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Published on: October 27, 2013
Experience with Invasive Aeromonas Infections at a Rural Hospital in the United States of America
Jimmy Henrichs1, Sridhar Gona1, Aaron George1
1Meritus Health, Hagerstown, Maryland, USA.
Introduction:
Aeromonas spp. are important human pathogens causing enteric disease or invasive infections commonly involving skin and soft tissue, biliary system, blood stream, and lung following aspiration. Only limited data regarding Aeromonas spp. infections from the United States are available.
Patients And Methods:
This is a retrospective analysis of all infections caused by Aeromoas spp. during a four-year period at a rural hospital in the Appalachian region. Data were retrieved from electronic medical records, including the microbiology database.
Results:
Between 10/2018 and 12/2022, 26 isolates of Aeromonas spp. in 21 patients (14 m/7 f) with a median age of 56 (range 0.1-86) years were identified. Six isolates were from blood cultures (four associated with biliary infections); 14 patients had soft-tissue infections, and one had acute cholecystitis. There were 18 A. hydrophila/A. caviae isolates, two specimens grew A. sobria, and one A. veronii. In 10 cases, Aeromonas spp. was the only isolated organism; 11 infections (52%) were polymicrobial. Isolated co-pathogens were gram-positive cocci (6), gram-negative rods (6), and anaerobes (2). Nine patients underwent interventions (n = 10), including wound debridement (3), endoscopic retrograde cholangiopancreatography (ERCP) (3), percutaneous cholecystostomy (2), and laparoscopic cholecystectomy (2). Preferred antibiotics were fluoroquinolones (5), 3rd/4th generation cephalosporins (5), trimethoprim/sulfamethoxazole (TMPS) (2), and doxycycline (2). All infections were successfully treated, and all patients are currently alive except one, who died from metastatic pancreatic cancer.
Conclusion:
Aeromonas spp. are rare clinical pathogens but are capable of causing severe infections. Most patients in this series had surgical infections. Surgeons need to be aware that the organism has a propensity for causing biliary infections.
Insights
Aeromonas spp. are rare but severe pathogens, often causing surgical and biliary tract infections in the Appalachian region. Prompt diagnosis and treatment led to successful outcomes in all patients.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Surgical Infections
Background:
- Aeromonas spp. are significant human pathogens causing various infections, including enteric and invasive diseases.
- Limited data exists on Aeromonas spp. infections specifically within the United States, particularly in rural settings.
- Understanding the epidemiology and clinical manifestations of Aeromonas infections is crucial for effective patient management.
Purpose of the Study:
- To analyze the characteristics of Aeromonas spp. infections over a four-year period at a rural hospital.
- To identify common infection sites, patient demographics, and treatment outcomes for Aeromonas spp. infections.
- To highlight the propensity of Aeromonas spp. to cause biliary tract infections and surgical site infections.
Main Methods:
- Retrospective analysis of all Aeromonas spp. isolates from October 2018 to December 2022.
- Data collection from electronic medical records and microbiology databases.
- Review of patient demographics, infection types, causative species, co-pathogens, interventions, and antibiotic treatments.
Main Results:
- Twenty-six Aeromonas spp. isolates were identified in 21 patients, with soft-tissue infections (14) and biliary-associated infections (6) being most common.
- Aeromonas hydrophila/A. caviae were the predominant species; 52% of infections were polymicrobial.
- Surgical interventions were common, and fluoroquinolones and cephalosporins were frequently used antibiotics, with successful treatment outcomes.
Conclusions:
- Aeromonas spp. are rare but capable of causing severe infections, particularly surgical and biliary tract infections.
- Awareness of Aeromonas spp. as a potential pathogen, especially in surgical contexts, is essential for clinicians.
- The study underscores the need for vigilance regarding Aeromonas spp. in rural healthcare settings.
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