Alcaligenes xylosoxidansBloodstream Infections in Outpatient Oncology Office

In 2002, we investigated a cluster of patients with Alcaligenes xylosoxidans bloodstream infections by conducting a matched case-control study and a prospective study. Pulsed-fi eld gel electrophoresis (PFGE) was performed on blood culture isolates, and 1 explanted central venous catheter (CVC) was tested for biofi lm. We identifi ed 12 cases of A. xylosoxidans bloodstream infection. Case-patients were more likely than controls to have had a CVC (7/7 [100%] vs 4/47 [8.7%], respectively; p<0.0001). Ten case isolates were indistinguishable by PFGE analysis, and A. xylosoxidans biofi lm from the CVC matched the outbreak strain. We observed multiple breaches in infection control, which may have caused contamination of multidose vials used to fl ush the CVCs. Our study links A. xylosoxidans with CVC biofi lm and highlights areas for regulation and oversight in outpatient settings.