Aeromonas dhakensis, an Increasingly Recognized Human Pathogen.
Aeromonas dhakensis, an Increasingly Recognized Human Pathogen.
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DOI：
10.3389/fmicb.2016.00793
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发表时间：
2016
影响因子：
5.2
通讯作者：
Ko WC
中科院分区：
文献类型：
--
作者：
Chen PL;Lamy B;Ko WC
达肯气单胞菌首次在孟加拉国达卡从患有腹泻的儿童中分离出来，并于 2002 年得到描述。在过去的十年中，越来越多的证据表明该物种广泛分布在环境中，可引起人类和动物的多种感染，特别是在沿海地区。在临床实验室的商业表型测试中，达肯放线菌经常被误认为是嗜水放线菌、维罗尼放线菌或豚鼠放线菌。正确的鉴定依赖于分子方法。越来越多地使用的基质辅助激光解吸电离飞行时间质谱 (MALDI-TOF MS) 可能能够快速、准确地识别气单胞菌种类。 A. dhakensis 在不同的动物模型和临床感染中显示出其强大的毒力。尽管已经报道了几种毒力因素，但没有单一机制是决定性的。达肯不动杆菌是导致软组织感染和菌血症的主要物种，尤其是肝硬化或恶性肿瘤患者。值得注意的是，达肯斯菌菌血症比其他气单胞菌引起的菌血症更致命。该物种在胃肠炎中的作用仍存在争议。由于存在AmpC ββ-内酰胺酶和金属-β-内酰胺酶基因，第三代头孢菌素和碳青霉烯类药物在治疗重度达肯斯阿霉素感染时应谨慎使用，最佳方案可能是头孢吡肟或氟喹诺酮类药物。对细菌毒力因子和相关宿主反应的研究可能提供了解物种之间异质毒力的机会。与其他气单胞菌属物种相比，达肯斯气单胞菌具有不同的地理流行率和更强的毒力的假设值得进行更多研究。
Aeromonas dhakensis was first isolated from children with diarrhea in Dhaka, Bangladesh and described in 2002. In the past decade, increasing evidence indicate this species is widely distributed in the environment and can cause a variety of infections both in human and animals, especially in coastal areas. A. dhakensis is often misidentified as A. hydrophila, A. veronii, or A. caviae by commercial phenotypic tests in the clinical laboratory. Correct identification relies on molecular methods. Increasingly used matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) may be able to identify Aeromonas specie rapidly and accurately. A. dhakensis has shown its potent virulence in different animal models and clinical infections. Although several virulence factors had been reported, no single mechanism is conclusive. Characteristically A. dhakensis is the principal species causing soft tissue infection and bacteremia, especially among patients with liver cirrhosis or malignancy. Of note, A. dhakensis bacteremia is more lethal than bacteremia due to other Aeromonas species. The role of this species in gastroenteritis remains controversial. Third generation cephalosporins and carbapenems should be used cautiously in the treatment of severe A. dhakensis infection due to the presence of AmpC ββ-lactamase and metallo-β-lactamase genes, and optimal regimens may be cefepime or fluoroquinolones. Studies of bacterial virulence factors and associated host responses may provide the chance to understand the heterogeneous virulence between species. The hypothesis A. dhakensis with varied geographic prevalence and enhanced virulence that compared to other Aeromonas species warrants more investigations.