Mediastinitis superinfected by Achromobacter xylosoxidans. A case report

J Infect Chemother. 2018 Dec;24(12):987-989. doi: 10.1016/j.jiac.2018.05.005. Epub 2018 Jun 9.

Abstract

We describe an extremely rare case of mediastinitis superinfected by emerging Achromobacter xylosoxidans. After mitral and aortic valves replacement, the patient first developed a Staphylococcus aureus mediastinitis, and five days after starting adapted antibiotic therapy, superficial pus analysis revealed the presence of Achromobacter xylosoxidans. This superinfection was considered superficial and focus was made on Staphylococcus aureus mediastinitis. Three weeks later, no more Staphylococcus aureus was found in pus samples and the sepsis seemed under control. Unfortunately, blood cultures were again positive for Achromobacter xylosoxidans three weeks later and the patient died from septic shock.

Keywords: Achromobacter xylosoxidans; Cardiac surgery; Mediastinitis; Staphylococcus aureus; Surinfection.

Publication types

  • Case Reports

MeSH terms

  • Achromobacter denitrificans / drug effects
  • Achromobacter denitrificans / genetics
  • Achromobacter denitrificans / isolation & purification*
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Aortic Valve / surgery
  • Fatal Outcome
  • Gram-Negative Bacterial Infections / blood
  • Gram-Negative Bacterial Infections / complications
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Humans
  • Male
  • Mediastinitis / blood
  • Mediastinitis / diagnosis
  • Mediastinitis / drug therapy
  • Mediastinitis / microbiology*
  • Mitral Valve / surgery
  • Opportunistic Infections / blood
  • Opportunistic Infections / complications
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology*
  • Shock, Septic / blood
  • Shock, Septic / complications
  • Shock, Septic / drug therapy
  • Shock, Septic / microbiology*
  • Staphylococcal Infections / blood
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification
  • Superinfection / blood
  • Superinfection / complications
  • Superinfection / drug therapy
  • Superinfection / microbiology*
  • Suppuration / microbiology

Substances

  • Anti-Bacterial Agents