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Srivastava A, Tripathy S, Gutte S, Sahu C, Gurjar M, Patel SS. Ventilator-associated pneumonia due to Aeromonas hydrophila: A rare case report. Access Microbiol 2023; 5:000672.v3. [PMID: 37970092 PMCID: PMC10634497 DOI: 10.1099/acmi.0.000672.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/06/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction Aeromonas hydrophila is an opportunistic pathogen that can cause various infections, including pneumonia, in immunocompromised individuals. This case report presents a rare occurrence of ventilator-associated pneumonia (VAP) caused by Aeromonas hydrophila in an apparently non-immunocompromised patient. Case presentation The patient exhibited signs and symptoms of VAP and was successfully treated with intravenous ciprofloxacin. The discussion highlights the characteristics of Aeromonas species, its virulence factors, risk factors for infection, and antibiotic profile. Conclusion It emphasizes the need for awareness and suspicion of Aeromonas as a potential cause of VAP in ICU settings, as well as the importance of early detection and appropriate treatment for improved outcomes.
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Affiliation(s)
- Amit Srivastava
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow-226014, India
| | - Sarvodaya Tripathy
- Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow-226014, India
| | - Shreyas Gutte
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow-226014, India
| | - Chinmoy Sahu
- Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow-226014, India
| | - Mohan Gurjar
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow-226014, India
| | - Sangram Singh Patel
- Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow-226014, India
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Reizine F, Delbove A, Tattevin P, Santos AD, Bodenes L, Bouju P, Fillâtre P, Frérou A, Halley G, Lesieur O, Courouble P, Berteau F, Morin J, Delamaire F, Marnai R, Le Meur A, Aubron C, Reignier J, Gacouin A, Tadié JM. Clinical and microbiological features of drowning-associated pneumonia: a retrospective multicentre cohort study. Clin Microbiol Infect 2023; 29:108.e7-108.e13. [PMID: 35944877 DOI: 10.1016/j.cmi.2022.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Pneumonia is the most frequent infectious complication in patients who have experienced drowning that requires intensive care unit (ICU) admission. We aimed to describe clinical, microbiological, and therapeutic data as well as predictors and impacts of such pneumonia on patients' outcomes. METHODS We conducted a retrospective, multicentre study (2013-2020) of 270 consecutive patients admitted for drowning to 14 ICUs in Western France. Their baseline characteristics and outcomes were compared according to the occurrence of drowning-associated pneumonia (DAP), defined as pneumonia diagnosed within 48 hours of ICU admission. A Cox regression model was used to compare survival on day 28, and logistic regression was used to identify risk factors for DAP. Microbiological characteristics and empirical antibacterial treatment were also analysed. RESULTS Among the 270 patients admitted to the ICU for drowning, 101 (37.4%) and 33 (12.2%) experienced pneumonia and microbiologically proven DAP, respectively. The occurrence of pneumonia was associated with higher severity scores at ICU admission (median Simplified Acute Physiology Score II, 34 [interquartile range {IQR}, 25-55] vs. 45 [IQR, 28-67]; p 0.006) and longer ICU length of stay (2 days [IQR, 1-3] vs. 4 days [IQR, 2-7]; p < 0.001). The 28-day mortality rate was higher among these patients (29/101 [28.7%] vs. 26/169 [15.4%]; p 0.013). Microbiologically proven DAP remained associated with higher 28-day mortality after adjustments for cardiac arrest and water salinity (adjusted hazard ratio, 1.86 [95% CI, 1.06-3.28]; p 0.03). A microbiological analysis of respiratory samples showed a high proportion of gram-negative bacilli (23/56; 41.1%), with a high prevalence of amoxicillin-clavulanate resistance (12/33; 36.4%). CONCLUSIONS Pneumonia is a common complication in patients admitted in the ICU for drowning and is associated with increased mortality.
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Affiliation(s)
- Florian Reizine
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France.
| | - Agathe Delbove
- CH Vannes, Service de Réanimation Polyvalente, Vannes, France
| | - Pierre Tattevin
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France
| | - Alexandre Dos Santos
- CH La Roche sur Yon, Service de Réanimation Polyvalente, La Roche sur Yon, France
| | | | - Pierre Bouju
- CH Lorient, Service de Réanimation Polyvalente, Lorient, France
| | - Pierre Fillâtre
- CH Saint-Brieuc, Service de Réanimation Polyvalente, Saint-Brieuc, France
| | - Aurélien Frérou
- CH Saint Malo, Service de Réanimation Polyvalente, Saint Malo, France
| | | | - Olivier Lesieur
- CH La Rochelle, Service de Réanimation Polyvalente, La Rochelle, France
| | - Patricia Courouble
- CH Saint Nazaire, Service de Réanimation Polyvalente, Saint Nazaire, France
| | - Florian Berteau
- CH Morlaix, Service de Réanimation Polyvalente, Morlaix, France
| | - Jean Morin
- CHU Nantes, Médecine Intensive Réanimation, Nantes, France
| | - Flora Delamaire
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France
| | - Rémy Marnai
- CH Le Mans, Service de Réanimation Polyvalente, Le Mans, France
| | - Anthony Le Meur
- CH Cholet, Service de Réanimation Polyvalente, Cholet, France
| | - Cécile Aubron
- CHU Brest, Médecine Intensive Réanimation, Brest, France
| | - Jean Reignier
- CHU Nantes, Médecine Intensive Réanimation, Nantes, France
| | - Arnaud Gacouin
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France
| | - Jean-Marc Tadié
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France
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Patil SM, Hilker ED. Aeromonas hydrophila Community-Acquired Bacterial Pneumonia With Septic Shock in a Chronic Lymphocytic Leukemia Patient Due to Absolute Neutropenia and Lymphopenia. Cureus 2022; 14:e23345. [PMID: 35475099 PMCID: PMC9018926 DOI: 10.7759/cureus.23345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2022] [Indexed: 12/03/2022] Open
Abstract
Aeromonas hydrophila is a gram-negative (GN) bacillus with an opportunistic potential in immunocompromised patients. They are ubiquitary in fresh and brackish water capable of infecting healthy and immunosuppressed patients. Clinical manifestations vary in healthy hosts compared to immunocompromised patients. Community-acquired bacterial pneumonia (CABP) is an infrequent clinical presentation of A. hydrophila infection, even in immunosuppressed patients. It is also an uncommon cause of nosocomial and drowning-related pneumonia. Although a rare cause of CABP, the clinical course is fulminant with higher mortality due to lower clinical suspicion. Here, we present an immunocompromised 63-year-old Caucasian male with chronic lymphocytic leukemia (CLL) presenting with acute A. hydrophila CABP with septic shock due to absolute neutropenia and lymphopenia.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Wang JB, Yu MS, Tseng TT, Lin LC. Molecular Characterization of Ahp2, a Lytic Bacteriophage of Aeromonas hydrophila. Viruses 2021; 13:v13030477. [PMID: 33799428 PMCID: PMC8001559 DOI: 10.3390/v13030477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/07/2021] [Accepted: 03/11/2021] [Indexed: 12/11/2022] Open
Abstract
Aeromonas hydrophila is an opportunistic pathogen that infects fish, amphibians, mammals, and humans. This study isolated a myophage, vB_AhyM_Ahp2 (Ahp2), that lytically infects A. hydrophila. We observed that 96% of the Ahp2 particles adsorbed to A. hydrophila within 18 min. Ahp2 also showed a latent period of 15 min with a burst size of 142 PFU/cell. This phage has a linear double-stranded DNA genome of 47,331 bp with a GC content of 57%. At least 20 Ahp2 proteins were detected by SDS-polyacrylamide gel electrophoresis; among them, a 40-kDa protein was predicted as the major capsid protein. Sequence analysis showed that Ahp2 has a genome organization closely related to a group of Aeromonas phages (13AhydR10RR, 14AhydR10RR, 85AhydR10RR, phage 3, 32 Asp37, 59.1), which infect Aeromonas hydrophila and Aeromonas salmonicida. The tail module encompassing ORF27-29 in the Ahp2 genome was present in all Aeromonas phages analyzed in this study and likely determines the host range of the virus. This study found that Ahp2 completely lyses A. hydrophila AH300206 in 3.5 h at a MOI of 0.0001 and does not lysogenize its host. Altogether, these findings show that Ahp2 is a lytic Aeromonas phage and could be a candidate for therapeutic phage cocktails.
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Affiliation(s)
- Jian-Bin Wang
- Laboratory of Microbial Genetics, Institute of Medical Sciences, Tzu Chi University, No. 701, Sec. 3, Zhongyang Rd., Hualien 97004, Taiwan;
| | - Mei-Shiuan Yu
- Department of Microbiology, School of Medicine, Tzu Chi University, No. 701, Sec. 3, Zhongyang Rd., Hualien 97004, Taiwan;
- Master Program in Microbiology and Immunology, School of Medicine, Tzu Chi University, No. 701, Sec. 3, Zhongyang Rd., Hualien 97004, Taiwan
| | - Tsai-Tien Tseng
- Department of Molecular and Cellular Biology, Kennesaw State University, 1000 Chastain Road, Kennesaw, GA 30144, USA;
| | - Ling-Chun Lin
- Department of Microbiology, School of Medicine, Tzu Chi University, No. 701, Sec. 3, Zhongyang Rd., Hualien 97004, Taiwan;
- Master Program in Microbiology and Immunology, School of Medicine, Tzu Chi University, No. 701, Sec. 3, Zhongyang Rd., Hualien 97004, Taiwan
- Correspondence: e-mail: ; Tel.: +886-3-8565301
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Mohanty S, Hallur V, Behera B, Nayak P. Urinary tract infection due to Aeromonas species: An uncommon causative agent. J Natl Med Assoc 2020; 112:294-9. [PMID: 32349861 DOI: 10.1016/j.jnma.2020.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/07/2020] [Accepted: 03/27/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Members of the genus Aeromonas are Gram-negative bacilli, belonging to family Aeromonadaceae, and are widely found in various aquatic environments. The most common species associated with human infections are A. hydrophila, A. caviae, and A. veronii biovar sobria. Aeromonas species are recognized as emerging opportunistic pathogens in humans mainly causing gastrointestinal infections and wound infections with or without progression to septicaemia. Aeromonas organisms rarely cause urinary tract infection (UTI) and are not known uropathogens. CASE We report a series of UTI due to Aeromonas species in three adult patients, specifically identified as A. veronii biovar sobria in two patients and A. hydrophila in one patient. Two patients had history of occupational exposure to aquatic environment. CONCLUSIONS The cases highlight another expanded range of infections caused by Aeromonas spp. that can be encountered in a community setting and indicate that infections with Aeromonas spp. should be kept in mind while investigating for the etiology of UTI, especially in adult patients with occupational exposure to aquatic ecosystems.
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Yang S, He T, Sun J, Sun S. Distinct Antimicrobial Resistance Profiling Of Clinically Important Aeromonas Spp. In Southwest China: A Seven-Year Surveillance Study. Infect Drug Resist 2019; 12:2971-2978. [PMID: 31571949 PMCID: PMC6756270 DOI: 10.2147/idr.s216926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/04/2019] [Indexed: 11/23/2022] Open
Abstract
Background Co-evolution of host and aeromonads has diversified their spectrums of diseases and antibiograms, while a paucity of data was concerning about this diversity in China. To fill this gap, this study was aimed to investigate and compare antimicrobial resistance (AMR) patterns of clinically important Aeromonas spp. from various clinical sources. Methods A multicenter retrospective surveillance study was conducted in Chongqing from 2011 to 2017. Data of strains were retrieved from the database of China Antimicrobial Resistance Surveillance System (CARSS). Whonet 5.6 and Graphpad Prism 6 Software were adopted to determine and compare distribution and AMR patterns. Results Among 1135 Aeromonas strains, Aeromonas hydrophila complex (65.6%, 745/1135) was the most predominant species, followed by Aeromonas veronii complex (16.7%, 190/1135) and Aeromonas caviae complex (15.3%, 174/1135). Sputum was the most frequent source of strains (27.7%), followed by wound (20.8%), bloodstream (10.8%) and urine (8.8%). Urinary strains demonstrated the highest resistance rates to ceftriaxone (65.6%), ceftazidime (52.1%), cefepime (38.3%), ciprofloxacin (47.7%) and trimethoprim-sulfamethoxazole (56.6%). Similar AMR pattern was observed in intestinal strains, with corresponding resistance rates of 29.4%, 28.9%, 22.2%, 27.3% and 45%, respectively. However, respiratory, bloodstream and skin strains exhibited resistance rates of less than 20% to most of the antimicrobials tested. In terms of species, approximately 30% of Aeromonas hydrophila complex and Aeromonas caviae complex strains were resistant to ceftriaxone and trimethoprim-sulfamethoxazole, while Aeromonas veronii complex strains harbored resistance rates of less than 20% to all tested antimicrobials. Although antibiograms of these species were distinct, they remained constant from 2011 to 2017. Conclusions Distinct AMR patterns between species and sources highlighted the predominance of Aeromonas hydrophila complex and high resistance of strains in urine and intestine to extended-spectrum cephalosporins, ciprofloxacin and trimethoprim-sulfamethoxazole in Southwest China. Temporally constant AMR patterns should not relax the vigilance of antimicrobial resistance in clinically important Aeromonas species.
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Affiliation(s)
- Shuangshuang Yang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.,Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Department of Laboratory Medicine, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Tong He
- Department of Laboratory Animal Medicine, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Jide Sun
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Shan Sun
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China
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Fouquet H, Guimas M, Teulier S, Testaert H, Bergot E, Reviron-Rabec L. [Near-drowning associated Aeromonas pneumonia]. Rev Mal Respir 2018; 35:959-62. [PMID: 30220490 DOI: 10.1016/j.rmr.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/06/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Aeromonas pneumonia associated with near-drowning, though uncommon, is serious and a major morbidity factor for patients. CLINICAL CASE A healthy 30-year-old man nearly drowned in a pound. He was admitted to the medical intensive care unit and required intubation and mechanical ventilation. He was given antibiotic therapy in the form of amoxicillin/clavulanic acid. After a brief stable period post immersion, he rapidly developed fever and respiratory failure. The thoracic scan revealed bilateral alveolar infiltrates and led to a fibreoptic bronchoscopy. Aeromonas veroniiandPseudomonas aeruginosa were found on culture of the bronchial aspirate. A change of antibiotic therapy appropriate to these bacteria led to clinical improvement and allowed complete withdrawal of ventilation. CONCLUSION Rapid respiratory deterioration following near-drowning should raise the suspicion of pulmonary infection with the bacteria usually found in the respiratory tract during ventilation but without overlooking the possibility of unusual organisms, particularly Aeromonas.It is usuallysensitive to third generation cephalosporins and fluoroquinolones. Ideally, Aeromonas should be sought in pulmonary aspirates and samples of the water where immersion occurred.
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Ku YH, Yu WL. Extensive community-acquired pneumonia with hemophagocytic syndrome caused by Aeromonas veronii in an immunocompetent patient. Journal of Microbiology, Immunology and Infection 2017; 50:555-556. [DOI: 10.1016/j.jmii.2015.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/17/2015] [Accepted: 06/30/2015] [Indexed: 11/28/2022]
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Nolla-Salas J, Codina-Calero J, Vallés-Angulo S, Sitges-Serra A, Zapatero-Ferrándiz A, Climent MC, Gómez J, Masclans JR. Clinical significance and outcome of Aeromonas spp. infections among 204 adult patients. Eur J Clin Microbiol Infect Dis 2017; 36:1393-403. [PMID: 28258303 DOI: 10.1007/s10096-017-2945-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Prediger KC, Surek M, Dallagassa CB, Assis FEA, Piantavini MS, Souza EM, Pedrosa FO, Farah SMSS, Alberton D, Fadel-Picheth CMT. Utilization of carbon sources by clinical isolates of Aeromonas. Can J Microbiol 2017; 63:359-364. [PMID: 28177792 DOI: 10.1139/cjm-2016-0526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Bacteria in the genus Aeromonas are primarily aquatic organisms; however, some species can cause diseases in humans, ranging from wound infections to septicemia, of which diarrhea is the most common condition. The ability to use a variety of carbon substrates is advantageous for pathogenic bacteria. Therefore, we used Biolog GN2 microplates to analyze the ability of 103 clinical, predominantly diarrheal, isolates of Aeromonas to use various carbon sources, and we verified whether, among the substrates metabolized by these strains, there were some endogenous to the human intestine. The results indicate that Aeromonas present great diversity in the utilization of carbon sources, and that they preferentially use carbohydrates and amino acids as carbon sources. Among the carbon sources metabolized by Aeromonas in vitro, some were found to be components of intestinal mucin, including aspartic acid, glutamic acid, l-serine, galactose, N-acetyl-glucosamine, and glucose, which were used by all strains tested. Additionally, mannose, d-serine, proline, threonine, and N-acetyl-galactosamine were used by several strains. The potential to metabolize substrates endogenous to the intestine may contribute to Aeromonas' capacity to grow in and colonize the intestine. We speculate that this may help explain the ability of Aeromonas to cause diarrhea.
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Affiliation(s)
- Karoline C Prediger
- a Departamento de Análises Clínicas, Universidade Federal do Paraná, Curitiba-PR, Brazil
| | - Monica Surek
- a Departamento de Análises Clínicas, Universidade Federal do Paraná, Curitiba-PR, Brazil
| | - Cibelle B Dallagassa
- a Departamento de Análises Clínicas, Universidade Federal do Paraná, Curitiba-PR, Brazil
| | - Flávia E A Assis
- a Departamento de Análises Clínicas, Universidade Federal do Paraná, Curitiba-PR, Brazil
| | - Mario S Piantavini
- b Departamento de Farmácia, Universidade Federal do Paraná, Curitiba-PR, Brazil
| | - Emanuel M Souza
- c Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Paraná, Curitiba-PR, Brazil
| | - Fábio O Pedrosa
- c Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Paraná, Curitiba-PR, Brazil
| | - Sônia M S S Farah
- d Laboratório Central do Estado do Paraná (LACEN-PR), Curitiba-PR, Brazil
| | - Dayane Alberton
- a Departamento de Análises Clínicas, Universidade Federal do Paraná, Curitiba-PR, Brazil
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Wang Y, Li R, Zhou Y, Ling Z, Guo X, Xie L, Liu L. Motif-Based Text Mining of Microbial Metagenome Redundancy Profiling Data for Disease Classification. Biomed Res Int 2016; 2016:6598307. [PMID: 27057545 DOI: 10.1155/2016/6598307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/12/2016] [Indexed: 12/02/2022]
Abstract
Background. Text data of 16S rRNA are informative for classifications of microbiota-associated diseases. However, the raw text data need to be systematically processed so that features for classification can be defined/extracted; moreover, the high-dimension feature spaces generated by the text data also pose an additional difficulty. Results. Here we present a Phylogenetic Tree-Based Motif Finding algorithm (PMF) to analyze 16S rRNA text data. By integrating phylogenetic rules and other statistical indexes for classification, we can effectively reduce the dimension of the large feature spaces generated by the text datasets. Using the retrieved motifs in combination with common classification methods, we can discriminate different samples of both pneumonia and dental caries better than other existing methods. Conclusions. We extend the phylogenetic approaches to perform supervised learning on microbiota text data to discriminate the pathological states for pneumonia and dental caries. The results have shown that PMF may enhance the efficiency and reliability in analyzing high-dimension text data.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Chen PL, Tsai PJ, Chen CS, Lu YC, Chen HM, Lee NY, Lee CC, Li CW, Li MC, Wu CJ, Ko WC. Aeromonas stool isolates from individuals with or without diarrhea in southern Taiwan: Predominance of Aeromonas veronii. J Microbiol Immunol Infect 2015; 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] [What about the content of this article? (0)] [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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In the Literature. Clin Infect Dis 2014; 58:iii-iv. [DOI: 10.1093/cid/ciu049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tang HJ, Lai CC, Lin HL, Chao CM. Clinical manifestations of bacteremia caused by Aeromonas species in southern Taiwan. PLoS One 2014; 9:e91642. [PMID: 24614100 DOI: 10.1371/journal.pone.0091642] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Gao S, Zhao N, Amer S, Qian M, Lv M, Zhao Y, Su X, Cao J, He H, Zhao B. Protective efficacy of PLGA microspheres loaded with divalent DNA vaccine encoding the ompA gene of Aeromonas veronii and the hly gene of Aeromonas hydrophila in mice. Vaccine 2013; 31:5754-9. [DOI: 10.1016/j.vaccine.2013.08.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 08/15/2013] [Accepted: 08/21/2013] [Indexed: 12/18/2022]
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