Frontiers in Cellular and Infection Microbiology (Oct 2021)

Pancreaticobiliary Cancers and Aeromonas Isolates Carrying Type Ⅲ Secretion System Genes ascF-ascG Are Associated With Increased Mortality: An Analysis of 164 Aeromonas Infection Episodes in Southern Taiwan

  • Ying-Wen Chen,
  • Shu-Li Su,
  • Chia-Wen Li,
  • Chia-Wen Li,
  • Chia-Wen Li,
  • Chin-Shiang Tsai,
  • Chin-Shiang Tsai,
  • Ching-Lung Lo,
  • Ching-Lung Lo,
  • Ling-Shan Syue,
  • Ling-Shan Syue,
  • Min-Chi Li,
  • Min-Chi Li,
  • Min-Chi Li,
  • Ching-Chi Lee,
  • Ching-Chi Lee,
  • Nan-Yao Lee,
  • Nan-Yao Lee,
  • Nan-Yao Lee,
  • Wen-Chien Ko,
  • Wen-Chien Ko,
  • Wen-Chien Ko,
  • Po-Lin Chen,
  • Po-Lin Chen,
  • Po-Lin Chen

DOI
https://doi.org/10.3389/fcimb.2021.749269
Journal volume & issue
Vol. 11

Abstract

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This prospective study aimed to investigate the clinical and microbiological characteristics of different Aeromonas species. Clinical isolates of Aeromonas species between 2016 to 2018 were collected in a university hospital in southern Taiwan. The species was determined by rpoD or gyrB sequencing. A total of 222 Aeromonas isolates from 160 patients in 164 episodes were identified. The crude in-hospital mortality was 17.2%. The most frequently isolated species was Aeromonas veronii (30.6%), followed by A. caviae (24.8%), A. hydrophila (23%), and A. dhakensis (16.7%). The major clinical manifestations were primary bacteremia (31.1%), skin and soft tissue infection (22.6%), and biliary tract infection (18.3%). The most common underlying diseases were malignancy (45.1%), diabetes mellitus (27.4%), and liver cirrhosis or chronic hepatitis (26.2%). A. hydrophila and A. dhakensis predominated in the skin and soft tissue infection (p<0.0001), whereas A. vernoii and A. caviae prevailed in primary bacteremia and biliary tract infections (p=0.012). Pneumonia, malignancy, and ascF-ascG genotype were independent factors associated with mortality. Ertapenem susceptibility was decreased in A. sobria (42.9%), A. veronii (66.7%), A. dhakensis (73%), and A. hydrophila (84.3%). Cefotaxime resistance was found in 30.9% of A. caviae and 18.9% of A. dhakensis isolates, much more prevalent than the other species. The metallo-β-lactamase blaCphA was almost invariably present in A. dhakensis, A. hydrophila, and A. veronii (100%, 100% and 89.9%, respectively). Amp-C β-lactamases such as blaMOX and blaAQU-1 were identified in all A. caviae and 91.9% of A. dhakensis isolates. Cefepime, fluoroquinolones and tigecycline showed good in vitro activity against aeromonads.

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