Aeromonas popoffii is a recently described species isolated mainly from freshwater. An isolate of Aeromonas popoffii was found to be responsible for a urinary tract infection in a 13-year-old boy suffering from spina bifida with enterocystoplasty. This is the first reported case of human infection attributed to this species.
CASE REPORTA 13-year-old boy was hospitalized in April 2003 for replacement of a urethral catheter. He suffered from congenital spina bifida and myelomeningocele complicated by a neurogenic bladder treated by anticholinergic drugs and intermittent bladder catheterization for 5 years. Imaging explorations did not reveal vesico-ureteral reflux. In 2001, the patient unsuccessfully underwent two transurethral injections of macroplastic substance on the vesical neck in order to palliate increasing urinary incontinence. He underwent an enterocystoplasty, using the sigmoid colon with surgical correction of the vesical neck (Young Dees type) and bilateral ureteral reimplantation with an antireflux valve (Cohen type) in April 2003. On the 10th postoperatory day, he returned home and was again treated by intermittent bladder catheterization (about four times a day). On day 15, the patient presented a fever of 38°C associated with left flank pain, and he was hospitalized. The urine analysis showed 10 5 polymorphonuclear leukocytes and 10 6 bacteria per ml. Blood leukocytes rose from 5,700 to 8,500/ l, platelet count rose from 321,000 to 488,000/l, and the sedimentation rate was 28 mm for the first hour. Preventive antibiotic treatment had been continued postoperatively with intravenously administered ceftriaxone (2 g/day) and metronidazole (1,500 mg/day) in the hospital, which was changed to amoxiclav given orally (1,500 mg/day) when he went home.The microbiological result confirmed a urinary tract infection due to Aeromonas sp., with intermediate susceptibility to amoxicillin and amoxicillin-clavulanate and susceptibility to ceftriaxone, ciprofloxacin, gentamicin, and cotrimoxazole. Treatment was changed to orally administered cotrimoxazole (800/160 mg twice per day), with a favorable clinical evolution later.Urine was cultured aerobically on Trypticase soy agar (bioMérieux, Marcy l'Etoile, France) at 37°C. After 48 h, 3-mm whitish colonies with irregular edges were observed. Gram staining revealed gram-negative, straight motile rods. Catalase and oxidase were positive, with resistance to vibriostatic agent O/129. The API-20 NE (bioMérieux) profile was 7 477 745, corresponding to a low level of discrimination between Aeromonas hydrophila or Aeromonas caviae (percentage of identification, 91.5%; T index, 0.76) and Vibrio parahaemolyticus (8.3% identical; T index, 0.58) (profile book, 6th ed., 1997).The antibiotic susceptibility profile was studied on sheep blood Mueller-Hinton agar plates by the disk diffusion method according to NCCLS recommendations (10). The MICs were 2 g/ml for amoxicillin, 0.25 g/ml for ceftriaxone, 4 g/ml for imipenem, 0.5 g/ml for amikacin, 0.75 g/ml for ciprofloxacin, and 0.25 ...