured with a combination of piperacillin and tazobactam. One of them subsequently returned uneventfully
to CAPD.
Am J Nephrol 2001;21:502-506 (DOI: 10.1159/000046657)
Copyright © 2001 S. Karger AG, Basel

Achromobacter (Alcaligenes) bacteraemia: a 14-year retrospective analysis at a comprehensive cancer
centre in the United States
Among 387 patients, Alcaligenes species was isolated from 699 culture samples. Forty-six patients (12%) were
bacteraemic; 1.8 positive blood culture per patient (82 positive cultures). In 28 patients (61%) single blood culture
sample grew Alcaligenes species; 18 (39%) had multiple positive blood cultures (11 had two (+) cultures, five patients
had equal to or greater than three (+) cultures and in one patient bacteraemia remained persistent at equal to or
greater than seven (+) blood cultures). Most bloodstream isolates (n = 76; 42 patients, 91%) were A. xylosoxidans; A.
denitrificans and A. faecalis were other identifiable species. In 34 patients (74%) Alcaligenes bacteraemia was
monomicrobial, whereas in nine individuals (20%) two organisms were identified, and in 6% (n = 3), three or more
microorganisms-associated concomitant bacteraemia–fungaemia was noted. In vitro susceptibility was performed in 43
patient isolates, 28 antimicrobial agents were tested. The MIC90 for all Alcaligenes species was within susceptible
range for carbapenems, piperacillin–tazobactam, ticarcillin–clavulanic acid, and trimethoprime–sulfamethoxazole.
MIC50 was in non-susceptible range against fluoroquinolones (ciprofloxacin, levofloxacin), aminoglycosides,
aztreonam, ampicillin–sulbactam. Following are the yearly distribution of blood culture Alcaligenes isolates: [year, total
isolates, blood isolates n (%)] 1989, 1, 0 (0%); 1990, 9, 2 (22%); 1991, 23, 6 (26%); 1992, 19, 1 (5%); 1993, 20, 2
(10%); 1994, 30, 3 (10%); 1995, 21, 3 (14%); 1996, 18, 3 (17%); 1997, 20, 4 (20%); 1998, 30, 4 (13%); 1999, 49, 4
(8%); 2000, 60, 4 (7%); 2001, 53, 6 (11%); 2002, 53, 5 (9%), and in 2003, 34 total Alcaligenes clinical isolates, 1 (3%)
was isolated from blood culture specimen.

Clinical Microbiology and Infection (CMI) is a monthly publication in English of the European Society of Clinical
Microbiology and Infectious Diseases

Alcaligenes xylosoxidans Conjunctivitis.

Case Report

Cornea. 26(7):868-869, August 2007.
Rush, Ryan MD; Friedlander, Miles MD
Purpose: To report a case of chronic unilateral conjunctivitis caused by Alcaligenes xylosoxidans.

Methods: A previously healthy 47-year-old woman presented with left eye purulent discharge and irritation beginning 3
months earlier. The patient had previously been treated with bacitracin and olopatadine without improvement. Bacterial
staining, culture, and antibiotic sensitivities were performed from a conjunctival swab.

Results: The cultures revealed heavy growth of A. xylosoxidans. The organism was resistant to aminoglycosides,
fluoroquinolones, and cephalosporins. The patient was started on polytrim, but an allergic reaction forced the use of
topical Timentin 2%. After 14 days of treatment, the infection completely resolved.

Conclusions: To our knowledge, this is the first case report of an external ocular infection caused by A. xylosoxidans in
a host without predisposing risk factors and the first case report of isolated conjunctivitis caused by A. xylosoxidans. A.
xylosoxidans should be considered a rare but potential pathogen capable of producing chronic conjunctivitis in an
otherwise healthy host.

An Med Interna. 2006 Mar ;23 (3):148-9 16752454   
[Community-acquired pneumonia and bacteraemia due to Alcaligenes xylosoxidans]  
[My paper] E Pastor Esplá , J Signes-Costa Miñana , E Chiner Vives , M Llombart Cantó , A L Andreu Rodríguez  

Mesh-terms: Aged; Alcaligenes, classification; Alcaligenes, drug effects; Alcaligenes, isolation & purification; Arthritis,
Rheumatoid, complications; Arthritis, Rheumatoid, drug therapy; Community-Acquired Infections, microbiology;
Comorbidity; Drug Resistance, Multiple, Bacterial; Female; Gram-Negative Bacterial Infections, microbiology; Humans;
Immunocompromised Host; Immunosuppressive Agents, adverse effects; Immunosuppressive Agents, therapeutic use;
Pleural Effusion, etiology; Pneumonia, Bacterial, microbiology;  

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