Skin and Soft Tissue Infections due to Aeromonas spp.: An Emerging Pathogen
DC05-DC09
Correspondence
Dr. Jampala Srinivas,
Professor, Department of Microbiology, Rajshree Medical Research Institute, Near Toll Plaza, Rampur Road, Bareilly-243122, Uttar Pradesh, India.
E-mail: ammassrinivas@gmail.com
Introduction: Aeromonas species the emerging human pathogens, can cause various diseases like gastrointestinal infections, Skin and Soft-Tissue Infections (SSTIs), respiratory tract infections, urinary tract infection, hepatobiliary tract infection, blood stream infections etc. Aeromonas consists of important pathogenic species like Aeromonas hydrophila being the most common one followed by A. sobria, A. veronii, A. caviae and A. salmonicida. SSTIs due to Aeromonads are most often associated with pre-existing ulcer, traumatic wound and exposure to water.
Aim: To analyse socio-epidemiological factors, clinical features, risk factors and antibiotic resistance potential of Aeromonas spp., SSTIs.
Materials and Methods: This prospective study was performed in Microbiology Department of Rajshree Medical Research Institute, Bareilly, Utter Pradesh, India. A total of 39 patients with Aeromonas spp., SSTIs were identified during the period from 2020 to 2022. All Gram-negative fermenting motile isolates which are positive for oxidase, H2S production, indole reaction, lysine decarboxylase were further identified by Vitek 2 compact system (Biomerieux, France). Patient demographics were presented as mean±standard deviation.
Results: Majority of patients hailed from urban areas, were in middle age group and were farmers. A. hydrophila 24 (62%) was the predominant isolate. Majority of the infections were superinfection of wound 16 (41%) and chronic non healing ulcer 13 (33.3%). A total of 33.3% of infections were polymicrobial, common concomitant pathogens being, Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA). Trauma and water exposure were main risk factors with co-morbidities like diabetes, hypertension and liver cirrhosis. A 20.5% of patients were immunocompromised. There was one case of Necrotising Fasciitis (NF) which resulted in patient’s death. Co-trimoxazole, 3rd and 4th generation cephalosporins. Aztreonam and Tigecycline were the most effective antibiotics while eight of the isolates were Multidrug Resistant (MDR). A 33 patients recovered completely and three patients died of complications.
Conclusion: Aeromonas hydrophila must be regarded as an emerging pathogen of SSTIs mainly in patients with pre-existing ulcers and can be MDR. Such infections have a good prognosis if prompt medical, surgical and supportive treatment is given.