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. 2019 Feb 14;19(1):158.
doi: 10.1186/s12879-019-3766-0.

Taxonomy, virulence genes and antimicrobial resistance of Aeromonas isolated from extra-intestinal and intestinal infections

Yanyan Zhou  1 , Li Yu  2 , Zheng Nan  1 , Pingping Zhang  1 , Biao Kan  3 , Donghui Yan  4 , Jianrong Su  5
Affiliations

Taxonomy, virulence genes and antimicrobial resistance of Aeromonas isolated from extra-intestinal and intestinal infections

Yanyan Zhou et al. BMC Infect Dis. .

Abstract

Background: Clinical characteristics (taxonomy, virulence genes and antimicrobial resistance ) of Aeromonas in isolated from extra-intestinal and intestinal infections were investigated to describe epidemiology, associated virulence factors and optimal therapy options.

Methods: Clinical samples (n = 115) of Aeromonas were collected from a general hospital in Beijing between the period 2015 and 2017. Taxonomy was investigate by Multilocus phylogenetic analysis (MLPA), 10 putative virulence factors by use of polymerase chain reaction (PCR) and antimicrobial resistance to 15 antibiotics by use of the microbroth dilution method.

Results: The most common species of Aeromonas detected in samples of intestinal tract included; A. caviae (43.9%), A. veronii (35.7%), and A. dhakensis (12.2%). Prevalent species of Aeromonas collected from extra-intestinal infections included; A. hydrophila (29.4%), A. caviae (29.4%), and A. dhakensis (23.5%). A. hydrophila were detected in 1% of stool samples and 29.4% (5/17) of extra-intestinal infections. A. hydrophila strains in extra-intestinal infections were related to malignancy. The most common medical conditions among patients with Aeromonas infections included malignancy and liver-transplant related cholecystitis. Multiple drug resistance (MDR) was prevalent in extra-intestinal isolates (82.3%, 14/17) and was greater than the prevalence in intestinal isolates (30.6%, 30/98) (P < 0.05). Resistant rates of extra-intestinal isolates were 70.6, 35.3, 23.5 and 5.9% for ceftriaxone, ciprofloxacin, gentamicin and imipenem, respectively, and were higher than found in previous studies. Despite differences in the number and type of virulence genes among samples of Aeromonas, no significant correlation was found between invasion and virulent genes in intestinal or extra-intestinal infections.

Conclusions: Overall results of this study support a role for Aeromonas spp. as a potential causative infectious agent of gastroenteritis, and malignancy, liver cirrhosis, post liver transplantation in immunocompromised patients. A. hydrophila was more prevalent in samples of extra-intestinal infections when compared to samples of intestinal infections, and was especially prominent in samples of patients presenting with malignancy. Aeromonas isolates from extra-intestinal samples had high rates of drug resistance but 3rd generation cephalosporins, fluoroquinolones and aminoglycosides remain as options to treat severe diarrhea. However, increasing MDR of extra-intestinal infection samples warrants monitoring.

Keywords: Aeromonas; Multi-drug resistance; Multilocus phylogenetic analysis (MLPA); Virulence genes.

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Conflict of interest statement

Ethics approval and consent to participate

The study obtained ethical approval (2017-P2–095-01) from the Medical Ethics Committee of Beijing Friendship Hospital, Capital Medical University, Beijing, P.R China. Given that the study was retrospective without any interventions in treatment and all the data were collected and analyzed anonymously, the requirement for informed consent was waived. Permissions for obtaining related medical records were approved by hosipital.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Unrooted neighbor -joined phylogenetic tree of species of Aeromonas isolated patients presenting with intestinal or extra-intestinal infections (n = 1000 bootstrap replicates). The tree was constructed by use of MLPA of seven housekeeping genes (gyrB, rpoD, recA, dnaJ, gyrA, dnaX and atpD). Red tree lines and triangles represent species detected in this study, blue lines represent the numbers of the extra-intestinal infections due to species of Aeromonas. The number of identified strains is indicated in brackets. Black tree lines and triangles represent other representative species
See this image and copyright information in PMC

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