Monomicrobial Necrotizing Fasciitis Caused by &lt;b&gt;&lt;i&gt;Aeromonas&lt;/i&gt;&lt;/b&gt; &lt;b&gt;&lt;i&gt;hydrophila&lt;/i&gt;&lt;/b&gt; and &lt;b&gt;&lt;i&gt;Klebsiella pneumoniae&lt;/i&gt;&lt;/b&gt;

Tsai, Yao-Hung; Shen, Shih-Hsun; Yang, Tien-Yu; Chen, Po‐Han; Huang, Kuo‐Chin; Lee, Mel S.

doi:10.1159/000431094

Cited by 35 publications

(38 citation statements)

References 27 publications

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“…Another study conducted in Taiwan between 2008 and 2010 showed that the incidence of bacteremia by Aeromonas was 76 cases per one million individuals [153]. Those studies therefore show that the incidence of diseases caused by Aeromonas vary by geographical location and can be related to bad hygiene habits in undeveloped regions [3,5,[152][153][154][155][156][157][158].…”

Section: Aeromonas In Human Infectionsmentioning

confidence: 99%

“…Aeromonas infections often involve more than one type of bacteria in the same clinical sample, which is defined as a polymicrobial or mixed infection [3,5,152,[154][155][156]183]. Polymicrobial infections occur in 80% of cases of respiratory tract infections and cholangitis cases, and in 77% of cases of surgical site infections, followed by 60% of wound infections, and 30% of bacteremia [5,152,167,183].…”

Section: Aeromonas In Human Infectionsmentioning

confidence: 99%

“…Wound infections due to Aeromonas can progress severely to necrotizing fasciitis (NF), usually in immunocompromised patients [5,211]. NF is commonly known as a flesh-eating disease that can cause hypotension, fever, necrosis, and gangrene and can be a life-threating infection [156,[186][187][188]211]. A. hydrophila is the Aeromonas species most frequently associated in reported NF cases and in some cases, water was considered the source of infection [156,186,[211][212][213][214].…”

Section: Wound Infectionsmentioning

confidence: 99%

“…NF is commonly known as a flesh-eating disease that can cause hypotension, fever, necrosis, and gangrene and can be a life-threating infection [156,[186][187][188]211]. A. hydrophila is the Aeromonas species most frequently associated in reported NF cases and in some cases, water was considered the source of infection [156,186,[211][212][213][214]. Three studies report the complex interactions, among multiple strains of A. hydrophila that were isolated from an immunocompetent young girl who developed NF resulting in amputation of almost all the extremities [186][187][188].…”

Section: Wound Infectionsmentioning

confidence: 99%

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An Update on the Genus Aeromonas: Taxonomy, Epidemiology, and Pathogenicity

2020

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The genus Aeromonas belongs to the Aeromonadaceae family and comprises a group of Gram-negative bacteria widely distributed in aquatic environments, with some species able to cause disease in humans, fish, and other aquatic animals. However, bacteria of this genus are isolated from many other habitats, environments, and food products. The taxonomy of this genus is complex when phenotypic identification methods are used because such methods might not correctly identify all the species. On the other hand, molecular methods have proven very reliable, such as using the sequences of concatenated housekeeping genes like gyrB and rpoD or comparing the genomes with the type strains using a genomic index, such as the average nucleotide identity (ANI) or in silico DNA–DNA hybridization (isDDH). So far, 36 species have been described in the genus Aeromonas of which at least 19 are considered emerging pathogens to humans, causing a broad spectrum of infections. Having said that, when classifying 1852 strains that have been reported in various recent clinical cases, 95.4% were identified as only four species: Aeromonas caviae (37.26%), Aeromonas dhakensis (23.49%), Aeromonas veronii (21.54%), and Aeromonas hydrophila (13.07%). Since aeromonads were first associated with human disease, gastroenteritis, bacteremia, and wound infections have dominated. The literature shows that the pathogenic potential of Aeromonas is considered multifactorial and the presence of several virulence factors allows these bacteria to adhere, invade, and destroy the host cells, overcoming the immune host response. Based on current information about the ecology, epidemiology, and pathogenicity of the genus Aeromonas, we should assume that the infections these bacteria produce will remain a great health problem in the future. The ubiquitous distribution of these bacteria and the increasing elderly population, to whom these bacteria are an opportunistic pathogen, will facilitate this problem. In addition, using data from outbreak studies, it has been recognized that in cases of diarrhea, the infective dose of Aeromonas is relatively low. These poorly known bacteria should therefore be considered similarly as enteropathogens like Salmonella and Campylobacter.

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Section: Aeromonas In Human Infectionsmentioning

confidence: 99%

Section: Aeromonas In Human Infectionsmentioning

confidence: 99%

Section: Wound Infectionsmentioning

confidence: 99%

Section: Wound Infectionsmentioning

confidence: 99%

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An Update on the Genus Aeromonas: Taxonomy, Epidemiology, and Pathogenicity

2020

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“…and Aeromonas spp. have been regarded as the most important gram-negative bacteria causing NF since 2004 [8,9,[11][12][13][17][18][19][20][21][22], and Vibrio cholerae non-O1 keratitis [23]. Our team, "Vibrio NSSTIs Treatment and Research (VTR) Group," at CGMH-Chiayi consists of professional medical staff working in various departments, namely, emergency medicine, orthopedic surgery, infectious diseases, intensive care unit, and hyperbaric oxygen treatment center.…”

Section: Introductionmentioning

confidence: 99%

Predictors for gram-negative monomicrobial necrotizing fasciitis in southern Taiwan

et al. 2020

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Background: Necrotizing fasciitis (NF) is a rare and life-threatening necrotizing skin and soft-tissue infection. Infectious pathogens of NF must be detected early and treated rapidly to prevent loss of limb or a fatal outcome. This study aimed to detect more reliable predictors between gram-negative and gram-positive monomicrobial NF of limbs. Methods: A total of 100 patients with limb monomicrobial NF were diagnosed prospectively from April 2015 to July 2018. These monomicrobial NF pathogens can be divided into gram-negative and gram-positive groups according to the result of Gram staining and final bacterial reports. Data such as demographics, seawater or seafood contact history, infectious location, comorbidities, presenting signs and symptoms, and laboratory findings were recorded and compared. Results: A total of 55 patients were infected with gram-negative organisms and 45 patients with gram-positive organisms. Among the 55 cases of monomicrobial gram-negative NF, 48 (87.3%) were caused mainly by Vibrio spp. (38, 69.1%) and Aeromonas spp. (10, 18.2%). A higher incidence of chronic kidney disease, cerebrovascular accident, tachypnea, and septic shock; a higher rate of band forms of leukocytes of more than 3%, serum lactate of more than 20 mg/dL, and C-reactive protein level of less than 150 mg/dL; prolonged prothrombin time; and a lower fibrinogen level were observed in patients with gram-negative infection. In a multivariate analysis, a higher incidence of seawater or seafood contact history (odds ratio [OR]: 66.301; 95% confidence interval [CI]: 7.467-588.702), a higher rate of hyperlactatemia (OR: 7.904; 95% CI: 1.231-50.744), and a low fibrinogen level (OR: 1.013; 95% CI: 1.004-1.023) indicated gram-negative infection. Conclusions: In southern Taiwan, NF of limbs mainly affected the lower limbs, exhibited monomicrobial infection, and was predominated by gram-negative bacteria. Gram-negative monomicrobial NF of limbs often occurred in individuals with the more seawater or seafood contact history, hyperlactatemia, and low fibrinogen levels.

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