Indwelling device-related and recurrent infections due to Aeromonas species

From October 1995 to February 1997, 13 isolates of Aeromonas species were recovered from four patients treated at National Taiwan University Hospital (Taipei). One of the patients, a diabetic, had simultaneous Aeromonas veronii biotype veronii bacteremia and A. veronii biotype sobria urinary tract infection. Seven weeks after the episode, the patient had necrotizing fasciitis due to A. veronii biotype veronii. The other three patients all had underlying hepatobiliary malignancies complicated by obstructive jaundice, and all underwent percutaneous transhepatic cholangiographic drainage. These three patients had multiple isolates of Aeromonas species (A. hydrophila and/or A. caviae) recovered from samples of blood or bile or from catheter insertion sites. All isolates were identified on the basis of the results of extended biochemical tests as well as characteristic cellular fatty acid profiles. The results of genotyping generated by arbitrarily primed polymerase chain reaction and of susceptibility testing showed that these Aeromonas species were pathogens that caused indwelling device-related infections and that the organisms could persist for long periods, with subsequent recurrence of severe infection. Concomitant infection due to more than one Aeromonas species or caused by polyclonal A. hydrophila or A. veronii biotype veronii was also documented.