Intra-abdominal infections caused by Achromobacter xylosoxidans: a systematic review
Abstract
Background: Achromobacter xylosoxidans is an emerging cause of intra-abdominal infections, typically after healthcare exposure or in patients with indwelling devices. Intrinsic multidrug resistance and biofilm formation impede empiric therapy and often necessitate source control (catheter/stent exchange or removal). Because guidance is scattered across case reports, we systematically reviewed published episodes to quantify healthcare exposure, antimicrobial selections and susceptibilities, use of source control, and outcomes.
Methods: In accordance with PRISMA 2020, we searched PubMed, Scopus, and Google Scholar from inception to 10 October 2025 for English-language case reports/series, correspondence, and letters. We extracted demographics, presentation, exposures, microbiology, treatment, source control, and outcomes.
Results: We included 32 episodes from 29 articles. The mean age was 53.9 years, and 17/32 (53.1%) were female. Healthcare exposure occurred in 30/32 (93.8%) patients, and device- or procedure-related involvement occurred in 22/32 (68.8%) patients. Abdominal pain was reported in 20/32 (62.5%) patients. All cases were culture-confirmed. Source control was performed in 12/32 (37.5%) patients. Clinical improvement occurred in 24/32 (75.0%); relapse occurred in 8/32 (25.0%), with most relapses device-associated; and death occurred in 6/32 (18.8%) cases.
Conclusions: A. xylosoxidans intra-abdominal infections are uncommon but largely healthcare-associated and often…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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