Primary Human Immunodeficiency Virus Type 1 Infection May Vary in Time, Place, and Person

susceptibility testing revealed that the organism was 0. anthropi and that it was susceptible only to trimethoprim-sulfamethoxazole (TMP-SMZ), ciprofloxacin, imipenem, and gentamicin (the typical susceptibility pattern for this organism) [2]. The patient was treated with vancomycin, rifampin, ciprofloxacin, and TMP-SMZ for 6 weeks, followed by ciprofloxacin and TMP-SMZ for 4 1/2 months. Her wound healed, and her symptoms have not recurred. 0. anthropi is an oxidase-positive, non-lactose-fermenting gram-negative bacillus. This organism (formerly CDC [Centers for Disease Control and Prevention] group Vd) was named 0. anthropi in 1988 and is the only species in the group. Other closely related oxidase-positive nonfermenters are the Achromobacter-like organisms: Achromobacter xylosoxidans, Agrobacterium radiobacter, and Achromobacter group B. Most of the early reports of infections due to these organisms, especially 0. anthropi, described catheter-related bacteremias [3]. Two of the three cases of pyogenic infection due to 0. anthropi recently reported by Cieslak et al. [1] involved a foreign body (a draining T tube in one case and a chest tube in the other); the third case did not involve a foreign body. Alnor et al. [4] studied bacterial adhesion to silicone tubing by Agrobacterium and Ochrobactrum and found that the binding abilities of both organisms were similar to those of Staphylococcus epidermidis and Staphylococcus aureus. Infections due to all three of the related Achromobacter-like organisms have been shown to be associated with prosthetic cardiac devices; these infections include a postoperative infection of an aortic prosthesis with A. xylosoxidans [5], prosthetic valve endocarditis due to A. radiobacter [6], and replacement valve endocarditis due to Achromobacter group B [7]. We believe this is the first report of a serious infection of a cardiac prosthetic device with 0. anthropi. Although it is an unusual pathogen, isolation of this species should not come as a surprise when infections involve catheters, silicone tubing, and foreign bodies.