Positioning Aeromonas Infection in Inflammatory Bowel Disease: A Retrospective Analysis

Abstract

Background and Aim: Aeromonas are Gram-negative rods known to cause a spectrum of diseases. Inflammatory bowel disease (IBD) is an idiopathic complex condition resulting from interaction of multiple factors. Aeromonas infection in association with IBD is still largely unknown. We aim to look for the significance of Aeromonas infection and for significant differences between IBD and non-IBD patients. Methods: A retrospective observational analysis was performed of all patients positive for Aeromonas in stool cultures, during a 10-year period, from a tertiary and university hospital. Results: Fifty patients were included, 56% male with a mean age of 42.1 years. Thirty-eight (76%) were non-IBD and 12 (24%) IBD patients. IBD patients were more frequently under immunosuppressors. Two patients were asymptomatic and 44% developed mild, 44% moderate, and 16.7% severe infection. The main strains isolated were Aeromonas hydrophila/caviae. Bacterial co-isolation was found in 4 non-IBD and histological findings of cytomegalovirus in 2 IBD patients. Non-IBD patients presented more frequently with fever and IBD patients with bloody diarrhea and abdominal pain. There was higher tendency for severe infection rate in IBD patients with higher antimicrobial therapy use. Steroids were exclusively used in the IBD group. From IBD, 4 patients had the diagnosis of ulcerative colitis and 9 of Crohn’s disease with colonic involvement. Of these patients, 5 received IBD diagnosis after the acute episode of Aeromonas infection. Conclusions: Clinical presentation of Aeromonas infection differs between IBD and non-IBD patients. Non-IBD patients had milder severity of infection with less use of antibiotics. Aeromonas infection seems to greatly contribute to IBD manifestation.

Emerging Aeromonas enteric infections: their association with inflammatory bowel disease and novel pathogenic mechanisms

“…By implementing such screening measures, targeted antibiotic intervention can be promptly provided. This viewpoint is further supported by previous clinical studies, which showed that patients with IBD infected with Aeromonas experienced more complications and required more frequent antibiotic treatment as compared to non-IBD patients ( 7 , 8 ).…”

“…Previous studies have examined the clinical presentations and treatment of Aeromonas enteric infection in patients with IBD ( 7 – 10 ). For example, studies from Lobaton et al and Guedes et al reported that patients with IBD infected with Aeromonas were treated more often with antibiotics compared to non-IBD patients ( 7 , 8 ).…”

Quorum-Sensing Signal DSF Inhibits the Proliferation of Intestinal Pathogenic Bacteria and Alleviates Inflammatory Response to Suppress DSS-Induced Colitis in Zebrafish

“…An increase in the relative abundance of Aeromonas was observed in patients with inflammatory bowel disease, including ulcerative colitis and Crohn’s disease. Its infection symptoms include diarrhea, bleeding, inflammation, and abdominal pain in IBD [ 53 ]. Staphylococcus is a type of pathogenic Gram-positive bacteria with a high detection rate in various inflammatory wounds.…”

An Unusual Encounter: Aeromonas veronii Infection in a Case of Ulcerative Colitis

“…The rates of stool isolation differ depending on factors such as geographical location, dietary habits, and isolation methods. In developed countries, the prevalence of infection ranges from 0.8% to 7.4%, and the carriage rate ranges from 0% to 4% [2]. Although it remains unclear what exactly causes inflammatory bowel disease (IBD), there are numerous factors at play within its network of pathogenic mechanisms, including environmental influences, genetic susceptibility, dysregulated immune responses, and microbiological factors.…”

“…The most frequent manifestation of Aeromonas infection is diarrhea, which is typically sudden and resolved on its own. However, there have also been reported cases of bloody diarrhea and abdominal pain, as well as chronic and less severe diarrhea [2]. Different types of Aeromonas species possess various virulence factors, such as cytotoxic and cytotonic toxins, proteases, hemolysins, lipases, adhesins, agglutinins, pili, enterotoxins, and several other enzymes.…”