Abstract
BackgroundSpecies of the genus Aeromonas are native inhabitants of aquatic environments and have recently been considered emerging human pathogens. Although the gastrointestinal tract is by far the most common anatomic site from which aeromonads are recovered, their role as etiologic agents of bacterial diarrhea is still disputed. Aeromonas-associated diarrhea is a phenomenon occurring worldwide; however, the exact prevalence of Aeromonas infections on a global scale is unknown.Methodology/Principal FindingsThe prevalence and virulence potential of Aeromonas in patients suffering from diarrhea in Israel was studied using molecular methods. 1,033 diarrheal stools were sampled between April and September 2010 and Aeromonas species were identified in 17 (∼2%) patients by sequencing the rpoD gene. Aeromonas species identity and abundance was: A. caviae (65%), A. veronii (29%) and Aeromonas taiwanensis (6%). This is the first clinical record of A. taiwanensis as a diarrheal causative since its recent discovery from a wound infection in a patient in Taiwan. Most of the patients (77%) from which Aeromonas species were isolated were negative for any other pathogens. The patients ranged from 1 to 92 years in age. Aeromonas isolates were found to possess different virulence-associated genes: ahpB (88%), pla/lip/lipH3/apl-1 (71%), act/hlyA/aerA (35%), alt (18%), ast (6%), fla (65%), lafA (41%), TTSS ascV (12%), TTSS ascF-ascG (12%), TTSS-dependent ADP-ribosylating toxins aexU (41%) and aexT (6%) in various combinations. Most of the identified strains were resistant to beta-lactam antibiotics but susceptible to third-generation cephalosporin antibiotics.Conclusions Aeromonas may be a causative agent of diarrhea in patients in Israel and therefore should be included in routine bacteriological screenings.
Highlights
Aeromonas species are waterborne, Gram-negative, oxidasepositive, rod-shaped bacteria that are ubiquitous in water
Aeromonas may be a causative agent of diarrhea in patients in Israel and should be included in routine bacteriological screenings
Aeromonas Prevalence in Diarrheal Stools The presence of Aeromonas was monitored in fecal specimens from diarrheal patients submitted to the Microbiology Laboratory of Clalit Health Services in Haifa
Summary
Gram-negative, oxidasepositive, rod-shaped bacteria that are ubiquitous in water. This includes chlorinated drinking water, as the bacteria can grow and survive in biofilms in the water distribution systems [1]. Patients may acquire Aeromonas infections both in community and hospital settings [3,4,5]. The gastrointestinal tract is by far the most common anatomic site from which aeromonads are recovered [3,6]. The gastrointestinal tract is by far the most common anatomic site from which aeromonads are recovered, their role as etiologic agents of bacterial diarrhea is still disputed. Aeromonas-associated diarrhea is a phenomenon occurring worldwide; the exact prevalence of Aeromonas infections on a global scale is unknown
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