Aeromonas dhakensis is not a rare cause of Aeromonas bacteremia in Hiroshima, Japan
Aeromonas dhakensis is not a rare cause of Aeromonas bacteremia in Hiroshima, Japan
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DOI：
10.1016/j.jiac.2019.08.020
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发表时间：
2020-02-01
影响因子：
2.2
通讯作者：
Sugai, Motoyuki
中科院分区：
文献类型：
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作者：
Kitagawa, Hiroki;Ohge, Hiroki;Sugai, Motoyuki
达克气单胞菌是一个新发现的种，商业表型试验常将其误认为嗜水气单胞菌、韦氏气单胞菌或豚鼠气单胞菌。在日本，关于A.dhakens的数据有限。我们对广岛大学医院2011年1月至2017年12月收治的单菌单胞菌菌血症患者进行了回顾性分析，并利用rpoD和gyrB基因测序和基质辅助激光解吸电离飞行时间质谱仪(MALDI-TOF MS)系统进行了菌种再鉴定。从血液分离的19株细菌中，重新鉴定出鼠疫杆菌9株(47.4%)、达卡弧菌4株(21.1%)、嗜水气单胞菌3株(15.8%)和韦氏弧菌3株(15.8%)。达卡沙门氏菌的表型被误认为嗜水气单胞菌(n=3，75%)或温和气单胞菌(n=1，25%)。在MALDI-TOF MS系统中，达卡曲霉也被误判为豚鼠曲霉(n=2，50%)、嗜水曲霉(n=1，25%)和简达曲霉(n=1，25%)。恶性肿瘤12例(63.2%)，肝硬变7例(36.8%)。胆道感染是气单胞菌菌血症最常见的来源(n=11，57.9%)。达卡支原体菌血症的主要来源也是胆道感染(n=3，75%)，与感染相关的14d死亡率为25%。达卡假单胞菌的临床特征、药物敏感性和死亡率与其他气单胞菌属分离株相似。这项研究表明，达卡弧菌并不是引起气单胞菌菌血症的罕见原因，但在日本广岛，它经常被误认为嗜水气单胞菌。应该进行进一步的研究，以确定日本达卡支原体的地理分布和临床影响。(C)2019年日本化疗学会和日本传染病协会。爱思唯尔有限公司出版。保留所有权利。
Aeromonas dhakensis, a newly recognized species, is often misidentified as A. hydrophila, A. veronii, or A. caviae by commercial phenotypic tests. Limited data about A. dhakensis are available in Japan. We retrospectively analyzed the patients with monomicrobial Aeromonas bacteremia at Hiroshima University Hospital from January 2011 to December 2017, and species re-identification was conducted using rpoD and gyrB gene sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry ( MALDI-TOF MS) system. Of the 19 strains from blood isolates, A. caviae (n = 9, 47.4%), A. dhakensis (n = 4, 21.1%), A. hydrophila (n = 3, 15.8%), and A. veronii (n = 3, 15.8%) were re-identified. A. dhakensis was phenotypically misidentified as A. hydrophila (n = 3, 75%) or A. sobria (n = 1, 25%). A. dhakensis was also misidentified as A. caviae (n = 2, 50%), A. hydrophila (n = 1, 25%), and A. jandaei (n = 1, 25%) in MALDI-TOF MS system. Malignancies (n = 12, 63.2%) and liver cirrhosis (n = 7, 36.8%) were common comorbidities. Biliary tract infection was the most frequent source of Aeromonas bacteremia (n = 11, 57.9%). The major source of A. dhakensis bacteremia was also biliary tract infection (n = 3, 75%), and the 14-day infection-related mortality of A. dhakensis was 25%. A. dhakensis isolates showed similar clinical characteristics, antimicrobial susceptibility, and mortality with those of other Aeromonas species isolates. This study demonstrated that A. dhakensis is not a rare cause of Aeromonas bacteremia, but is often misidentified as A. hydrophila in Hiroshima, Japan. Further studies should be conducted to identify the geographical distribution and clinical impact of A. dhakensis in Japan. (c) 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.