Cystitis Caused by Aeromonas caviae

Abstract

Aeromonas sp. organisms rarely cause urinary tract infection. We report for the first time a case of urinary tract infection caused by A. caviae in an adult patient with a history of increased frequency of urination, dysuria, hematuria, and weight loss. CASE REPORTA 39-year-old Bangladeshi male presented to the emergency department of Al-Amiri Hospital, Kuwait, with a 2-month history of increased frequency of urination, dysuria, hematuria, and weight loss of 7 kg. Seven weeks earlier, he was treated with amoxicillin for 5 days by his general practitioner. But despite the therapy, his symptoms deteriorated.On examination, the patient was afebrile (37°C) with normal vital signs for his age. His suprapubic area was tender. Ultrasonography of the abdomen and pelvis revealed generalized and irregular thickening (4 to 5 mm) of the wall of the urinary bladder suggestive of cystitis. A chest X-ray was normal. Hematological examination revealed a hemoglobin level of 153 g/liter, a platelet count of 170 ϫ 10 9 /liter, a white-cell count of 7.7 ϫ 10 9 /liter, and an erythrocyte sedimentation rate of 3 mm/h (all values were within the normal range). The biochemical profile revealed an alanine aminotransferase level of 57 IU/liter, alkaline phosphatase level of 76 IU/liter, creatinine level of 80 mol/liter, and blood urea level of 2.6 mmol/liter (all were within the normal ranges). Stool culture was negative for Aeromonas spp., Salmonella spp., Shigella spp., and Campylobacter spp.The urine analysis showed an erythrocyte level of 30/hpf and a leukocyte level of 4/hpf. The urine sample was plated on cystine-lactose-electrolyte-deficient agar, MacConkey agar, and sheep blood agar (Oxoid, Basingstoke, United Kingdom) and incubated at 37°C. After 24 h, pure growth of smooth, entire colonies of about 2 mm in diameter appeared on the plates. The concentration of bacteria was calculated to be Ͼ10 5 colonies/ml of urine. The colonies were non-lactose fermenters on MacConkey agar and nonhemolytic on blood agar. One purified isolate was deposited in the BCCM/LMG Bacteria Collection, Ghent University (Belgium) (http://bccm.belspo.be /db/lmg_search_form.php) as LMG 24107. The isolate was a gram-negative, motile bacillus and was catalase and oxidase positive. The API-20E identification strip (bioMerieux, Marcy l'Etoile, France) profile obtained (3006126) identified LMG 24107 as either Vibrio fluvialis or Aeromonas caviae with differential tests of growth in KCN and growth without salt for A. caviae. Results of further biochemical characterization as described previously (1) are shown in Table 1. The extensive biochemical characterization of the isolate indicated that the isolate was not V. fluvialis (growth without salt supplementation and growth in KCN broth) and was, in fact, A. caviae. Next, we performed molecular identification of the isolate by sequencing of the 16S rRNA and gyrB genes. Bacterial DNA was extracted by the cetyltrimethylammonium bromide method (10) for 16S rRNA sequencing and by the method of Pitcher and colleagues (9...

Aeromonas caviae septicemia in immunocompetent gastrointestinal carriers

“…Simultaneous enrichment was also done in Gram-negative broth and alkaline peptone water, incubated overnight at 37ºC and then sub cultured on the above mentioned media. Stool samples from two of the patients showed heavy growth of the A. caviae (as confirmed by the standard biochemical tests) on the primary isolation medium [7]. While from one patient's stool it was grown only after enrichment.…”

“…cause cellulitis or wound infections following traumatic injury in an aqueous environment. They also cause various infections associated with hospitalization such as rare urinary tract infections, surgical wound infections, meningitis, peritonitis, endocarditis, or other serious infections [1,7]. Major predisposing conditions for Aeromonas infections include cirrhosis or other hepatic disease, hematologic malignancies and hepatobiliary diseases [9].…”

Microbiological quality of trahira fish (Hoplias malabaricus) from Baixada Maranhense, municipality of São Bento, MA

“…Among the species of Aeromonas spp., A. caviae and A. veronii biovar sobria are more commonly associated with infections in humans and are responsible for more than 85% of all clinical cases related to this genus (AL- BENWAN et al, 2007;TSAI et al, 2009). In Brazil, there are reports of isolation of different species of Aeromonas spp.…”

Urinary tract infection due to Aeromonas spp., a lesser known causative bacterium

“…So far there have been few case reports regarding UTI caused by Aeromonas spp. [2][3][4][5][6]. They have also been associated with haemolytic uremic syndrome [3].…”

“…The pathogenesis of urinary tract infection due to Aeromonas spp. has not been elucidated in any of the available literature; however, they are known to produce a number of putative virulence factors such as fimbriae and haemolysin [5]. These organisms can affect any age group.…”