title: A molecular study on the prevalence and virulence potential of Aeromonas spp. recovered from patients suffering from diarrhea in Israel.
abstract: BACKGROUND
  Species of the genus Aeromonas are native inhabitants of aquatic environments and have recently been considered emerging human pathogens. Although the gastrointestinal tract is by far the most common anatomic site from which aeromonads are recovered, their role as etiologic agents of bacterial diarrhea is still disputed. Aeromonas-associated diarrhea is a phenomenon occurring worldwide; however, the exact prevalence of Aeromonas infections on a global scale is unknown.
  
  
  RESULTS
  The prevalence and virulence potential of Aeromonas in patients suffering from diarrhea in Israel was studied using molecular methods. 1,033 diarrheal stools were sampled between April and September 2010 and Aeromonas species were identified in 17 (∼2%) patients by sequencing the rpoD gene. Aeromonas species identity and abundance was: A. caviae (65%), A. veronii (29%) and Aeromonas taiwanensis (6%). This is the first clinical record of A. taiwanensis as a diarrheal causative since its recent discovery from a wound infection in a patient in Taiwan. Most of the patients (77%) from which Aeromonas species were isolated were negative for any other pathogens. The patients ranged from 1 to 92 years in age. Aeromonas isolates were found to possess different virulence-associated genes: ahpB (88%), pla/lip/lipH3/apl-1 (71%), act/hlyA/aerA (35%), alt (18%), ast (6%), fla (65%), lafA (41%), TTSS ascV (12%), TTSS ascF-ascG (12%), TTSS-dependent ADP-ribosylating toxins aexU (41%) and aexT (6%) in various combinations. Most of the identified strains were resistant to beta-lactam antibiotics but susceptible to third-generation cephalosporin antibiotics.
  
  
  CONCLUSIONS
  Aeromonas may be a causative agent of diarrhea in patients in Israel and therefore should be included in routine bacteriological screenings.
authors.affiliation: Department of Evolutionary and Environmental Biology, Faculty of Natural Sciences, University of Haifa, Mount Carmel, Haifa, Israel.
authors.forename: Yigal
authors.initials: Y
authors.lastname: Senderovich
authors.forename: Shifra
authors.initials: S
authors.lastname: Ken-Dror
authors.forename: Irina
authors.initials: I
authors.lastname: Vainblat
authors.forename: Dvora
authors.initials: D
authors.lastname: Blau
authors.forename: Ido
authors.initials: I
authors.lastname: Izhaki
authors.forename: Malka
authors.initials: M
authors.lastname: Halpern
mesh_terms: D000293:Adolescent; D000328:Adult; D000333:Aeromonas / Q000145:classification / Q000302:isolation & purification / Q000472:pathogenicity*; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D015995:Prevalence; D014774:Virulence / Q000235:genetics*; D037521:Virulence Factors; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D001426:Bacterial Proteins; D037521:Virulence Factors