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Aeromonas-associated gastroenteritis in children

V H San Joaquin1, D A Pickett

  • 1Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City 73190.

The Pediatric Infectious Disease Journal
|January 1, 1988
PubMed

Insights

Aeromonas species are a significant cause of childhood diarrhea, particularly in young children during warmer months. Aeromonas caviae, despite lacking toxins, was the most common isolate, linked to chronic cases.

Area of Science:

  • Microbiology
  • Pediatric Infectious Diseases
  • Gastroenterology

Background:

  • Aeromonas species are increasingly recognized as potential bacterial enteropathogens.
  • Understanding the prevalence and clinical significance of Aeromonas in pediatric diarrhea is crucial for diagnosis and treatment.
  • Previous studies have varied in their assessment of Aeromonas virulence factors and clinical associations.

Purpose of the Study:

  • To determine the isolation rate and clinical significance of Aeromonas species in children with diarrhea.
  • To compare the prevalence of Aeromonas with other common bacterial enteropathogens.
  • To investigate the virulence properties of different Aeromonas species and their association with clinical outcomes.

Main Methods:

  • Prospective isolation of bacterial enteropathogens from stool samples of children with and without diarrhea over 20 months.
  • Identification of Aeromonas species and other common enteric pathogens (Shigella, Salmonella, Campylobacter, Yersinia).
  • Assessment of Aeromonas toxin production (cytotoxin and enterotoxin) using specific assays.

Main Results:

  • Aeromonas species were isolated from 2.5% of children with diarrhea, with Aeromonas caviae being the most prevalent (69%).
  • Aeromonas was the sole identified bacterial enteropathogen in 45 children; isolated from 0.5% of asymptomatic children.
  • Aeromonas sobria and Aeromonas hydrophila strains showed significant toxin production, unlike A. caviae, which was weakly enterotoxigenic.
  • Children under 3 years old accounted for 92% of Aeromonas-associated diarrhea cases, predominantly seen from May to October.
  • Acute watery diarrhea was common; fever and vomiting were associated with A. sobria.
  • Chronic diarrhea cases were exclusively linked to A. caviae.
  • Complications included bacteremia, intussusception, and hemolytic uremic syndrome.

Conclusions:

  • Aeromonas species, particularly Aeromonas caviae, are significant contributors to childhood diarrhea, including chronic presentations.
  • While A. caviae lacks strong virulence factors, its prevalence suggests a role in pediatric gastroenteritis.
  • Aeromonas infections can lead to severe complications, necessitating prompt diagnosis and management.

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