Aeromonas

Aeromonas is a genus of Gram-negative, facultative anaerobic, rod-shaped bacteria that morphologically resembles members of the family Enterobacteriaceae. Most of the 14 described species have been associated with human diseases. The most important pathogens are A. hydrophila, A. caviae, and A. veronii biovar sobria. The organisms are ubiquitous in fresh and brackish water. [1]

They group with the gamma subclass of the Proteobacteria.[2]

Two major diseases associated with Aeromonas are gastroenteritis and wound infections, with or without bacteremia. Gastroenteritis typically occurs after the ingestion of contaminated water or food, whereas wound infections result from exposure to contaminated water. In it's most severe form, Aeromonas spp. can cause necrotizing fasciitis, which is life threatening, usually requiring treatment with antibiotics and even amputation.[3]

Although some potential virulence factors (e.g. endotoxins, hemolysins, enterotoxins, adherence factors) have been identified, their precise roles are unknown. Aeromonas species cause:

  1. opportunistic systemic disease in immunocompromised patients
  2. diarrheal disease in otherwise healthy individuals
  3. wound infections

Caution about differential diagnosis

If automated machines are not using the most updated database, Elizabethkingia meningoseptica may be mistaken for Aeromonas salmonicida.

Gastroenteritis

Gastrointestinal disease in children is usually an acute, severe illness, whereas that in adults tends to be chronic diarrhea. Severe Aeromonas gastroenteritis resembles shigellosis, with blood and leukocytes in the stool. Acute diarrheal disease is self-limited, and only supportive care is indicated in affected patients.

Wound infection

Wound infections are the second most common type of human infection associated with Aeromonas.[4] They are associated with penetrating wounds or abrasions that place the wound in contact with fresh water or soil.[4]

Medicinal leeches

Aeromonas species are endosymbionts of Hirudo medicinalis, a species of leech that is FDA approved for use in vascular surgery such as skin grafts and flaps.[5][6] Aeromonas aides leeches in digesting blood meals.[7] When H. medicinalis is used after surgery, it has led to Aeromonas infections, most commonly with A. veronii.[5] This can present as a local cellulitis, though can progress to subcutaneous abscess and sepsis.[5]

Respiratory infection

Aeromonas species have also been associated with pneumonia after near-drowning events, especially in fresh water.[8] Most commonly this has been reported with A. hydrophila, though the ability of clinical laboratories to correctly identify species of Aeromonas has been limited.[8] Aeromonas pneumonia due to episodes of near-drowning are frequently complicated by bacteremia and death.[8]

Antimicrobial therapy

Aeromonas species are resistant to penicillins, most cephalosporins, and erythromycin. Ciprofloxacin is consistently active against their strains in the U.S. and Europe, but resistant cases have been reported in Asia.

Etymology

The name Aeromonas derives from:
Greek noun aer, aeros (ἀήρ, ἀέρος), air, gas; and -monas|monas (μονάς / μονάδα), unit, monad; gas(-producing) monad.[9]

Members of the genus Aeromonas can be referred to as aeromonads (viz. trivialisation of names).

References

  1. ↑ Graf J (editor). (2015). Aeromonas. Caister Academic Press. ISBN 978-1-908230-56-0.
  2. ↑ Martinez-Murcia AJ, Benlloch S, Collins MD (July 1992). "Phylogenetic interrelationships of members of the genera Aeromonas and Plesiomonas as determined by 16S ribosomal DNA sequencing: lack of congruence with results of DNA-DNA hybridizations". Int. J. Syst. Bacteriol. 42 (3): 412–21. doi:10.1099/00207713-42-3-412. PMID 1380289.
  3. ↑ Minnaganti, Venkat R.; Patel, Pankaj J.; Iancu, Dan; Schoch, Paul E.; Cunha, Burke A. (2000). "Necrotizing fasciitis caused by Aeromonas hydrophila". Heart & Lung: The Journal of Acute and Critical Care 29 (4): 306–308. doi:10.1067/mhl.2000.106723. ISSN 0147-9563.
  4. 1 2 Parker, Jennifer L.; Shaw, Jonathan G. "Aeromonas spp. clinical microbiology and disease". Journal of Infection 62 (2): 109–118. doi:10.1016/j.jinf.2010.12.003.
  5. 1 2 3 Whitaker, Iain S.; Kamya, Cyril; Azzopardi, Ernest A.; Graf, Joerg; Kon, Moshe; Lineaweaver, William C. (2009-11-01). "Preventing infective complications following leech therapy: Is practice keeping pace with current research?". Microsurgery 29 (8): 619–625. doi:10.1002/micr.20666. ISSN 1098-2752.
  6. ↑ "FDA approves leeches as medical devices". msnbc.com. Retrieved 2016-01-28.
  7. ↑ "Aeromonas-Hirudo medicinalis symbiosis". sp.uconn.edu. Retrieved 2016-01-28.
  8. 1 2 3 Ender, Peter T.; Dolan, Matthew J. (1997-10-01). "Pneumonia Associated with Near-Drowning". Clinical Infectious Diseases 25 (4): 896–907. doi:10.1086/515532. ISSN 1058-4838. PMID 9356805.
  9. ↑ Aeromonas entry in LPSN [Euzéby, J.P. (1997). "List of Bacterial Names with Standing in Nomenclature: a folder available on the Internet". Int J Syst Bacteriol 47 (2): 590–2. doi:10.1099/00207713-47-2-590. ISSN 0020-7713. PMID 9103655.]

Further reading

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