A series of Aeromonas hydrophilia infections – report from a rural hospital

Jimmy Hendrichs; Sridhar Gona; Aaron George; Hugo Bonatti

Aeromonas spp. are important human pathogens, which cause enteric disease or invasive infections most commonly involving the skin and soft tissue, blood stream and lung following aspiration. Only little data on intraabdominal infections due to Aeromonas spp. Are available.

Aeromonas spp. may play an important role in surgical infections.

This is a retrospective analysis of all infections caused by Aeromoas spp during a four-year period at a rural hospital. Data were retrieved from electronic medical records including the microbiology database.

Between 10/2018 and 12/2022, a total of 26 isolates of Aeromonas spp in 21 patients were identified. Median age of the 14 men and seven women was 56 years (range 13 days to 86 year). 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, two grew A. sobria, and one grew A. veronii. In 10 cases Aeromonas spp was the only isolated organism, eleven infections (52%) were polymicrobial, including Staphylococcus spp. (3), Streptococcus spp. (2), Enterococcus faecium (2), E. Coli (2), Klebsiella pneumoniae (2), Enterobacter cloacae (1), Serratia marcescens (1), Finegoldia magna (1) and Clostridium perfringens (1) as co-pathogens.  Nine patients underwent interventions (n=10) including wound debridement (3), ERCP (n=3), percutaneous cholecystostomy (2), laparoscopic cholecystectomy (2). Preferred antibiotics were either fluoroquinolones (5), 3^rd/4^th generation cephalosporins (5), TMPS (2), Doxycycline (2). All infections were successfully treated and all patients are currently alive except one who died from metastatic pancreatic cancer.

Aeromonas spp are important clinical pathogens causing a variety of infections. Most patients in this series had surgical infections. Aeromonas may be an underestimated pathogen in biliary infections.