398. Aeromonas bacteremia: Clinical features and laboratory characteristics
Session: Poster Abstract Session: Gram Negative Infection - Epidemiology and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • (Aeromonas学会).pdf (291.7 kB)
  • Background: 

    The 30-day mortality rate of patients with Aeromonas bacteremia has been reported to be 20% to 50%. However sufficient studies on the clinical features of Aeromonas bacteremia have not been performed in Japan.

    Methods: 

    We reviewed the medical records of patients at Toranomon Hospital (890 beds, Tokyo, Japan) with blood cultures positive for Aeromonas species between January 1994 and September 2010. The identification and antimicrobial susceptibility test of Aeromonas species were performed using VITEK, VITEK2 and MicroScan WalkAway 96 SI.

    Results: 

    We reviewed the records of Aeromonas bacteremia in 36 patients. There were 24 males and 12 females. Median age of patients was 63.5 years (range 33-87 years). Eighteen Aeromonas bacteremia cases were nosocomial infection. Among 36 strains isolated, 18 were A.caviae, 13 were A.hydrophiia, and 5 were A.veronii. The abdomen was the predominant site of infection; 15 patients had cholangitis, 8 had spontaneous peritonitis, 2 had abdominal surgical site infection, and 1 had liver abscess. The underlying diseases of the patients were solid tumor (21 cases), chronic hepatic diseases (13 cases), diabetes mellitus (9 cases), hematological malignancy (4 cases), and aplastic anemia (2 cases). Hepatocellular carcinoma (5 cases) and pancreatic cancer (5 cases) were the most common among patients with solid tumor. The 30-day mortality rate was 19%. In 16 patients, the bacteremic episodes were polymicrobial. Among these patients, 12 had some anatomic structural disorders of the bile duct or pancreatic duct, such as occlusion. All 36 Aeromonas strains showed more than 90% susceptibility to antimicrobial agents such as third generation cephalosporins, carbapenems, fluoloquinolones, aminoglycoside and trimethoprim-surfamethoxazole.

    Conclusion: 

    This is the first report indicating A. caviae was alone as the most causative pathogen of Aeromonas bacteremia.  In addition, in an endemic area, if clinicians observe intra-abdominal infections in patients with hepatic, biliary or pancreatic malignancy, Aeromonas bacteremia may be suspected for optimal empiric treatment.


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Muneyoshi Kimura, MD, Hideki Araoka, MD and Akiko Yoneyama, MD, Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan

    Disclosures:

    M. Kimura, None

    H. Araoka, None

    A. Yoneyama, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.