Aeromonas-associated gastroenteritis in children

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.