1263. Clinical epidemiology of Edwardsiella tarda bacteremia ; Review of 49 cases from 1968 to 2012
Session: Poster Abstract Session: Bacteremia and Endocarditis
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: Edwardsiella tarda is an eneterobacteria occasionally isolated from the intestine of humans and animals such as freshwater fishes. E.tarda, a rare cause of infections in human, has been most isolated from stool. E.tardaBacteremia (ETB) is very uncommon but fatal. There are a few reports about ETB. Clinical epidemiology of ETB is still unclear.

Methods: The study design was a retrospective chart and literature review. We performed a PubMed MEDLINE search and ICHU-SHI web (http://www.jamas.or.jp) by Japanese Medical Abstract Society on case reports of ETB. An episode of ETB was define as a patient with at least 1 positive blood culture yielding E.tarda. Patients with ETB from 2000 to 2012 in Tokyo Women's Medical University Hospital (TWMU) were included in this study.

Results: From 1968 to 2012, 46 cases in 37 papers in the English, French, or Japanese literature and 3 cases diagnosed at TWMU from 2000 to 2012 were included. The most frequently reported geographic area was eastern asia (33/49 ; 67%) including Japan and Chinese-Taipei, followed by United states of America (10/49 ; 20.4%) around the Gulf of Mexico in particular. The mean age was 52 (2 days to 88 years old) years old. 17 cases (34%) were female. Underlying diseases were liver cirrhosis (32%), hepatobiliary cancer (29%), cholelithiasis including sickle cell anemia (15%), neonatal (8%). 21 cases (43%) presented ETB without complication. 11 (22%) developed severe soft tissue infection, 6 (12%) developed diarrhea, 5 (10%) developed liver abscess, 3 (6%) developed meningitis. Treatment antimicrobial agents were distributed as follows: cephalosporin in 20 (48%) of 42 (lacking data for 7 cases), penicillin in 12 (28%), carbapenem in 6 (14%). The mortality rates were 48% in overall but 72% in ETB with soft tissue infection, respectively.

Conclusion: To our knowledge, this is the largest literature review of ETB. In published reports including recent 3 case in TWMU, ETB is rare but fatal disease in all age. E.tarda is rare and emerging pathogen. The frequently reported geographic area, including Eastern Asia and gulf of mexico in USA, face the sea and river mouth. There are rich in popular marine products and freshwater fish in each area. Our result may have shown geographical distribution is available in ETB. Further  clinical and epidemiological investigation of ETB is needed.

Yuji Hirai, M.D. , Ph.D.1,2, Sayaka Asahata, MD2, Yusuke Ainoda, MD, PhD3, Takahiro Fujita, MD.2 and Kyoichi Totsuka, M.D. , Ph.D.2, (1)Hematology, Tokyo Women's Medical University, Tokyo, Japan, (2)Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan, (3)Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan

Disclosures:

Y. Hirai, None

S. Asahata, None

Y. Ainoda, None

T. Fujita, None

K. Totsuka, None

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