Monomicrobial Aeromonas and Vibrio bacteremia in cirrhotic adults in southern Taiwan: Similarities and differences
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
49
Journal Issue
4
Pages
509-515
Date Issued
2016
Author(s)
Abstract
Background/Purpose Aeromonas and Vibrio are important water-borne pathogens causing substantial morbidity and mortality in cirrhotic patients in Taiwan, but the differences in clinical manifestations of Aeromonas and Vibrio bacteremia have not been reported in detail. Methods From January 2003 to September 2013, cirrhotic patients with monomicrobial Aeromonas or Vibrio bacteremia at a medical center in Taiwan were included in this study. Results The study population consisted of 77 cirrhotic patients with Aeromonas bacteremia and 48 patients with Vibrio bacteremia. Both pathogens clustered during the summer season; Vibrio bacteremia was more correlated with higher temperatures (Vibrio: r2 = 0.95, p < 0.0001; Aeromonas: r2 = 0.74, p = 0.006) and was associated with ingestion of undercooked seafood (p = 0.03) or cutaneous exposure (p < 0.001). Vibrio bacteremia mainly occurred in mildly or moderately decompensated cirrhosis (Child–Pugh class A and B: 45.8% vs. 20.8%, p = 0.003), and caused more soft-tissue infections (31.3% vs. 5.2%; p < 0.001) and renal dysfunction (1.6 ± 1.2 mg/dL vs. 1.3 ± 0.8 mg/dL, p = 0.006). Sepsis-related mortality was similar in the cases of Vibrio and Aeromonas bacteremia (14.6% vs. 14.3%, p = 0.96), but those with Vibrio bacteremia underwent a fulminant course, as evidenced by a shorter time from bacteremia onset to death (3.1 days vs. 8.2 days, p = 0.04). Conclusion In cirrhotic patients, bacteremia caused by Aeromonas and Vibrio species clustered in summer months and caused similar mortality, but Vibrio bacteremia led to a more severe and fulminant sepsis. ? 2014
Other Subjects
abdominal infection; adult; Aeromonas; aged; Article; bacteremia; bacterial peritonitis; bloodstream infection; decompensated liver cirrhosis; diabetes mellitus; disease severity; female; fever; human; leukocytosis; leukopenia; liver cell carcinoma; liver cirrhosis; liver function; major clinical study; male; middle aged; mortality; necrotizing fasciitis; nonhuman; sea food; sepsis; severe hepatic impairment; soft tissue infection; Taiwan; thrombocytopenia; Vibrio; Vibrio vulnificus; vibriosis; Aeromonas; bacteremia; liver cirrhosis; microbiology; pathogenicity; pathology; season; Soft Tissue Infections; very elderly; Vibrio; Vibrio Infections; Adult; Aeromonas; Aged; Aged, 80 and over; Bacteremia; Female; Humans; Liver Cirrhosis; Male; Middle Aged; Seasons; Soft Tissue Infections; Taiwan; Vibrio; Vibrio Infections
Type
journal article