Skin and soft-tissue infections caused by Aeromonas species
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ARTICLE
Skin and soft-tissue infections caused by Aeromonas species C. M. Chao & C. C. Lai & H. J. Tang & W. C. Ko & P.-R. Hsueh
Received: 15 September 2012 / Accepted: 22 October 2012 / Published online: 8 November 2012 # Springer-Verlag Berlin Heidelberg 2012
Abstract This study investigated the clinical characteristics of patients with skin and soft-tissue infections (SSTIs) due to Aeromonas species. Patients with SSTIs caused by Aeromonas species during the period from January 2009 to December 2011 were identified from a computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. A total of 129 patients with SSTIs due to Aeromonas species were identified. A. hydrophila (n077, 59.7 %) was the most common pathogen, followed by A. veronii biovar sobria (n022, 17.1 %), A. veronii biovar veronii (n020, 15.5 %), A. caviae (n09, 7.0 %), and A. schubertii (n01, 0.8 %). The most common isolates obtained from patients with polymicrobial infections were Klebsiella species (n033), followed by Enterococcus spp. (n024), Enterobacter spp. (n021), Escherichia coli (n 017), Staphylococcus spp. (n 017), Streptococcus spp. (n017), and Acinetobacter spp. (n015). Liver cirrhosis and concomitant bacteremia were more common among patients with monomicrobial Aeromonas SSTIs than among patients with polymicrobial SSTIs. Nine (7 %) patients required limb amputations. The in-hospital mortality rate was 1.6 %. In conclusion, Aeromonas species should C. M. Chao : C. C. Lai Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan C. M. Chao Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan W. C. Ko Department of Internal Medicine and Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan W. C. Ko Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
be considered as important causative pathogens of SSTIs, and most infections are polymicrobial. In addition, the clinical presentation differs markedly between patients with monomicrobial and those with polymicrobial Aeromonas SSTIs.
Introduction Aeromonas species are Gram-negative, rod-shaped bacteria that are ubiquitous in aquatic environments. These organisms are frequently isolated from fresh or brackish water, sewage, soil, and tap water in temperate or subtropical countries, such as Taiwan [1–5]. Human infections caused by Aeromonas species are commonly associated with wound exposure to environmental sources or ingestion of food contaminated with aeromonads [1, 2]. Although the gastrointestinal tract is the most common site of Aeromonas spp. infection [1, 2], extra-intestinal diseases such as bacteremia, pneumonia, empyema, arthritis, endocarditis, meningitis, urinary tract infection, biliary tract infection, peritonitis, and skin and soft-tissue infections (SSTIs) have also been reported [1, 2, 6–14]. Traumatic wound infections H. J. Tang (*) Department of Medicine, Chi Mei Medical Center
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