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Dai Y, Gao J, Jiang M. Case Report: A rare infection of multidrug-resistant Aeromonas caviae in a pediatric case with acute lymphoblastic leukemia and review of the literature. Front Pediatr 2024; 12:1233600. [PMID: 38803640 PMCID: PMC11128555 DOI: 10.3389/fped.2024.1233600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
Aeromonas caviae infection of the bloodstream and intestine is a rare and severe opportunistic infection in immunocompromised people. In Southwest China, we first reported a case of bloodstream and intestinal infection with multidrug-resistant (MDR) Aeromonas caviae in a 4-year-old child with T-cell acute lymphoblastic leukemia. Blood and stool cultures were used to identify the infection. The selection of antibiotics was based on clinical expertise and medication sensitivity tests. We used linezolid, levofloxacin, and polymyxin B to treat the patient aggressively. Aeromonas caviae infection is uncommon in juvenile acute lymphoblastic leukemia. Doctors should be aware of the likelihood of opportunistic infection during the post-chemotherapy bone marrow suppression period. We further conducted a review of the literature and performed a detailed analysis of Aeromonas infection in pediatric leukemia. It is becoming increasingly apparent that antibiotic is abused domestically and abroad, resulting in the sharp increase of MDR bacteria. In general, most of the Aeromonas isolates are susceptible to third- or fourth-generation cephalosporins, aminoglycosides, quinolones, and carbapenem, but drug-resistant strains are being reported increasingly. We summarized the drug resistance rate of Aeromonas caviae and Aeromonas hydrophila in China in the last 10 years. Early recognition and effective treatment will improve prognosis and reduce mortality.
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Affiliation(s)
- Yiling Dai
- Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Ju Gao
- Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Mingyan Jiang
- Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
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Mao LY, Wang Q, Lin H, Wang HN, Lei CW. Novel multidrug resistance genomic islands and transposon carrying blaVEB-1 identified in mcr-positive Aeromonas strains from raw meat in China. J Antimicrob Chemother 2024; 79:678-682. [PMID: 38319867 DOI: 10.1093/jac/dkae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVES To characterize the genetic environments of ESBL gene blaVEB-1 in mcr-positive Aeromonas strains from raw meat in China. METHODS Whole genomes of Aeromonas strains were sequenced using the Illumina or Nanopore platforms. Genetic environments of blaVEB-1 were analysed using the BLAST program. RESULTS The blaVEB-1 gene was detected in five Aeromonas strains carrying the mcr-7-like gene. WGS revealed that all blaVEB-1 genes were located on Aeromonas chromosome, and were carried by two novel different genomic islands named Aeromonas veronii genomic islands AveGI1 and AveGI2, as well as one transposon named Tn7690. AveGI1 is a new member of the Salmonella genomic island 1 family, incorporated into the 3'-end of mnmE (trmE). AveGI2 is a novel genomic island that has a size of 23 180 bp and is incorporated into the 3'-end of syd. The MDR regions of AveGI1 and AveGI2 are two different class 1 integrons containing 10 and five resistance genes, respectively. Tn7690 is a Tn1722 derivative containing In4-type integron and Tn5393, which harbours 10 resistance genes and integrates into different positions on the chromosomes of three strains with the capacity for mobility. CONCLUSIONS We report chromosomally located novel MDR genomic islands and transposon that carry blaVEB-1 in mcr-positive Aeromonas strains. These genetic elements may mediate the spread of blaVEB-1 in Aeromonas, and may also evolve by capturing new antimicrobial resistance genes or other mobile genetic elements.
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Affiliation(s)
- Ling-Ya Mao
- College of Life Sciences, Sichuan University, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, No. 29 Wangjiang Road, 610064 Chengdu, People's Republic of China
| | - Qin Wang
- College of Life Sciences, Sichuan University, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, No. 29 Wangjiang Road, 610064 Chengdu, People's Republic of China
| | - Heng Lin
- College of Life Sciences, Sichuan University, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, No. 29 Wangjiang Road, 610064 Chengdu, People's Republic of China
| | - Hong-Ning Wang
- College of Life Sciences, Sichuan University, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, No. 29 Wangjiang Road, 610064 Chengdu, People's Republic of China
| | - Chang-Wei Lei
- College of Life Sciences, Sichuan University, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, No. 29 Wangjiang Road, 610064 Chengdu, People's Republic of China
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Kaki R. A retrospective study of Aeromonas hydrophila infections at a university tertiary hospital in Saudi Arabia. BMC Infect Dis 2023; 23:671. [PMID: 37814215 PMCID: PMC10563259 DOI: 10.1186/s12879-023-08660-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/29/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Aeromonas hydrophila can cause a wide range of diseases and is mainly found in patients with underlying diseases. Globally the data on Aeromonas infections is limited, and no studies have been published about the situation in Saudi Arabia. The aim of this study was to investigate the risk factors, clinical presentation, treatment, and outcomes of Aeromonas infections in Saudi Arabia. METHODS A retrospective study was performed at a tertiary university hospital with 1000 beds in Jeddah, Saudi Arabia. All patients 14 years and older with Aeromonas-positive cultures between January 1, 2015, and December 31, 2022 were included. Patient information was extracted from the electronic health records, including patient demographics, comorbidities, presenting symptoms, source of infection, human immunodeficiency virus status, culture results and antimicrobial susceptibility, use of immunosuppressive medication, and 30-day mortality. RESULTS In total 24 patients were identified with Aeromonas hydrophila-positive cultures, 22 of which were males (91.7%), and most (75%) had hospital-acquired infections. The 30-day mortality was 20.8%. All Aeromonas cultures were susceptible to gentamicin, cefepime, and ciprofloxacin, while the majority were resistant to ceftazidime (83.3%) and meropenem (62.5%). The most common disease presentation was skin and soft tissue infection (33.3%), the most common clinical sign was fever (58.3%), and the most common symptom was abdominal pain (37.5%). Comorbidities were very common (median 3, range 1-7). Pitt bacteremia score (p < 0.001), Charlson weighted comorbidity index (p < 0.02), international normalized ratio (p < 0.005), and the number of comorbidity factors (p < 0.05) were all associated with 30-day mortality due to Aeromonas infection. The number of comorbidities had the best predictive value (83.3%) of 30-day mortality (p < 0.05, Odds ratio 3.253, 95% confidence interval: 1.088-9.729). CONCLUSIONS Aeromonas hydrophila is an important pathogen to consider in nosocomial infections. The number of comorbidities had the best predictive value of 30-day mortality. The susceptibility pattern of this organism indicates that, in Saudi Arabia, when an Aeromonas infection is suspected, treatment with quinolone along with other broad-spectrum antibiotics should be started until the culture and susceptibility results are known.
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Affiliation(s)
- Reham Kaki
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
- Department of Infectious Disease & Infection Control and Environmental Health, King Abdulaziz University Hospital, Jeddah, 22252, Saudi Arabia.
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Solís-Sánchez P, Fernández-Martínez M, Rodrigo-Calabia E, de Alegría-Puig CR. Chronic Diarrhea Due to Aeromonas hydrophila in an Immunosuppressed Patient with a Pancreas-Kidney Transplant. Pathogens 2023; 12:1151. [PMID: 37764959 PMCID: PMC10536218 DOI: 10.3390/pathogens12091151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
The genus Aeromonas belongs to the Aeromonadaceae family. A patient with a pancreas-kidney transplant had multiple episodes of abdominal sepsis after surgery. Aeromonas hydrophila was isolated in the ascitic and biliary fluid drains. After discharge, the patient had several diarrhea episodes, and A. hydrophila was isolated in four stool samples. We decided to test whether the one strain that we initially isolated in ascitic fluid was the same that appeared in the successive stool samples. Five isolates of A. hydrophila were found in the patient. Identification was performed using the MALDI-TOF system and confirmed via multiplex PCR. The analysis of the REP-PCR fingerprint patterns showed one cluster and confirmed that all isolates were related. We also demonstrated the virulent character of this species associated with genes encoding different toxins (act, alt, ast, hlyA, and aerA). The virulence of this species is associated with the expression of genes that encode different toxins, structural proteins, and metal-associated proteins. This case report highlights the severity of this disease, especially in immunocompromised patients, and its adequate treatment.
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Affiliation(s)
- Pablo Solís-Sánchez
- Internal Medicine Service, University Hospital Marqués de Valdecilla-IDIVAL, 39008 Santander, Spain
| | | | - Emilio Rodrigo-Calabia
- Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, 39008 Santander, Spain
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Yuwono C, Wehrhahn MC, Liu F, Zhang L. Enteric Aeromonas Infection: a Common Enteric Bacterial Infection with a Novel Infection Pattern Detected in an Australian Population with Gastroenteritis. Microbiol Spectr 2023; 11:e0028623. [PMID: 37378724 PMCID: PMC10433960 DOI: 10.1128/spectrum.00286-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Aeromonas species are emerging human enteric pathogens. However, they are currently not routinely detected in many diagnostic laboratories, and information regarding Aeromonas enteric infections detected using molecular methods is lacking. Here, we investigated the detection of Aeromonas species and four other enteric bacterial pathogens in 341,330 fecal samples from patients with gastroenteritis processed in a large Australian diagnostic laboratory between 2015 and 2019. These enteric pathogens were detected using quantitative real-time PCR (qPCR) methods. Furthermore, we compared the qPCR cycle threshold (CT) values obtained from fecal samples that tested positive for Aeromonas only by molecular detection with those of samples that tested positive by both molecular detection and bacterial isolation methods. Aeromonas species were found to be the second most common bacterial enteric pathogens among patients with gastroenteritis. We observed a unique pattern of three infection peaks for Aeromonas, which correlated with the age of the patients. Aeromonas species were the most common enteric bacterial pathogens in children younger than 18 months. Fecal samples that tested positive for Aeromonas only by molecular detection had significantly higher CT values than fecal samples that tested positive by both molecular detection and bacterial culture. In conclusion, our findings reveal that Aeromonas enteric pathogens exhibit an age-related three-peak infection pattern, distinguishing them from other enteric bacterial pathogens. Moreover, the high rate of Aeromonas enteric infection discovered in this study suggests that Aeromonas species should be routinely tested in diagnostic laboratories. Our data also show that combining qPCR with bacterial culture can enhance the detection of enteric pathogens. IMPORTANCE Aeromonas species are emerging human enteric pathogens. However, these species are currently not routinely detected in many diagnostic laboratories, and no studies have reported the detection of Aeromonas enteric infection using molecular methods. We investigated the presence of Aeromonas species and four other enteric bacterial pathogens in 341,330 fecal samples from patients with gastroenteritis using quantitative real-time PCR (qPCR) methods. Interestingly, we discovered that Aeromonas species were the second most common bacterial enteric pathogens in patients with gastroenteritis, exhibiting a novel infection pattern compared to those of other enteric pathogens. Furthermore, we found that Aeromonas species were the most prevalent enteric bacterial pathogens in children aged 6 to 18 months. Our data also revealed that qPCR methods exhibit higher sensitivity in detecting enteric pathogens compared to that of bacterial culture alone. Moreover, combining qPCR with bacterial culture enhances the detection of enteric pathogens. These findings emphasize the importance of Aeromonas species in public health.
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Affiliation(s)
- Christopher Yuwono
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | | | - Fang Liu
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | - Li Zhang
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
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Wang YD, Gong JS, Guan YC, Zhao ZL, Cai YN, Shan XF. OmpR (TCS response regulator) of Aeromonas veronii plays a major role in drug resistance, stress resistance and virulence by regulating biofilm formation. Microb Pathog 2023; 181:106176. [PMID: 37244492 DOI: 10.1016/j.micpath.2023.106176] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/25/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
Aeromonas veronii (A. veronii), a highly pathogenic bacteria with a wide range of hosts, widely exists in the environment of humans, animals and aquatic animals, and can cause a variety of diseases. In this study, the receptor regulator ompR in the envZ/ompR of two-component system was selected to construct a mutant strain (Δ ompR) and a complement strain (C-ompR) to explore the regulatory effect of ompR on the biological characteristics and virulence of TH0426. The results showed that the ability of biofilm formation and osmotic stress of TH0426 were significantly reduced (P < 0.001), the resistance to ceftriaxone and neomycin were slightly down-regulate when the ompR gene was deleted. At the same time, animal pathogenicity experiments showed that the virulence of TH0426 was significantly down-regulated (P < 0.001). These results indicated that ompR gene regulates the biofilm formation of TH0426, and regulates some biological characteristics of TH0426, including drug sensitivity, resistance to osmotic stress, and also affects its virulence.
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Affiliation(s)
- Ying-da Wang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, 130118, China
| | - Jin-Shuo Gong
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, 130118, China
| | - Yong-Chao Guan
- Institute of Comparative Medicine College of Veterinary Medicine, Yangzhou University, Yangzhou, China
| | - Ze-Lin Zhao
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, 130118, China
| | - Ya-Nan Cai
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, 130118, China.
| | - Xiao-Feng Shan
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, 130118, China.
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Hu X, Zhang H, Liu Y, Liu X, Qiao J, Ge H, Zhao J, Ma X, Chen M, Liu R. Genetic characterization and virulence determinants of multidrug-resistant NDM-1-producing Aeromonas caviae. Front Microbiol 2023; 13:1055654. [PMID: 36726560 PMCID: PMC9885098 DOI: 10.3389/fmicb.2022.1055654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
The emergence of carbapenemase significantly threatens public health. It is prevalent worldwide but rare in Aeromonas caviae. Unlike most bacterial species, A. caviae has two distinct flagella systems, which are closely related to biofilm formation. The ability to form biofilms on host tissues or inert surfaces constitutes an important cause of many persistent infections, which causes difficulties in clinical treatment. Here, we report on a multidrug-resistant (MDR) A. caviae carrying bla NDM-1 with a novel sequence type 1,416. The strong ability of biofilm formation of FAHZZU2447 was verified by a crystal violet assay. The resistome profile and location of the bla NDM-1 gene were determined by antimicrobial susceptibility testing, S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), and Southern blot analysis. Moreover, the strain underwent whole-genome sequencing to identify its genomic characteristics. In addition, the bla NDM-1 gene was located on a ∼243 kb plasmid with genetic context IS1R-bla NDM-1-ble-trpF-dsbD-hp-sul1-qacE. Phylogenetic analysis indicated the transmission of A. caviae in China, Japan, and Thailand. Our study aimed to elucidate the genomic features of bla NDM-1-producing A. caviae, thereby clarifying the distribution of A. caviae worldwide and emphasizing the harmfulness of biofilm formation to the clinic. Further comprehensive surveillance of this species is needed to control further dissemination.
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Affiliation(s)
- Xinjun Hu
- Department of Infectious Diseases, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, China,Xinjun Hu,
| | - Huanran Zhang
- Department of Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China,Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases of Zhejiang Province, Hangzhou, China
| | - Yi Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaojing Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China,Department of Structure and Morphology, Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
| | - Jie Qiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Haoyu Ge
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Junhui Zhao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaohan Ma
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China,School of Basic Medical Sciences, Beihua University, Jilin, China
| | - Mantao Chen
- Department of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China,Mantao Chen,
| | - Ruishan Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China,*Correspondence: Ruishan Liu,
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Detection of changes in biological characteristics of Aeromonas veronii TH0426 after deletion of lsrB gene by homologous recombination. Microb Pathog 2023; 174:105938. [PMID: 36526036 DOI: 10.1016/j.micpath.2022.105938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/11/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
Aeromonas veronii is a widespread pathogenic microorganism that can infect humans, animals, and a variety of aquatilia, at the same time, can cause diseases, mainly sepsis and ulcer syndrome. In this research, we first deleted the gene of lsrB's nucleotide sequences by homologous recombination. The results showed that the median lethal dose (LD50) of the mutant strain (ΔlsrB) for zebrafish was 1.28-times higher than that of the TH0426 strain. The toxicity of TH0426 to epithelioma papulosum cyprini (EPC) cells was 1.15-times and 1.64-times higher than that of ΔlsrB, 1 and 2 h after infection. The production ability of the biofilm of ΔlsrB decreased by 1.38-times, and the adhesion ability of ΔlsrB to EPC cells greatly decreased by 1.96-times than the TH0426. The result of motility detection pointed out that the swimming ability of ΔlsrB was down by 1.67-times. The results indicated that almost all of them lost their flagella after deleting the lsrB gene. In general, the virulence of TH0426 was reduced after deleting the lsrB gene. The final results point out that the lsrB gene of TH0426 is related to motility, biofilm formation, adhesion, and virulence.
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Song Y, Wang LF, Zhou K, Liu S, Guo L, Ye LY, Gu J, Cheng Y, Shen DX. Epidemiological characteristics, virulence potential, antimicrobial resistance profiles, and phylogenetic analysis of Aeromonas caviae isolated from extra-intestinal infections. Front Cell Infect Microbiol 2023; 13:1084352. [PMID: 36909720 PMCID: PMC9999030 DOI: 10.3389/fcimb.2023.1084352] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Objective Aeromonas caviae (A. caviae) is one of the major etiological agents in human intestinal infections reported to be associated with a broad spectrum of extra-intestinal infections with increasing incidence over recent years. Although previous studies have established its significance as a causative agent of both bloodstream and gastrointestinal infections, the characteristics of A. caviae that cause extra-intestinal infections remain unilluminated.In this single-center retrospective study, we investigated epidemiological characteristics, antimicrobial resistance genes and phenotypes, virulence genes, and phyloevolution of 47 clinical A. caviae isolated from patients with extra-intestinal infections from 2017 to 2020. Methods A. caviae strains were identified by biochemical tests and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF/MS), ultimately confirmed to species level by whole-genome sequencing (WGS). Antimicrobial resistance and virulence genes were identified using the Comprehensive Antibiotic Resistance Database (CARD) and the virulence factor database (VFDB), respectively. Phylogenetic analysis of 47 clinical strains was performed by combining with 521 A. caviae strains from NCBI database. Results A. caviae was an opportunistic pathogen in immunocompromised patients, especially those with underlying hepatobiliary diseases and malignancies. 19 out of 47 isolates were identified as multidrug resistance (MDR) strains. Piperacillin-tazobactam, levofloxacin, gentamicin, amikacin with a resistance rate of less than 10% remained as options to treat extra-intestinal infections. 24 out of 47 isolates exhibited non-susceptibility to cephalosporins and cephamycins, all of which carried β-lactamase gene, including bla MOX, bla PER-3, bla OXA, bla NDM, and bla CphA. Most stains (98%, 46/47) carried at least one of the virulence genes, but extra-intestinal infections had a low mortality rate. Phylogenetic analysis indicated the risk of nosocomial transmission but revealed no outbreak. However, the emergence of MDR and β-lactamase resistance genes in extra-intestinal isolates of A. caviae is becoming an increasing risk to public health and requires attention. Conclusions This study strengthen our understanding of A.caviae isolated from extra-intestinal infections. It may contribute to the management of extra-intestinal infections as well as the prevention and control of drug resistance.
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Affiliation(s)
- Yang Song
- Department of Clinical Laboratory, Medical School of Chinese PLA, Beijing, China
| | - Li-feng Wang
- Department of Clinical Laboratory, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Kuai Zhou
- Department of Clinical Laboratory, Xuanhan People’s Hospital, Xuanhan, Sichuan, China
| | - Shuang Liu
- Department of Clinical Laboratory, Hainan Modern Women and Children’s Hospital, Haikou, China
| | - Ling Guo
- Department of Clinical Laboratory, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Li-yan Ye
- Department of Clinical Laboratory, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiang Gu
- Department of Clinical Microbiology and Immunology, College of Pharmacy and Medical Laboratory, Army Medical University, Chongqing, China
| | - Yan Cheng
- Department of Basic Medical Laboratory, The 980th Hospital of the PLA Joint Logistical Support Force, Bethune International Peace Hospital, Shijiazhuang, China
- *Correspondence: Ding-xia Shen, ; Yan Cheng,
| | - Ding-xia Shen
- Department of Clinical Laboratory, Medical School of Chinese PLA, Beijing, China
- Department of Clinical Laboratory, First Medical Center of Chinese PLA General Hospital, Beijing, China
- *Correspondence: Ding-xia Shen, ; Yan Cheng,
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Pessoa RBG, de Oliveira WF, Correia MTDS, Fontes A, Coelho LCBB. Aeromonas and Human Health Disorders: Clinical Approaches. Front Microbiol 2022; 13:868890. [PMID: 35711774 PMCID: PMC9195132 DOI: 10.3389/fmicb.2022.868890] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
The genus Aeromonas comprises more than 30 Gram-negative bacterial species and naturally inhabitants from aquatic environments. These microorganisms, commonly regarded as pathogens of fish and several other animals, have been gaining prominence on medical trial due to its ability to colonize and infect human beings. Besides water, Aeromonas are widely spreaded on most varied sources like soil, vegetables, and food; Although its opportunistic nature, they are able to cause infections on immunocompromised or immunocompetent patients. Aeromonas species regarded as potential human pathogens are usually A. hydrophila, A. caviae, and A. veronii biovar sobria. The main clinical manifestations are gastrointestinal tract disorders, wound, and soft tissue infections, as well as septicemia. Regarding to antibiotic responses, the bacteria present a diversified susceptibility profile and show inherence resistance to ampicillin. Aeromonas, as an ascending genus in microbiology, has been carefully studied aiming comprehension and development of methods for detection and medical intervention of infectious processes, not fully elucidated in medicine. This review focuses on current clinical knowledge related to human health disorders caused by Aeromonas to contribute on development of efficient approaches able to recognize and impair the pathological processes.
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Affiliation(s)
| | - Weslley Felix de Oliveira
- Departamento de Bioquímica, Centro de Biociências, Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Adriana Fontes
- Departamento de Biofísica e Radiobiologia, Centro de Biociências, Universidade Federal de Pernambuco, Recife, Brazil
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Chen YW, Su SL, Li CW, Tsai CS, Lo CL, Syue LS, Li MC, Lee CC, Lee NY, Ko WC, Chen PL. Pancreaticobiliary Cancers and Aeromonas Isolates Carrying Type Ⅲ Secretion System Genes ascF-ascG Are Associated With Increased Mortality: An Analysis of 164 Aeromonas Infection Episodes in Southern Taiwan. Front Cell Infect Microbiol 2021; 11:749269. [PMID: 34737976 PMCID: PMC8562565 DOI: 10.3389/fcimb.2021.749269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
This prospective study aimed to investigate the clinical and microbiological characteristics of different Aeromonas species. Clinical isolates of Aeromonas species between 2016 to 2018 were collected in a university hospital in southern Taiwan. The species was determined by rpoD or gyrB sequencing. A total of 222 Aeromonas isolates from 160 patients in 164 episodes were identified. The crude in-hospital mortality was 17.2%. The most frequently isolated species was Aeromonas veronii (30.6%), followed by A. caviae (24.8%), A. hydrophila (23%), and A. dhakensis (16.7%). The major clinical manifestations were primary bacteremia (31.1%), skin and soft tissue infection (22.6%), and biliary tract infection (18.3%). The most common underlying diseases were malignancy (45.1%), diabetes mellitus (27.4%), and liver cirrhosis or chronic hepatitis (26.2%). A. hydrophila and A. dhakensis predominated in the skin and soft tissue infection (p<0.0001), whereas A. vernoii and A. caviae prevailed in primary bacteremia and biliary tract infections (p=0.012). Pneumonia, malignancy, and ascF-ascG genotype were independent factors associated with mortality. Ertapenem susceptibility was decreased in A. sobria (42.9%), A. veronii (66.7%), A. dhakensis (73%), and A. hydrophila (84.3%). Cefotaxime resistance was found in 30.9% of A. caviae and 18.9% of A. dhakensis isolates, much more prevalent than the other species. The metallo-β-lactamase blaCphA was almost invariably present in A. dhakensis, A. hydrophila, and A. veronii (100%, 100% and 89.9%, respectively). Amp-C β-lactamases such as blaMOX and blaAQU-1 were identified in all A. caviae and 91.9% of A. dhakensis isolates. Cefepime, fluoroquinolones and tigecycline showed good in vitro activity against aeromonads.
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Affiliation(s)
- Ying-Wen Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shu-Li Su
- Diagnostic Microbiology and Antimicrobial Resistance Laboratory, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Wen Li
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chin-Shiang Tsai
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Lung Lo
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Shan Syue
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Min-Chi Li
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Chi Lee
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Yao Lee
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Lin Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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12
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Jie TTZ, Shelat VG. Aeromonas caviae and Aeromonas veronii Causing Acute Cholecystitis. Surg Infect (Larchmt) 2021; 22:873-874. [PMID: 33533674 DOI: 10.1089/sur.2020.474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
| | - Vishal G Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore
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Valcarcel B, De-la-Cruz-Ku G, Malpica L, Enriquez-Vera D. Clinical features and outcome of Aeromonas sobria bacteremia in pediatric and adult patients with hematologic malignancies: A single-center retrospective study in Peru. PLoS One 2021; 16:e0255910. [PMID: 34379680 PMCID: PMC8357087 DOI: 10.1371/journal.pone.0255910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Background Previous studies have found that healthcare-associated bacteremia (HAB) by Aeromonas species is associated with mortality. However, there is limited data on this outcome in patients with hematologic malignancies. This study aimed to identify the clinical features of patients with malignant hematologic diseases diagnosed with Aeromonas sobria bacteremia and to evaluate whether the type of bacteremia, community-acquired bacteremia (CAB) or HAB, is associated with mortality. Methods We retrospectively reviewed the clinical records of pediatric and adult patients between January 2000 and December 2017. Clinical characteristics were compared between CAB and HAB. Additionally, we stratified based on age group. Survival outcomes were assessed with Kaplan-Meier curves and a multivariate Cox regression analysis. Results A total of 37 patients (median age 24 years) were identified; 23 (62%) had HAB and 14 (38%) had CAB. Overall, the most common presenting symptom was abdominal pain (41%). Acute lymphoblastic leukemia (n = 12/15, 80%) and acute myeloid leukemia (n = 8/22, 36%) were the primary hematologic malignancies in pediatric and adult patients, respectively. CAB patients had worse overall survival (OS) rates at 30 days in all (43% versus HAB 91%, p = 0.006) and adult patients (30% versus HAB 92%, p = 0.002). Cox regression analysis found that quick Sequential Organ Failure Assessment and CAB were statistically significant factors associated with mortality. Low antimicrobial-resistant was noted, except for ciprofloxacin (n = 5/37, 14%). Conclusion Our study found a worse OS among patients with hematologic malignancies and CAB by Aeromonas sobria. Our results suggest that patients with CAB present with a worse disease severity. These findings should aid clinicians to determine the survival prognosis in this population.
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Affiliation(s)
- Bryan Valcarcel
- Facultad de Ciencias de la Salud, Escuela de Medicina Humana, Universidad Científica del Sur, Lima, Perú
- * E-mail:
| | - Gabriel De-la-Cruz-Ku
- Facultad de Ciencias de la Salud, Escuela de Medicina Humana, Universidad Científica del Sur, Lima, Perú
| | - Luis Malpica
- Division of Cancer Medicine, Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Daniel Enriquez-Vera
- Departmento de Hematología y Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
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Yuwono C, Wehrhahn MC, Liu F, Riordan SM, Zhang L. The Isolation of Aeromonas Species and Other Common Enteric Bacterial Pathogens from Patients with Gastroenteritis in an Australian Population. Microorganisms 2021; 9:microorganisms9071440. [PMID: 34361876 PMCID: PMC8306920 DOI: 10.3390/microorganisms9071440] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/16/2022] Open
Abstract
Aeromonas species are emerging human enteric pathogens. However, systematic analysis of Aeromonas species infection in human gastroenteritis in comparison with other enteric bacterial pathogens in the Australian population is lacking. Here we analysed the isolation of Aeromonas species and other bacterial pathogens in five consecutive years (2015–2019) from 375,842 stool samples of patients with gastroenteritis in a large Australian diagnostic laboratory and identified a subset (48 isolates) of Aeromonas isolates to species level, using multilocus phylogenetic analysis. Aeromonas species were the third most common bacterial pathogens, following Campylobacter and Salmonella species. Aeromonas infection rate was significantly correlated with increasing age (p < 0.001). Aeromonas species were more often isolated in warm seasons and in males than females (p < 0.001). Five Aeromonas species were identified. Most of the infections were from three species, namely Aeromonas veronii (52%), Aeromonas caviae (27%) and Aeromonas hydrophila (12.5%). The majority of patients with Aeromonas species infection did not have a documented overseas travel history. The findings from this study support the importance of Aeromonas species in human gastroenteritis and suggest that the sources of Aeromonas infection in Australian patients should be further investigated.
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Affiliation(s)
- Christopher Yuwono
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia; (C.Y.); (F.L.)
| | - Michael C. Wehrhahn
- Douglass Hanly Moir Pathology, 14 Giffnock Ave, Macquarie Park, NSW 2113, Australia
- Correspondence: (M.C.W.); (L.Z.)
| | - Fang Liu
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia; (C.Y.); (F.L.)
| | - Stephen M. Riordan
- Gastrointestinal and Liver Unit, Prince of Wales Hospital, University of New South Wales, Sydney, NSW 2031, Australia;
| | - Li Zhang
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia; (C.Y.); (F.L.)
- Correspondence: (M.C.W.); (L.Z.)
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15
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The Great ESKAPE: Exploring the Crossroads of Bile and Antibiotic Resistance in Bacterial Pathogens. Infect Immun 2020; 88:IAI.00865-19. [PMID: 32661122 DOI: 10.1128/iai.00865-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Throughout the course of infection, many pathogens encounter bactericidal conditions that threaten the viability of the bacteria and impede the establishment of infection. Bile is one of the most innately bactericidal compounds present in humans, functioning to reduce the bacterial burden in the gastrointestinal tract while also aiding in digestion. It is becoming increasingly apparent that pathogens successfully resist the bactericidal conditions of bile, including bacteria that do not normally cause gastrointestinal infections. This review highlights the ability of Enterococcus, Staphylococcus, Klebsiella, Acinetobacter, Pseudomonas, Enterobacter (ESKAPE), and other enteric pathogens to resist bile and how these interactions can impact the sensitivity of bacteria to various antimicrobial agents. Given that pathogen exposure to bile is an essential component to gastrointestinal transit that cannot be avoided, understanding how bile resistance mechanisms align with antimicrobial resistance is vital to our ability to develop new, successful therapeutics in an age of widespread and increasing antimicrobial resistance.
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16
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Gu XX, Zhang MP, Zhao YF, Huang GM. Clinical and microbiological characteristics of patients with biliary disease. World J Gastroenterol 2020; 26:1638-1646. [PMID: 32327912 PMCID: PMC7167412 DOI: 10.3748/wjg.v26.i14.1638] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Biliary diseases are common digestive system disorders which may combine with biliary tract infection such as cholecystitis or cholangitis. Thus, rapid identification of the bacteria and their antibiotic susceptibility profiles are crucial for reducing the mortality of patients with biliary tract infection. AIM To identify bacterial species and antibiotic susceptibility for antibacterial therapy and analyze bile cultivation risk factors for increasing detection rates. METHODS This retrospective study was conducted from July 2008 to July 2017. In total, 1339 bile samples which were collected during therapeutic endoscopic retrograde cholangiopan-creatography or percutaneous transhepatic cholangiodrainage or other biliary surgeries or biliary drainage were obtained to characterize pathogen spectra, antibiotic susceptibility, and clinical features. Clinical data including age, sex, comorbidities, clinical symptoms, protopathies, and history of biliary tract diseases and surgeries were collated from hospital medical records. Species identification and initial drug susceptibility were further identified by biochemical characterization using the VITEK 2 Compact test. RESULTS Positive microbiological findings were observed in 738 samples. The most frequently encountered strains were gram-negative bacteria (74.94%), including Escherichia coli (37.78%), Pseudomonas aeruginosa (8.96%), and Klebsiella pneumoniae (10.29%). Bile bacteria were largely sensitive to carbapenems, piperacillin/tazobactam, and gentamicin. Gram-negative strains had low susceptibility to ceftriaxone, quinolones and ampicillin. Almost the same micro-organisms were present in patients with malignant and benign diseases. The number of samples with Klebsiella pneumoniae in the bile culture were significantly different between patients with malignant and benign diseases (55 vs 30; P = 0.019). Age (P < 0.001), fever (P < 0.001), history of biliary tract diseases and surgeries (both P < 0.001), benign disease (P = 0.002), and the comorbidity chronic renal insufficiency (P = 0.007) affected the positive rates of the bile samples. CONCLUSION Gram-negative bacteria were the most commonly isolated biliary bacteria. We determined the major factors associated with positive detection rates. Microbiological analysis of bile samples allowed accurate antibiotic treatments.
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Affiliation(s)
- Xue-Xiang Gu
- Department of Gastroenterology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian 223001, Jiangsu Province, China
| | - Meng-Pei Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Yan-Feng Zhao
- Center of Laboratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Guang-Ming Huang
- Department of Gastroenterology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
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17
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Aeromonas Isolates from Fish and Patients in Tainan City, Taiwan: Genotypic and Phenotypic Characteristics. Appl Environ Microbiol 2019; 85:AEM.01360-19. [PMID: 31420346 DOI: 10.1128/aem.01360-19] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 08/12/2019] [Indexed: 11/20/2022] Open
Abstract
The present study aimed to isolate Aeromonas from fish sold in the markets as well as in sushi and seafood shops and compare their virulence factors and antimicrobial characteristics with those of clinical isolates. Among the 128 fish isolates and 47 clinical isolates, Aeromonas caviae, A. dhakensis, and A. veronii were the principal species. A. dhakensis isolates carried at least 5 virulence genes, more than other Aeromonas species. The predominant genotype of virulence genes was hlyA lip alt col ela in both A. dhakensis and A. hydrophila isolates, alt col ela in A. caviae isolates, and act in A. veronii isolates. A. dhakensis, A. hydrophila, and A. veronii isolates more often exhibited hemolytic and proteolytic activity and showed greater virulence than A. caviae isolates in Caenorhabditis elegans and the C2C12 cell line. However, the link between the genotypes and phenotypes of the studied virulence genes in Aeromonas species was not evident. Among the four major clinical Aeromonas species, nearly all (99.0%) A. dhakensis, A. hydrophila, and A. veronii isolates harbored bla CphA, which encodes a carbapenemase, but only a minority (6.7%, 7/104) were nonsusceptible to carbapenem. Regarding AmpC β-lactamase genes, bla AQU-1 was exclusively found in A. dhakensis isolates, and bla MOX3 was found only in A. caviae isolates, but only 7.6% (n = 6) of the 79 Aeromonas isolates carrying bla AQU-1 or bla MOX3 exhibited a cefotaxime resistance phenotype. In conclusion, fish Aeromonas isolates carry a variety of combinations of virulence and β-lactamase resistance genes and exhibit virulence phenotypes and antimicrobial resistance profiles similar to those of clinical isolates.IMPORTANCE Aeromonas species can cause severe infections in immunocompromised individuals upon exposure to virulent pathogens in the environment, but the characteristics of environmental Aeromonas species remain unclear. Our study showed that several pathogenic Aeromonas species possessing virulence traits and antimicrobial resistance similar to those of Aeromonas isolates causing clinical diseases were present in fish intended for human consumption in Tainan City, Taiwan.
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Ran C, Qin C, Xie M, Zhang J, Li J, Xie Y, Wang Y, Li S, Liu L, Fu X, Lin Q, Li N, Liles MR, Zhou Z. Aeromonas veroniiand aerolysin are important for the pathogenesis of motile aeromonad septicemia in cyprinid fish. Environ Microbiol 2018; 20:3442-3456. [DOI: 10.1111/1462-2920.14390] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/01/2018] [Accepted: 08/17/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Chao Ran
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Chubin Qin
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Mingxu Xie
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Jinxiong Zhang
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Jie Li
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Yadong Xie
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Yibing Wang
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Shuning Li
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
| | - Lihui Liu
- Chinese Academy of Fishery Sciences, Key Laboratory of Fishery Drug Development, Ministry of Agriculture, Key Laboratory of Aquatic Animal Immune Technology; Pearl River Fisheries Research Institute; Guangdong Province, Guangzhou 510380 People's Republic of China
| | - Xiaozhe Fu
- Chinese Academy of Fishery Sciences, Key Laboratory of Fishery Drug Development, Ministry of Agriculture, Key Laboratory of Aquatic Animal Immune Technology; Pearl River Fisheries Research Institute; Guangdong Province, Guangzhou 510380 People's Republic of China
| | - Qiang Lin
- Chinese Academy of Fishery Sciences, Key Laboratory of Fishery Drug Development, Ministry of Agriculture, Key Laboratory of Aquatic Animal Immune Technology; Pearl River Fisheries Research Institute; Guangdong Province, Guangzhou 510380 People's Republic of China
| | - Ningqiu Li
- Chinese Academy of Fishery Sciences, Key Laboratory of Fishery Drug Development, Ministry of Agriculture, Key Laboratory of Aquatic Animal Immune Technology; Pearl River Fisheries Research Institute; Guangdong Province, Guangzhou 510380 People's Republic of China
| | - Mark R. Liles
- Department of Biological Sciences; Auburn University; Auburn AL 36849 USA
| | - Zhigang Zhou
- Key Laboratory for Feed Biotechnology of the Ministry of Agriculture; Feed Research Institute, Chinese Academy of Agricultural Sciences; Beijing 100081 People's Republic of China
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Clinical significance and outcome of Aeromonas spp. infections among 204 adult patients. Eur J Clin Microbiol Infect Dis 2017; 36:1393-1403. [PMID: 28258303 PMCID: PMC7102105 DOI: 10.1007/s10096-017-2945-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/07/2017] [Indexed: 01/29/2023]
Abstract
The objectives of this investigation were to analyze the clinical patterns, risk groups, prognostic factors, and mortality of infections caused by Aeromonas spp. This was a retrospective study of adult patients with Aeromonas spp. isolates attended at the Hospital del Mar in Barcelona, Spain, between January 2006 and December 2012. Epidemiological data, antimicrobial susceptibility, clinical patterns, underlying illnesses, type of infection, admission to the intensive care unit (ICU), number of episodes, coinfection, antimicrobial therapy, and evolution were analyzed. A total of 221 clinical samples from 204 patients were positive for Aeromonas spp. The mean age of the patients was 67.6 years. The main clinical form of presentation was gastrointestinal (78.4%). Malignancy was the main risk group in 69 (33.8%) patients, and 48 (23.5%) were previously healthy. Twenty-one patients (10.3%) were admitted to the ICU. Infections were acquired in the hospital in 52.5% of the patients, and 28.9% were polymicrobial. The overall mortality (after 1 year of follow-up from the first positive culture) was 26.5%. Univariate analysis identified an association between increased mortality and the following variables: age ≥80 years, hospitalization, admission to the ICU, malignancy, extraintestinal infection, and appropriate antimicrobial therapy. In the multivariate analysis, age ≥80 years [odds ratio (OR), 4.37 [95% confidence interval (CI), 1.68-11.35; p = 0.002]], admission to the ICU (OR, 6.59 [95% CI, 2.17-19.99; p = 0.001]), and malignancy (OR, 3.62 [95% CI, 1.32-9.90; p = 0.012]) were significantly associated with mortality. Aeromonas infections are mainly gastrointestinal. The 1-year follow-up mortality rate was high. Old age (age ≥80 years), admission to the ICU, and malignancy were identified as independent risk factors for mortality.
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Alves JR, Silva RDC, Guerra SCP, Freitas TTD, Souza DLBD, Amico EC. MICROBIOLOGICAL ANALYSIS OF BILE IN PATIENTS WITH BENIGN AND MALIGNANT BILIOPANCREATIC DISEASES AND ITS CONSEQUENCES. ARQUIVOS DE GASTROENTEROLOGIA 2016; 53:156-62. [PMID: 27438420 DOI: 10.1590/s0004-28032016000300007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 03/22/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Bactibilia has several consequences to human health. OBJETIVE Assessing the bile microbiology of patients with biliopancreatic diseases in order to identify bacteria and their possible infectious complications. METHODS Retrospective study of 30 bile culture samples from patients with benign and malignant biliopancreatic diseases. The samples were assessed to set the bile microbiological flora and to search for its possible link with comorbidity, carcinogenesis and postoperative infectious complications. RESULTS Thirty bile samples from patients at mean age ≈57.7 years, mostly female (n=18), were assessed. Bactibilia was found in 12 cases, mostly in patients with benign diseases (n=8), older than 50 years (n=23) and female (n=10). Adenocarcinoma of the duodenal papilla (n=9) and cholelithiasis (n=8) were the most common diseases. Escherichia coli (n=5) and Klebsiella sp (n=3) were predominantly found in patients with benign diseases; and Klebsiella sp (n=2) and Streptococcus sp (n=2) were prevalent in cancer patients. There were postoperative infectious complications in seven cases, five of them in bactibilia-associated patients (P=0.084). CONCLUSION Bactibilia was found in 12 samples and Escherichia coli and Klebsiella sp were most often identified in patients with benign diseases, as well as Streptococcus sp and Klebsiella sp in cancer patients. There was a trend of higher postoperative infectious complication incidence in patients with bactibilia.
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Affiliation(s)
- José Roberto Alves
- Departamento de Medicina Integrada, Faculdade de Medicina, Universidade Federal do Rio Grande do Norte, RN, Brasil
| | | | | | | | | | - Enio Campos Amico
- Departamento de Medicina Integrada, Faculdade de Medicina, Universidade Federal do Rio Grande do Norte, RN, Brasil
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Wang JB, Lin NT, Tseng YH, Weng SF. Genomic Characterization of the Novel Aeromonas hydrophila Phage Ahp1 Suggests the Derivation of a New Subgroup from phiKMV-Like Family. PLoS One 2016; 11:e0162060. [PMID: 27603936 PMCID: PMC5014404 DOI: 10.1371/journal.pone.0162060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/16/2016] [Indexed: 12/15/2022] Open
Abstract
Aeromonas hydrophila is an opportunistic pathogenic bacterium causing diseases in human and fish. The emergence of multidrug-resistant A. hydrophila isolates has been increasing in recent years. In this study, we have isolated a novel virulent podophage of A. hydrophila, designated as Ahp1, from waste water. Ahp1 has a rapid adsorption (96% adsorbed in 2 min), a latent period of 15 min, and a burst size of 112 PFU per infected cell. At least eighteen Ahp1 virion proteins were visualized in SDS-polyacrylamide gel electrophoresis, with a 36-kDa protein being the predicted major capsid protein. Genome analysis of Ahp1 revealed a linear doubled-stranded DNA genome of 42,167 bp with a G + C content of 58.8%. The genome encodes 46 putative open reading frames, 5 putative phage promoters, and 3 transcriptional terminators. Based on high degrees of similarity in overall genome organization and among most of the corresponding ORFs, as well as phylogenetic relatedness among their DNAP, RNAP and major capsid proteins, we propose a new subgroup, designated Ahp1-like subgroup. This subgroup contains Ahp1 and members previously belonging to phiKMV-like subgroup, phiAS7, phi80-18, GAP227, phiR8-01, and ISAO8. Since Ahp1 has a narrow host range, for effective phage therapy, different phages are needed for preparation of cocktails that are capable of killing the heterogeneous A. hydrophila strains.
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Affiliation(s)
- Jian-Bin Wang
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
| | - Nien-Tsung Lin
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
- Master Program in Microbiology and Immunology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Yi-Hsiung Tseng
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
- Institute of Molecular Biology, National Chung Hsing University, Taichung 402, Taiwan
- * E-mail: (YHT); (SFW)
| | - Shu-Fen Weng
- Institute of Molecular Biology, National Chung Hsing University, Taichung 402, Taiwan
- * E-mail: (YHT); (SFW)
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Sinclair HA, Heney C, Sidjabat HE, George NM, Bergh H, Anuj SN, Nimmo GR, Paterson DL. Genotypic and phenotypic identification of Aeromonas species and CphA-mediated carbapenem resistance in Queensland, Australia. Diagn Microbiol Infect Dis 2016; 85:98-101. [DOI: 10.1016/j.diagmicrobio.2016.02.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/03/2016] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
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Pileflebitis por Aeromonas caviae secundaria a colecistitis aguda. Enferm Infecc Microbiol Clin 2016; 34:70-2. [DOI: 10.1016/j.eimc.2015.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/14/2015] [Accepted: 04/14/2015] [Indexed: 11/18/2022]
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Chen CM, Lai CC, Chao CM. Port-related Aeromonas bacteremia. Infect Control Hosp Epidemiol 2015; 35:1204-6. [PMID: 25111938 DOI: 10.1086/677644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Chin-Ming Chen
- Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; and Department of Critical Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan
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Castelo-Branco DDSCM, Guedes GMDM, Brilhante RSN, Rocha MFG, Sidrim JJC, Moreira JLB, Cordeiro RDA, Sales JA, Riello GB, de Alencar LP, Paiva MDAN, Vasconcelos DC, de Menezes ISB, de Ponte YB, Sampaio CMDS, Monteiro AJ, Bandeira TDJPG. Virulence and antimicrobial susceptibility of clinical and environmental strains of Aeromonas spp. from northeastern Brazil. Can J Microbiol 2015; 61:597-601. [PMID: 26103449 DOI: 10.1139/cjm-2015-0107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aims of the present study were to isolate and identify clinical and environmental strains of Aeromonas spp. by means of biochemical tests and the automated method VITEK 2 and to investigate the presence of the virulence genes cytotoxic enterotoxin (act), hemolysin (asa-1), and type III secretion system (ascV), and also the in vitro antimicrobial susceptibility of the strains. From the clinical isolates, 19 Aeromonas hydrophila, 3 Aeromonas veronii bv. sobria, and 1 Aeromonas caviae were identified, while from the environmental strains, 11 A. hydrophila, 22 A. veronii bv. sobria, 1 A. veronii bv. veronii, and 1 A. caviae were recovered. The gene act was detected in 69.5% of clinical isolates, asa-1 in 8.6%, and ascV in 34.7%. In the environmental strains, the detection rates were 51.4%, 45.7%, and 54.2% for the genes act, asa-1, and ascV, respectively. Resistance to amoxicillin-clavulanate and piperacillin-tazobactam was observed in 15 and 3 clinical strains, respectively, and resistance to ceftazidime, meropenem, imipenem, ciprofloxacin, and trimethoprim-sulfamethoxazole was observed in 1 strain for each drug. Resistance to amoxicillin-clavulanate and piperacillin-tazobactam was detected in 17 and 1 environmental strain, respectively. Higher resistance percentages were observed in clinical strains, but environmental strains also showed this phenomenon and presented a higher detection rate of virulence genes. Thus, it is important to monitor the antimicrobial susceptibility and pathogenic potential of the environmental isolates.
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Affiliation(s)
| | - Glaucia Morgana de Melo Guedes
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Raimunda Sâmia Nogueira Brilhante
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Marcos Fábio Gadelha Rocha
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.,b School of Veterinary Medicine, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, Ceará, Brazil
| | - José Júlio Costa Sidrim
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - José Luciano Bezerra Moreira
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Rossana de Aguiar Cordeiro
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Jamille Alencar Sales
- b School of Veterinary Medicine, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, Ceará, Brazil
| | - Giovanna Barbosa Riello
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Lucas Pereira de Alencar
- b School of Veterinary Medicine, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, Ceará, Brazil
| | - Manoel de Araújo Neto Paiva
- b School of Veterinary Medicine, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, Ceará, Brazil
| | - David Caldas Vasconcelos
- c Department of Pathology and Legal Medicine, Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Isis Sousa Bezerra de Menezes
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Yago Brito de Ponte
- b School of Veterinary Medicine, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, Ceará, Brazil
| | - Célia Maria de Souza Sampaio
- b School of Veterinary Medicine, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, Ceará, Brazil
| | - André Jalles Monteiro
- d Department of Statistics and Applied Mathematics, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Tereza de Jesus Pinheiro Gomes Bandeira
- a Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.,e School of Medicine, Christus College - Unichristus, Fortaleza, Ceará, Brazil.,f Diagnósticos da América SA (DASA), Fortaleza, Ceará, Brazil
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Virulence diversity among bacteremic Aeromonas isolates: ex vivo, animal, and clinical evidences. PLoS One 2014; 9:e111213. [PMID: 25375798 PMCID: PMC4222899 DOI: 10.1371/journal.pone.0111213] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/09/2014] [Indexed: 11/26/2022] Open
Abstract
Background The objective of this study was to compare virulence among different Aeromonas species causing bloodstream infections. Methodology/Principal Findings Nine of four species of Aeromonas blood isolates, including A. dhakensis, A. hydrophila, A. veronii and A. caviae were randomly selected for analysis. The species was identified by the DNA sequence matching of rpoD. Clinically, the patients with A. dhakensis bacteremia had a higher sepsis-related mortality rate than those with other species (37.5% vs. 0%, P = 0.028). Virulence of different Aeromonas species were tested in C. elegans, mouse fibroblast C2C12 cell line and BALB/c mice models. C. elegans fed with A. dhakensis and A. caviae had the lowest and highest survival rates compared with other species, respectively (all P values <0.0001). A. dhakensis isolates also exhibited more cytotoxicity in C2C12 cell line (all P values <0.0001). Fourteen-day survival rate of mice intramuscularly inoculated with A. dhakensis was lower than that of other species (all P values <0.0001). Hemolytic activity and several virulence factor genes were rarely detected in the A. caviae isolates. Conclusions/Significance Clinical data, ex vivo experiments, and animal studies suggest there is virulence variation among clinically important Aeromonas species.
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Aeromonas stool isolates from individuals with or without diarrhea in southern Taiwan: Predominance of Aeromonas veronii. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 48:618-24. [PMID: 25440979 DOI: 10.1016/j.jmii.2014.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/04/2014] [Accepted: 08/07/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although aeromonads are important pathogens causing invasive infections in southern Taiwan, Aeromonas-associated intestinal infections have been rarely mentioned. PURPOSE The aim of this study was to understand the frequency of isolation and clinical significance of aeromonads recovered from adult stool samples in southern Taiwan. METHODS During a 15-month study period, 514 adults with diarrhea and 167 asymptomatic controls were prospectively screened for the presence of aeromonads in stools. The identity of Aeromonas species was determined by the rpoD sequencing. Clinical information was retrieved from medical records, and in vitro cytotoxicity assay and polymerase chain reaction detection of putative virulent genes were performed. RESULTS Thirteen (2.5 %) of 514 diarrheal patients and six (3.6%) of 167 asymptomatic controls had Aeromonas isolates in their stools. Of 11 diarrheal patients with available clinical information, Aeromonas veronii, the predominant species, was noted in six patients, and another potential enteropathogen was present in four patients. The cytotoxicity of A. veronii isolates to the HT-29 cell line was more potent in the isolates from diarrheal patients than those from asymptomatic controls (p = 0.015). The cytotoxicity of A. veronii isolates was more potent than that of A. caviae from symptomatic patients (p = 0.001). Putative virulence markers, including AHCYTONE, ascV, ascF-ascG, and aexT, were detected exclusively in A. veronii. The presence of the ascV gene was associated with cytotoxicity in A. veronii isolates. All Aeromonas isolates were susceptible to varied antimicrobial agents, except ampicillin/sulbactam. CONCLUSION A. veronii is the predominant species in stools from individuals with or without diarrhea in southern Taiwan.
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Chao CM, Lai CC, Huang SH, Lin SH. Comparison of skin and soft tissue infections caused by Vibrio and Aeromonas species. Surg Infect (Larchmt) 2014; 15:576-80. [PMID: 25126885 DOI: 10.1089/sur.2013.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The aim of this study was to compare skin and soft tissue infections (SSTIs) caused by Vibrio and Aeromonas spp. METHODS Patients whose cultures yielded Vibrio or Aeromonas spp. from July 2004 to June 2010 were retrieved from the computerized database of the bacteriology laboratory at a hospital in southern Taiwan. The medical records were reviewed for all patients fulfilling the criteria of monomicrobial Vibrio or Aeromonas spp. SSTIs and the clinical characteristics were analyzed. RESULTS During the study period, there were 28 patients with Vibrio spp. and 26 patients with Aeromonas spp., respectively. Vibrio vulnificus (n=25) and A. hydrophila (n=14) were the most common spp. There were no significant differences in age, gender, underlying diseases between patients with Vibrio and Aeromonas SSTIs. In comparison to Aeromonas SSTIs, more patients with Vibrio SSTIs were complicated with acute respiratory failure (39.3% vs. 3.8%, p=0.002) and required intensive care unit admission (50.0% vs. 7.7%, p<0.001). Furthermore, patients with Aeromonas SSTIs had a higher likelihood of discharge alone within 30 days than Vibrio SSTIs (p=0.049). The difference in in-hospital mortality among the two groups was not statistically significant (p=0.11). CONCLUSION Both Aeromonas and Vibrio spp. cause SSTIs in southern Taiwan and the pathogenicity of Vibrio spp. might be higher than Aeromonas spp.
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Affiliation(s)
- Chien-Ming Chao
- 1 Department of Intensive Care Medicine, Chi-Mei Medical Center , Liouying, Tainan, Taiwan
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Matrix-assisted laser desorption ionization-time of flight mass spectrometry can accurately differentiate Aeromonas dhakensis from A. hydrophila, A. caviae, and A. veronii. J Clin Microbiol 2014; 52:2625-8. [PMID: 24759711 DOI: 10.1128/jcm.01025-14] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Among 217 Aeromonas isolates identified by sequencing analysis of their rpoB genes, the accuracy rates of identification of A. dhakensis, A. hydrophila, A. veronii, and A. caviae were 96.7%, 90.0%, 96.7%, and 100.0%, respectively, by the cluster analysis of spectra generated by matrix-assisted laser desorption ionization-time of flight mass spectrometry.
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Clinical manifestations of bacteremia caused by Aeromonas species in southern Taiwan. PLoS One 2014; 9:e91642. [PMID: 24614100 PMCID: PMC3948878 DOI: 10.1371/journal.pone.0091642] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 02/13/2014] [Indexed: 02/07/2023] Open
Abstract
Aim This study is conducted to investigate the clinical characteristics of patients with bacteremia caused by Aeromonas species. Materials and Methods Patients with bacteremia caused by Aeromonas species during the period 2009 to 2013 were identified from a computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. Results A total of 91 patients with bacteremia due to Aeromonas species were identified. In addition to 16 (17.6%) primary bacteremia, the most common source of secondary infection is peritonitis (n = 27, 29.7%), followed by biliary tract infection (n = 18, 19.8%), and SSTI (n = 12, 13.2%), pneumonia (n = 9, 9.9%), catheter-related bloodstream infection (n = 5, 5.5%), and genitourinary tract infection (n = 4, 4.4%). A. hydrophila (n = 35, 38.5%) was the most common pathogen, followed by A. veronii biovar sobria (n = 31, 34.1%), A. caviae (n = 14, 15.4%), and A. veronii biovar veronii (n = 9, 9.9%). Forty-three (47.3%) patients were classified as healthcare-associated infections (HCAI) causes by Aeromonas species, and patients with HCAI were more likely to have cancer, and receive immunosuppressant than patients with community-acquired bacteremia. The overall outcomes, including rate of ICU admission, acute respiratory failure, and mortality were 33.3%, 28.6%, and 23.1%, respectively. Multivariate analysis showed that the in-hospital day mortality was significantly associated only with underlying cancer (P <.001), and initial shock (P <.001). Conclusions Aeromonas species should be considered one of the causative pathogens of healthcare-associated bacteremia, especially in immunocompromised patients. In addition, it can be associated with high fatality. Cancer and initial shock were the poor prognostic factors.
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Bile microbiology at a hospital in southern Taiwan. Infection 2013; 41:901-2. [DOI: 10.1007/s15010-013-0415-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
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Chao CM, Lai CC, Tsai HY, Wu CJ, Tang HJ, Ko WC, Hsueh PR. Pneumonia caused by Aeromonas species in Taiwan, 2004-2011. Eur J Clin Microbiol Infect Dis 2013; 32:1069-75. [PMID: 23474673 DOI: 10.1007/s10096-013-1852-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/26/2013] [Indexed: 12/19/2022]
Abstract
We investigated the clinical characteristics of patients with pneumonia caused by Aeromonas species. Patients with pneumonia caused by Aeromonas species during the period 2004 to 2011 were identified from a computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. Of the 84 patients with pneumonia due to Aeromonas species, possible Aeromonas pneumonia was diagnosed in 58 patients, probable Aeromonas pneumonia was diagnosed in 18 patients, and pneumonia due to Aeromonas was conclusively diagnosed in 8 patients. Most of the cases of Aeromonas pneumonia developed in men and in patients of advanced age. A. hydrophila (n = 50, 59.5 %) was the most common pathogen, followed by A. caviae (n = 24, 28.6 %), A. veronii biovar sobria (n = 7, 8.3 %), and A. veronii biovar veronii (n = 3, 3.6 %). Cancer (n = 37, 44.0 %) was the most common underlying disease, followed by diabetes mellitus (n = 27, 32.1 %). Drowning-associated pneumonia developed in 6 (7.1 %) patients. Of 47 patients who were admitted to the intensive care ward, 42 patients developed acute respiratory failure and 24 of those patients died. The overall in-hospital mortality rate was significantly associated with liver cirrhosis, cancer, initial presentation of shock, and usage of mechanical ventilation. In conclusion, Aeromonas species should be considered as one of the causative pathogens of severe pneumonia, especially in immunocompromised patients, and should be recognized as a cause of drowning-associated pneumonia. Cirrhosis, cancer, and shock as the initial presenting symptom are associated with poor outcome.
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Affiliation(s)
- C M Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
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Differences in bile microbiology according to region and hospital: response to correspondence on "Bile microbiology at a hospital in southern Taiwan". Infection 2013; 41:1037-8. [PMID: 23397257 DOI: 10.1007/s15010-013-0416-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
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Lin WT, Su SY, Lai CC, Tsai TC, Gau SJ, Chao CM. Peritonitis caused by Aeromonas species at a hospital in southern Taiwan. Intern Med 2013; 52:2517-21. [PMID: 24240790 DOI: 10.2169/internalmedicine.52.0180] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study was conducted to investigate the clinical characteristics of patients with Aeromonas peritonitis, particularly secondary peritonitis. METHODS Patients with Aeromonas peritonitis treated between July 2004 and December 2011 were identified from the computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. RESULTS A total of 50 patients with Aeromonas peritonitis were identified. Nine cases were classified as spontaneous bacterial peritonitis, and 41 cases were classified as secondary peritonitis. The most common etiology of secondary peritonitis was acute appendicitis (n=26), followed by small bowel perforation (n=7) and colon perforation (n=6). The patients with spontaneous bacterial peritonitis were more likely to be immunocompromised (p=0.0013) and more frequently had an initial presentation of shock (p=0.0129), an abnormal liver function (p<0.05) and concomitant bacteremia (p=0.0024) than the patients with secondary peritonitis. Although the patients with secondary peritonitis had higher levels of inflammatory parameters, including leukocytes and C-reactive protein, and more frequent polymicrobial infections, their survival outcome rates, such as in-hospital mortality, were significantly lower (p=0.0007). The overall in-hospital mortality rate was 20%, and initial shock was the only independent prognostic factor for mortality (p=0.012). CONCLUSION The clinical characteristics, including outcomes, of patients with spontaneous and secondary Aeromonas peritonitis differ. In-hospital mortality is significantly associated with the initial presentation of shock.
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Affiliation(s)
- Wei-Ting Lin
- Department of Orthopaedics, Chi Mei Medical Center, Taiwan
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Chao CM, Lai CC, Tang HJ, Ko WC, Hsueh PR. Skin and soft-tissue infections caused by Aeromonas species. Eur J Clin Microbiol Infect Dis 2012; 32:543-7. [PMID: 23135756 DOI: 10.1007/s10096-012-1771-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 10/22/2012] [Indexed: 12/12/2022]
Abstract
This study investigated the clinical characteristics of patients with skin and soft-tissue infections (SSTIs) due to Aeromonas species. Patients with SSTIs caused by Aeromonas species during the period from January 2009 to December 2011 were identified from a computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. A total of 129 patients with SSTIs due to Aeromonas species were identified. A. hydrophila (n = 77, 59.7 %) was the most common pathogen, followed by A. veronii biovar sobria (n = 22, 17.1 %), A. veronii biovar veronii (n = 20, 15.5 %), A. caviae (n = 9, 7.0 %), and A. schubertii (n = 1, 0.8 %). The most common isolates obtained from patients with polymicrobial infections were Klebsiella species (n = 33), followed by Enterococcus spp. (n = 24), Enterobacter spp. (n = 21), Escherichia coli (n = 17), Staphylococcus spp. (n = 17), Streptococcus spp. (n = 17), and Acinetobacter spp. (n = 15). Liver cirrhosis and concomitant bacteremia were more common among patients with monomicrobial Aeromonas SSTIs than among patients with polymicrobial SSTIs. Nine (7 %) patients required limb amputations. The in-hospital mortality rate was 1.6 %. In conclusion, Aeromonas species should be considered as important causative pathogens of SSTIs, and most infections are polymicrobial. In addition, the clinical presentation differs markedly between patients with monomicrobial and those with polymicrobial Aeromonas SSTIs.
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Affiliation(s)
- C M Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
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