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Volume 42, Number 6, December 2009

Clinical presentations, prognostic factors, and mortality in patients with Aeromonas sobria complex bacteremia in a teaching hospital: a 5-year experience


Chien-Yu Wang, Chih-Yu Chi, Mao-Wang Ho, Cheng-Mao Ho, Po-Chang Lin, Jen-Hsien Wang


Received: December 30, 2007    Revised: June 6, 2008    Accepted: August 20, 2008   

 

Corresponding author:

Dr. Jen-Hsien Wang, Section of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Rd, North District, Taichung 404, Taiwan E-mail: jerrywang6414@yahoo.com.tw



 

Background and purpose: 

 

Bacteremia due to Aeromonas sobria complex is an uncommon clinical presentation, associated with a high mortality rate. This retrospective study reviewed the clinical manifestations and prognostic factors of A. sobria complex bacteremia.

 



 

Methods:

From September 2001 to August 2006, all adult patients with A. sobria complex bacteremia treated at a tertiary medical center in Taiwan were included. Antibiotic susceptibility was tested by disc diffusion method.



 

Results:

Of 33 patients with A. sobria complex bacteremia, 66.7% were men and 72.0% were older than 50 years. Most patients (72.7%) had community-acquired infection. The commonest associated conditions were liver cirrhosis (42.4%) and neoplasm (30.3%). With the exception of diarrhea, the clinical manifestations were similar to those of other Aeromonas spp. Secondary bacteremia occurred in 51.5% of patients, most of whom had either biliary tract infection (47%) or peritonitis (23.5%) as the major infection focus. Monomicrobial bacteremia was recorded in 23 patients. All isolates were susceptible to gentamicin, amikacin, ceftazidime, cefepime, and ciprofloxacin; 90.9% were susceptible to aztreonam and piperacillin-tazobactam, 87.9% to imipenem, and 78.8% to trimethoprim-sulfamethoxazole. The mortality rate was 39.4% and nearly 50% of deaths occurred within 96 h of admission. Hypotension, impaired renal function, and liver cirrhosis were significantly associated with a high mortality rate.



 

Conclusion:

A. sobria complex bacteremia usually occurs in patients with liver cirrhosis or neoplasm. In patients with A. sobria complex bacteremia, a secondary infection focus should be considered. Adequate antibiotics should be given early, especially to patients with hypotension and impaired renal function. 



 

Key words:

Aeromonas sobria; Bacteremia; Liver cirrhosis; Neoplasms; Taiwan