A Rare Case of Aeromonas Hydrophila Catheter Related Sepsis in a Patient with Chronic Kidney Disease Receiving Steroids and Dialysis: A Case Report and Review of Aeromonas Infections in Chronic Kidney Disease Patients

Khalil, Muhammad Abdul Mabood; Rehman, Abdur; Kashif, Waqar; Rangasami, Manickam; Tan, Jackson

doi:10.1155/2013/735194

Cited by 7 publications

(10 citation statements)

References 22 publications

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“…These infections can range from mild illness such as cellulitis or gastrointestinal disease, to serious disease such as sepsis and necrotizing fasciitis (Lee et al, 2008;Wu et al, 2009;Janda and Abbott, 2010). Nosocomial infections with A. hydrophila can occur and in some cases these infections are associated with contaminated medical devices such as catheters used in hemodialysis treatment (Lin et al, 1996;Khalil et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Hilt

Fitzwater

Ward

et al. 2020

Front. Cell. Infect. Microbiol.

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Aeromonas hydrophila resides in a variety of aquatic environments. Infections with A. hydrophila mainly occur after contact with fresh or brackish water. Nosocomial infections with A. hydrophila can also occur. A. hydrophila infections can be difficult to treat due to both intrinsic and acquired antimicrobial resistance (AMR) mechanisms. In 2018-19, we isolated multi-drug resistant (MDR) A. hyrodphila from two solid organ transplant patients with intra-abdominal infections. We aimed to characterize their AMR mechanisms and to determine their genetic relatedness to aid epidemiological investigation. We performed whole genome sequencing (WGS) using Illumina MiSeq and Nanopore MinIon on 3 A. hydrophila isolates, with one isolate from Patient A (blood) and two isolates from Patient B (abdominal and T-tube fluid, isolated 2 weeks apart). Phenotypic assays included: Broth Microdilution (BMD), Modified Hodge Test (MHT), Modified Carbapenem Inactivation Method (mCIM), and EDTA Carbapenem Inactivation Method (eCIM). Data analyses were performed using CLCbio and Geneious. AMR genomic analysis revealed that all three isolates possess chromosomally encoded genes including bla OXA−12 (oxacillinase), bla cepS (AmpC), and bla cphA7 (metallo-beta-lactamase). All isolates tested strongly positive by MHT and mCIM, but only Patient B's second isolate (after 2 weeks of meropenem treatment) tested positive by eCIM. More intriguingly, Patient B's first isolate (before meropenem treatment) tested falsely susceptible to carbapenems by BMD, suggesting bla cphA7 gene was not expressed constitutively. Phylogenetic analysis showed the two isolates from Patient B were highly similar with only 1 SNP difference. The isolate from Patient A only differed from Patient B's isolates by 35 and 36 SNPs, respectively, suggesting close genetic relatedness. Further epidemiological investigation is undergoing. We report the first cases of CphA-mediated carbapenem resistant A. hydrophila in the U.S. It is concerning that 1 out of 3 isolates tested falsely susceptible to carbapenems by BMD despite clear carbapenemase production shown by strongly positive MHT and mCIM. In both cases, meropenem was initially used to treat the patients. Clinicians and microbiologists in the US should be aware of the emerging MDR Aeromonas nosocomial infections and the potential false carbapenem susceptible results due to CphA-type carbapenemase, which may be induced during treatment.

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Section: Introductionmentioning

confidence: 99%

Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Hilt

Fitzwater

Ward

et al. 2020

Front. Cell. Infect. Microbiol.

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“…[5][6][7] There was also a reported case of catheter related sepsis in a patient with chronic kidney disease on regular dialysis caused by Aeromonas hydrophila. 8 Similar to other acute septic arthritis, patients will present with joint pain and limited movement over the affected joint. Fever was also one of the most common clinical manifestations and it was noted in 90% of the patients.…”

Section: Case Summarymentioning

confidence: 99%

Aeromonas Hydrophilia as a Rare Cause of Septic Arthritis in a Hemodialysis Patient

2020

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Septic arthritis usually represents a direct invasion of joint space by various microorganisms, most commonly caused by bacteria. Most of the time, it is caused by Staphylococci spp. or Streptococci spp. This is a case of a 70-year-old Chinese man with underlying end stage renal failure on regular hemodialysis who presented with recurrent right shoulder pain and swelling. He was diagnosed with right shoulder septic arthritis whereby arthrotomy was performed. Intra-operative tissue specimen from his right shoulder grew Aeromonas hydrophilia which was susceptible to ceftriaxone, cefepime, ciprofloxacin, gentamicin and sulfamethoxazole-trimethoprim. He was given intravenous cefepime for 21 days and discharged after treatment completed. J MEDICINE JUL 2020; 21 (2) : 113-116

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“…Symptoms range from acute self-limiting diarrhea to lethal sepsis; however, wounds, skin, bones, heart, lungs, eyes, and other organs can be potentially affected ( Parker and Shaw, 2011 ; Ahmed et al, 2021 ; Meng et al, 2021 ). Most reports classify Aeromonas ’s human infections as events caused by “rare” or “uncommon” microorganisms ( Lai et al, 2007 ; Khalil et al, 2013 ; Hasan et al, 2018 ; Salehi et al, 2019 ). Indeed, other bacterial genus causing the same clinical symptoms are more frequent at hospital level.…”

Section: Introductionmentioning

confidence: 99%

Aeromonas and Human Health Disorders: Clinical Approaches

et al. 2022

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The genus Aeromonas comprises more than 30 Gram-negative bacterial species and naturally inhabitants from aquatic environments. These microorganisms, commonly regarded as pathogens of fish and several other animals, have been gaining prominence on medical trial due to its ability to colonize and infect human beings. Besides water, Aeromonas are widely spreaded on most varied sources like soil, vegetables, and food; Although its opportunistic nature, they are able to cause infections on immunocompromised or immunocompetent patients. Aeromonas species regarded as potential human pathogens are usually A. hydrophila, A. caviae, and A. veronii biovar sobria. The main clinical manifestations are gastrointestinal tract disorders, wound, and soft tissue infections, as well as septicemia. Regarding to antibiotic responses, the bacteria present a diversified susceptibility profile and show inherence resistance to ampicillin. Aeromonas, as an ascending genus in microbiology, has been carefully studied aiming comprehension and development of methods for detection and medical intervention of infectious processes, not fully elucidated in medicine. This review focuses on current clinical knowledge related to human health disorders caused by Aeromonas to contribute on development of efficient approaches able to recognize and impair the pathological processes.

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A Rare Case of Aeromonas Hydrophila Catheter Related Sepsis in a Patient with Chronic Kidney Disease Receiving Steroids and Dialysis: A Case Report and Review of Aeromonas Infections in Chronic Kidney Disease Patients

Cited by 7 publications

References 22 publications

Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Aeromonas Hydrophilia as a Rare Cause of Septic Arthritis in a Hemodialysis Patient

Aeromonas and Human Health Disorders: Clinical Approaches

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