Clinical Characteristics of Seven Patients with Aeromonas Septicemia in a Japanese Hospital

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  • Morinaga Yoshitomo
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Yanagihara Katsunori
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Araki Nobuko
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Harada Yosuke
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Yamada Koichi
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Akamatsu Norihiko
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Matsuda Junichi
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Nishino Tomoya
    Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Hasegawa Hiroo
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Izumikawa Koichi
    Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Kakeya Hiroshi
    Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Yamamoto Yoshihiro
    Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Yasuoka Akira
    Nagasaki University Infection Control and Education Center, Nagasaki University Hospital
  • Kohno Shigeru
    Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences Global COE Program, Nagasaki University
  • Kamihira Shimeru
    Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences

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Abstract

The genus Aeromonas comprises flagellated gram-negative rods widely distributed in freshwater, estuarine and marine environments. Aeromonas species may cause a variety of illnesses in humans, such as enterocolitis and septicemia, especially in warmer tropical or subtropical environments. To recognize the characteristics of Aeromonas septicemia in Japan, we reviewed laboratory data and medical records in our hospital. During 11 years (from 2000 to 2010), Aeromonas septicemia was observed in seven patients involving six female subjects. Six patients were observed in summer or fall. The incidence of Aeromonas septicemia was about 0.07 per 1000 admissions, and two out of the seven patients died. All patients had underlying diseases such as malignancy (six patients) and choledocholithiasis (one patient). Two patients developed septicemia within two days after ingesting raw seafood. Five patients developed Aeromonas septicemia > 48 h after admission. Fever was present in all patients, and four out of the seven patients developed septic shock. All patients developed monomicrobial septicemia. A. hydrophila was isolated from five patients, and A. caviae and A. veronii biovar sobria were isolated from one patient each. Most antimicrobial agents had high activity against the isolated strains. However, a carbapenem-resistant strain appeared in one patient during treatment and led to death. Aeromonas septicemia is uncommon in temperate areas but can occur particularly in warm seasons. Immunocompromised conditions and recent ingestion of raw fish or shellfish are important characteristics of developing Aeromonas septicemia.

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