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Aeromonas species

Background:

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Other   (Gram Negative Bacilli)  
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>Aeromonas species: led
     1] Aeromonas hydrophila
     2] Aeromonas veronii
     3] Aeromonas shubertii
>Bartonella species:
     1] Bartonella bacilliformis
     2] Bartonella henselae (organism responsible for cat scratch disease)
     3] Bartonella Quintana
     4] Other
>Campylobacter:
     1] Campylobacter fetus
     2] Campylobacter jejuni
>Capnocytophaga species:
     1] Capnocytophaga canimorsus
     2] Capnocytophaga ochracea
>Francisella tularensis
>Helicobacter pylori
>Legionella species: ( L. pneumophila)
>Plesiomonas shigelloides
>Vibrio species:
     1] Vibrio cholera
     2] Vibrio parahaemolyticus
     3] Vibrio damsela
     4] Other

Aeromonas:

  • gram-negative, facultative anaerobic rod that morphologically resembles members of the family Enterobacteriaceae. 
  • The most important pathogens are A. hydrophila, A. caviae, and A. veronii biovar sobria.
  • Two major diseases associated with Aeromonas are gastroenteritis and wound infections, with or without bacteremia.
  • Gastroenteritis typically occurs after the ingestion of contaminated water or food, whereas wound infections result from exposure to contaminated water.

 
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Therapy:

Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first.   Most strains are resistant to penicillin, ampicillin, and ticarcillin and susceptible to Bactrim, 2nd and 3rd generation cephalosporins, fluoroquinolones, carbapenems, and aminoglycosides.  Mild diarrhea is usually self-limiting and may not require antibiotic therapy.

Reserve oral therapy for mild-moderate cases and IV therapy for severe cases (bacteremia etc.).

  1. Ciprofloxacin 750 mg orally q12h
  2. Levofloxacin 750 mg orally once daily
  3. Bactrim DS (TMP-SMX) 160/800mg po bid.
  4. Ciprofloxacin 400mg IV q12h
  5. Levofloxacin 750 mg IV once daily
  6. Bactrim   Mild-moderate infection:  8 to 10 mg/kg/day (based on trimethoprim component) IV divided in 2-4 doses.    Severe infection: 15 to 20 mg/kg/day (based on trimethoprim component)  IV, given in equally divided doses every 6 to 8 hours.
  7. Cefepime 2 grams IV every 8-12 hours
  8. Carbapenems (Imipenem,  Doripenem, etc.)

Aeromonas species