Retrospective study of Aeromonas infection in a Malaysian urban area: a 10-year experience

Abstract

Aims: To describe the patterns of isolation of Aeromonas spp. and the resulting spectrum of infection, intestinal and extra-intestinal,from infants and children in an urban area in a hot and humid country from SoutheastAsia.

Materials and methods: Retrospective review of all bacterial culture records from children below 16 years of age, from the Department of Medical Microbiology, University of Malaya Medical Centre, Kuala Lumpur, from January 1988 to December 1997. Review of all stool samples and rectal swabs obtained from children during the same period were carried out to ascertain the isolation rate of Aeromonas sp. from stools and rectal swabs. The case records of those with a positive Aeromonas culture were retrieved and reviewed.

Results: During the study period, 84 culture samples were positive of Aeromonas spp. (stools 48, rectal swabs 36). During the same period, 1,352 stool samples were positive for at least one enteropathogen. Aeromonas spp. constituted 0.62% of all stool samples. Of the 61 cases reviewed,four patterns of colonization were observed: (a) 17 cases of mostly asymptomatic nursery newborns with a positive rectal swab; (b) 9 children with no diarrhoea; (c) 23 cases, of who seven were immunocompromised, had acute, brief watery diarrhoea without severe dehydration or disturbances of serum electrolytes. No chronic diarrhoea or bacteraemia was noted. (d) 12 cases had a mixed infection with a second enteropathogen isolated from stool samples. Three had chronic diarrhoea No extra-intestinal infection attributed to Aeromonas spp. was identified in this study.

Conclusion: Aeromonas was a rare cause of gastroenteritis in urban Malaysian children. It was isolated almost exclusively from gastro-intestinal tract, caused mostly by mild gastroenteritis with no serious complications. Asymptomatic stool carriage among newborns admitted to special care nursery and older children with no diarrhoea were observed.