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2016 ; 7
(ä): 793
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Aeromonas dhakensis, an Increasingly Recognized Human Pathogen
#MMPMID27303382
Chen PL
; Lamy B
; Ko WC
Front Microbiol
2016[]; 7
(ä): 793
PMID27303382
show ga
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 ??-lactamase and metallo-?-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.