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. 2022 Mar 29;22(1):303.
doi: 10.1186/s12879-022-07277-7.

Clinical characteristics and risk factors of Aeromonas bloodstream infections in patients with hematological diseases

Chunhui Xu #  1 , Qingsong Lin #  1 , Yuanqi Zhao  2 , Guoqing Zhu  1 , Erlie Jiang  2 , Shangzhu Li  3 , Yingchang Mi  4 , Yizhou Zheng  5 , Fengkui Zhang  5 , Xiaofan Zhu  6 , Zhijian Xiao  7 , Mingzhe Han  2 , Jianxiang Wang  4 , Sizhou Feng  8
Affiliations

Clinical characteristics and risk factors of Aeromonas bloodstream infections in patients with hematological diseases

Chunhui Xu et al. BMC Infect Dis. .

Abstract

Background: To analyze the clinical features, risk factors and outcomes of Aeromonas bloodstream infections (BSIs) in patients with hematological diseases to establish an effective optimal therapy against it.

Methods: A retrospective study was performed by reviewing medical records of patients admitted to a tertiary blood disease hospital in China. Patients with hematological diseases who suffered from Aeromonas bacteremia during January 2002 to December 2020 were enrolled in this study.

Results: A total of 63 patients who developed Aeromonas bacteremia were enrolled in the study, and 91.9% of patients were neutropenic at the onset of BSIs. The major complications were skin and soft tissue infection (SSTI) (22.2%), followed by gastroenteritis (19.0%) and pneumonia (14.3%). High carbapenem resistance rates (70.8% for imipenem, 71.4% for meropenem) were note among the cases. Furthermore, Aeromonas strains isolated from five individuals developed resistance to quinolone, β-lactams and tigecycline during the therapy. The 30-day mortality rate was 15.9%, while bacteremia with SSTI showed a much worse prognosis, with 50.0% (7/14) of the patients dying within 30 days of initiating the therapy. In the multivariate analysis, SSTI (OR = 28.72; 95% CI, 1.50-551.30; P = 0.026) and shock (OR = 47.58; 95% CI,1.06-2126.80; P = 0.046) were independent risk factors for mortality.

Conclusions: Aeromonas bacteremia usually occurred in patients with neutropenic status, and patients with SSTIs were more likely to show a worse prognosis. Carbapenems should be avoided in patients with Aeromonas BSIs and SSTIs given high resistance rate.

Keywords: Aeromonas; Bacteremia; Hematological diseases; Risk factors.

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Conflict of interest statement

No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Figures

Fig. 1
Fig. 1
The clinical characteristics of patients with concomitant skin and soft tissue infections. A The ratio of patients who with SSTIs, and the mortality rates of patients with and without SSTIs. B The patients’ lower limbs showed swelling with massive subcutaneous bruising and blister formation. C The patient with bilateral swelling of the lower extremities and massive subcutaneous bruising with blister formation bilaterally around navel and groin. The perineum and scrotum were swollen with bruising. D Depiction of the possible mechanism by which Aeromonas causes skin and soft tissue infection through bloodstream infection. Necrotizing soft tissue infection often involves limbs, perineum, and abdomen. The lower extremities are most commonly involved and may present with erythema, severe pain, skin bullae, necrosis, or ecchymosis
Fig. 2
Fig. 2
Monthly distribution of Aeromonas bacteremia
Fig. 3
Fig. 3
Kaplan-Meier curves of the 30-day probability of survival for BSI caused by Aeromonas. A Patients with and without unresolved neutropenic. B Patients with and without shock. C Patients with and without SSTI. D Patients with appropriate empirical treatment in 24 h
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