AUTHOR=Chen Ying-Wen , Su Shu-Li , Li Chia-Wen , Tsai Chin-Shiang , Lo Ching-Lung , Syue Ling-Shan , Li Min-Chi , Lee Ching-Chi , Lee Nan-Yao , Ko Wen-Chien , Chen Po-Lin 

TITLE=Pancreaticobiliary Cancers and Aeromonas Isolates Carrying Type Ⅲ Secretion System Genes ascF-ascG Are Associated With Increased Mortality: An Analysis of 164 Aeromonas Infection Episodes in Southern Taiwan

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2021.749269

DOI=10.3389/fcimb.2021.749269

ISSN=2235-2988

ABSTRACT=<p>This prospective study aimed to investigate the clinical and microbiological characteristics of different <italic>Aeromonas</italic> species. Clinical isolates of <italic>Aeromonas</italic> species between 2016 to 2018 were collected in a university hospital in southern Taiwan. The species was determined by <italic>rpoD</italic> or <italic>gyrB</italic> sequencing. A total of 222 <italic>Aeromonas</italic> isolates from 160 patients in 164 episodes were identified. The crude in-hospital mortality was 17.2%. The most frequently isolated species was <italic>Aeromonas veronii</italic> (30.6%), followed by <italic>A. caviae</italic> (24.8%), <italic>A. hydrophila</italic> (23%), and <italic>A. dhakensis</italic> (16.7%). The major clinical manifestations were primary bacteremia (31.1%), skin and soft tissue infection (22.6%), and biliary tract infection (18.3%). The most common underlying diseases were malignancy (45.1%), diabetes mellitus (27.4%), and liver cirrhosis or chronic hepatitis (26.2%). <italic>A. hydrophila</italic> and <italic>A. dhakensis</italic> predominated in the skin and soft tissue infection (p&lt;0.0001), whereas <italic>A. vernoii</italic> and <italic>A. caviae</italic> prevailed in primary bacteremia and biliary tract infections (p=0.012). Pneumonia, malignancy, and <italic>ascF-ascG</italic> genotype were independent factors associated with mortality. Ertapenem susceptibility was decreased in <italic>A. sobria</italic> (42.9%), <italic>A. veronii</italic> (66.7%), <italic>A. dhakensis</italic> (73%), and <italic>A. hydrophila</italic> (84.3%). Cefotaxime resistance was found in 30.9% of <italic>A. caviae</italic> and 18.9% of <italic>A. dhakensis</italic> isolates, much more prevalent than the other species. The metallo-β-lactamase <italic>bla<sub>CphA</sub></italic> was almost invariably present in <italic>A. dhakensis</italic>, <italic>A. hydrophila</italic>, and <italic>A. veronii</italic> (100%, 100% and 89.9%, respectively). Amp-C β-lactamases such as <italic>bla<sub>MOX</sub></italic> and <italic>bla<sub>AQU-1</sub></italic> were identified in all <italic>A. caviae</italic> and 91.9% of <italic>A. dhakensis</italic> isolates. Cefepime, fluoroquinolones and tigecycline showed good <italic>in vitro</italic> activity against aeromonads.</p>