Aeromonas Hydrophila Infection: 6-Year Experience and Literature Review

Background: While uncommon, Aeromonas hydrophila bacteremia can be fatal. Method: From January 1, 2003 to December 31, 2008, 48 patients (39 males, 9 females) diagnosed with A. hydrophila bacteremia were admitted to Mackay Memorial Hospital in Taitung. Patient demographic data, clinical features, laboratory data, and outcomes were retrospectively analyzed. Result: Of the 48 cases of A. hydrophila bacteremia, 36 were monomicrobial and 12 were polymicrobial infections. The most common symptoms were fever (43/48, 90%), jaundice (28/48, 58%), and abdomen pain (25/48, 52%). Underlying diseases included liver cirrhosis (27/48, 56%), and malignancy (7/48, 15%). In vitro, A. hydrophila was generally susceptible to gentamycin (100%), quinolones (98%), chloramphenicol (98%), cefuroxime (94%), and cefotaxime (94%) and resistant to ampicillin (98%). A. hydrophila bacteremia usually occurred in patients with liver cirrhosis or malignancy and heralded a poor prognosis. The overall crude fatality rate was (15/48, 31%). Anemia, leukocytosis, and impaired renal function were independent significant risk factors of death. Conclusion: A. hydrophila, although not common, can cause notable rates of morbidity and mortality among immunocompetent and immunocompromised persons. It is important to have a high index of suspicion and increase awareness of A. hydrophila infection at initial presentation. Prompt diagnosis and early treatment with adequate antibiotics are vital.