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Musculoskeletal and soft tissue Aeromonas infection: an environmental disease
L M Voss1, K H Rhodes, K A Johnson
1Section of General Pediatrics and Pediatric Infectious Diseases, Mayo Clinic, Rochester, MN 55905.
Abstract:
During a 4-year period from November 1985 to November 1989, Aeromonas was isolated from wounds and soft tissues with clinical evidence of infection in 28 patients at our institution. Of the 28 patients, 23 (82%) had sustained an acute open or penetrating injury, more than half of which (13 of the 23) were water-related trauma. One patient had Aeromonas osteomyelitis. Five patients had no history of trauma, and three of these five had an underlying chronic disease. Treatment included débridement and antimicrobial agents. Susceptibility testing on 25 isolates from 23 patients showed uniform resistance to ampicillin and considerable resistance to cefazolin sodium (68%), but all isolates were sensitive to gentamicin sulfate, cefuroxime sodium, and the third-generation cephalosporins.
Insights
Aeromonas bacteria commonly infect wounds, particularly those from water-related injuries. Gentamicin and third-generation cephalosporins are effective treatments, while ampicillin is not.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- Aeromonas species are increasingly recognized as opportunistic pathogens.
- Wound infections require prompt diagnosis and effective antimicrobial therapy.
Observation:
- Aeromonas was isolated from 28 patients with infected wounds and soft tissues over a 4-year period.
- The majority of infections (82%) were associated with acute open or penetrating injuries, with over half linked to water-related trauma.
- One case of Aeromonas osteomyelitis and three cases in patients with chronic diseases were noted.
Findings:
- Susceptibility testing revealed uniform resistance to ampicillin and significant resistance (68%) to cefazolin sodium among 25 Aeromonas isolates.
- All isolates demonstrated sensitivity to gentamicin sulfate, cefuroxime sodium, and third-generation cephalosporins.
Implications:
- This study highlights the importance of considering Aeromonas in wound infections, especially those related to water exposure.
- Effective antimicrobial choices for Aeromonas infections include gentamicin and third-generation cephalosporins, while ampicillin should be avoided.
- Further research into Aeromonas pathogenesis and treatment strategies is warranted.