Diversity and hazard of respiratory infection of Achromobacter spp. in cystic fibrosis patients

Background and aims. Achromobacter spp., as causative agent of the nosocomial infections, has caught the eye last Decades. The growth of the infecting of the respiratory tract of the cystic fibrosis patients by this microorganism is formidable. The aim of this investigation was the Achromobacter spp. identification in expanded cohort of the Russian CF patients, genotyping of the microorganism according to the international standards and molecular epidemiological analysis of the situation with this opportunistic microorganism. Methods. Clinical samples from about 300 patients: sputum, tracheal aspirate, throat swabs and strains, isolated from the samples, were the material for the investigation. Method of the multilocus sequence typing (MLST), extended by the additional targets, was the base for the research. Results. 25 percents of the patients routinely hospitalized because of the severity of the disease, were infected by Achromobacter spp. of five species: A. xylosoxidans, A. ruhlandii, A. marplatensis, A. dolens, A. pulmonis, and one genogroup. The species A. ruhlandii has dominated (58.5%). One of the drug resistance indicator – oxacillinase gene blaOXA – helps in the differentiation of the genera Achromobacter and Burkholderia, and also some species in the genus Achromobacter. From 26 identified Achromobacter spp. genotypes (sequence type, ST) 16 STs relate to the species A. xylosoxidans, five – to A. ruhlandii. ST263 is specific to the patients from the Far Eastern Federal District. ST261 and 36 are the most numerous: the patients of all Federal Districts are infected by this ST. The chronological analysis allows suggesting the replacement of the genotype 261 by the genotype 36 in the end of the 1990s years and the A. ruhlandii ST36 nosocomial outbreak. At present 39% of the patients with Achromobacter spp. are infected by A. ruhlandii ST36, transmissivity of which is proved the coinfection cases of the siblings and simultaneously hospitalized patients. The influence on the respiratory function of the CF patients was the most expressed for the A. ruhlandii ST261strains. For the younger age group (1997 year of birth and younger), infected by A. ruhlandii ST36, the median of the FEV1 was slightly lower than in older age group, infected by those strain, that can indicate the accumulation of the pathogenic properties by the A. ruhlandii ST36 during the circulation between the patients. Conclusions. A. ruhlandii ST36 strain by the combination of the identified properties may be considered as the Russian epidemic strain.

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