Acinetobacter,

Stenotrophomonas,
and Similar
Organisms
Chapter 21

General characteristics

Epidemiology

Pathogenesis

Laboratory diagnosis

Acinetobacter

Stenotrophomonas maltophilia

Pseudomonas luteola and

Pseudomonas oryzihabitans

Burkholderia gladioli

General Characteristics
Grow on MAC (except CDC group NO-1)
They prefer and grow much better in an aerobic environment
Some group members oxidize carbohydrates to derive energy
for their metabolism = Oxidizers
Others do not break down carbohydrates at all and are inert
or biochemically inactive = nonoxidizers or asaccharolytic
Nonfermenters
Either oxidize glucose or do not utilize glucose
(asaccharolytic)

OF Medium
Test the ability of the organism to use carbohydrates
substrates (glucose) to produce acid by products
Fermentative:
Change in
color in both tubes.
Enterobacteriaceae, Vibrio,
Aeromonas, Plesiomonas and
Chromobacterium
Oxidative: Change in color in tubes
w/out mineral oil (Open tube)
Acinetobacter, Stenotrophomonas,
Pseudomonas,
Burkholderia

Epidemiology
Inhabit environmental niches
Natural & hospital environment
Opportunistic pathogens
Human skin colonizer
Tap water and salads

Pathogenesis
Opportunistic
No virulence factors known
Common colonizers of hospitalized patients
Risk factors:
Immunosuppression
Trauma
Foreign body implantation
Infused liquids

Nosocomial

Laboratory diagnosis
Specimen collection transport & processing: no special considerations

Direct detection: Gram Stain

Culture:
MAC, 5% Sheep Blood & CHOC
Blood culture systems, thioglycollate & BHI

Incubation: BAP = 35oC

Acinetobacter
2nd most commonly isolated NF bacilli

Family Moraxellaceae

Have the tendency to resist alcohol

denaturation

Microscopy:
Plump Gram (-) coccobacilli, appear in pairs
Can appear as gram positive cocci in smears
made from blood culture bottles

 Culture:
MACpurplish colonies
NLF, might be mistaken from lactose
fermenters
BAPBubble gum colonies (smooth,
opaque, raised, creamy & smaller than
enterobacteriaceae)
some are beta-hemolytic

Biochemical:
Strict aerobic & nonmotile
Catalase positive, oxidase negative
Optimum growth @ 30-35oC; pH 5.56.0

 Related infections: UTI,

pneumonia, endocarditis,
meningitis & cellulitis

Species:
A. baumanii glucoseoxidizing; nonhemolytic
A. lwof nonglucoseoxidizing; nonhemolytic
A. hemolyticus
glucoseoxidizing; hemolytic

Stenotrophomonas maltophilia
3rd most commonly isolated NLF
Isolated from plant materials, water, milk, frozen food & sewage

Strictly aerobic motile with growth @ 42 oC

Can contaminate blood drawing equipments & disinfectants

maltophiliamaltose-loving; produce acid with maltose & not

glucose

 Microscopy:
Short to medium size Gram negative straight rods

Culture:
BAPlavender-green to light purple pigment with ammonia smell
BHI+tyrosinebrown pigment

Biochemical test:
Oxidase(-)NLF
Positive:catalase, DNAse, esculin and gelatin hydrolysis & LysineDecarboxylase

Assoc. with pseudoinfectionsas a result of contaminated blood

collection tubes

 Susceptible to SXT (drug of choice for most inf)

Antimicrobial tests:
Broth microdilution
Etest

Broth microdilution

Etest

Pseudomonas luteola and

Pseudomonas oryzihabitans
Pseudomonas luteola (formerly
Chryseomonas luteola)
Pseudomonas oryzihabitans (formerly
Flavimonas oryzihabitans)
found in Japanese rice paddies and has
been isolated from hospital drains and
respiratory therapy equipment
isolated in eye cultures and was described
as the cause of sticky eye

gram-negative, nonfermentative,
Catalase positive and motile, oxidize
glucose and other sugars,
MAC agar: intracellular nondiffusible
yellow pigment

Burkholderia gladioli
Primarily a plant pathogen
found in patients with CF and chronic granulomatous disease
motile by means of one or two polar flagella
catalase and urease positive
oxidizes glucose, is mannitol positive and decarboxylase
negative