Aeromonas hydrophila infection: clinical aspects and therapeutic options

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Aeromonas hydrophila is distributed widely in nature and is responsible for various but infrequent human infections. More and more clinical reports together with studies of the organism's resistance to antibiotics are appearing. We review A. hydrophila, including clinical manifestations of diseases, antibiotic resistances, treatments and prognosis. Unlike earlier publications, recent clinical reports have more often involved healthy, rather than immunocompromised, individuals. Soft-tissue infections, diarrhoea, bacteraemia and septicaemia are common; however the spectrum of clinical syndromes continues to expand. This organism is usually susceptible to many antimicrobial agents active against Gram-negative bacteria, but is resistant to some penicillins. The major mechanism of resistance of A. hydrophila to β-lactams is the production of inducible β-lactamases that are mainly chromosomally controlled. There are many choices of antimicrobial chemotherapy, but fluoroquinolones may be considered first based on in vitro susceptibility and limited clinical experience. In some cases chemotherapy alone is not enough and surgery or other treatments are necessary. Different prognoses have been seen in different situations and good outcomes do not always occur. Aeromonas hydrophila is a pathogen to which attention should be consciously paid and more work on it should be carried out.

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