title: Monomicrobial Aeromonas and Vibrio bacteremia in cirrhotic adults in southern Taiwan: Similarities and differences.
abstract: OBJECTIVE
  Aeromonas and Vibrio are important water-borne pathogens causing substantial morbidity and mortality in cirrhotic patients in Taiwan, but the differences in clinical manifestations of Aeromonas and Vibrio bacteremia have not been reported in detail.
  
  
  METHODS
  From January 2003 to September 2013, cirrhotic patients with monomicrobial Aeromonas or Vibrio bacteremia at a medical center in Taiwan were included in this study.
  
  
  RESULTS
  The study population consisted of 77 cirrhotic patients with Aeromonas bacteremia and 48 patients with Vibrio bacteremia. Both pathogens clustered during the summer season; Vibrio bacteremia was more correlated with higher temperatures (Vibrio: r(2) = 0.95, p < 0.0001; Aeromonas: r(2) = 0.74, p = 0.006) and was associated with ingestion of undercooked seafood (p = 0.03) or cutaneous exposure (p < 0.001). Vibrio bacteremia mainly occurred in mildly or moderately decompensated cirrhosis (Child-Pugh class A and B: 45.8% vs. 20.8%, p = 0.003), and caused more soft-tissue infections (31.3% vs. 5.2%; p < 0.001) and renal dysfunction (1.6 ± 1.2 mg/dL vs. 1.3 ± 0.8 mg/dL, p = 0.006). Sepsis-related mortality was similar in the cases of Vibrio and Aeromonas bacteremia (14.6% vs. 14.3%, p = 0.96), but those with Vibrio bacteremia underwent a fulminant course, as evidenced by a shorter time from bacteremia onset to death (3.1 days vs. 8.2 days, p = 0.04).
  
  
  CONCLUSIONS
  In cirrhotic patients, bacteremia caused by Aeromonas and Vibrio species clustered in summer months and caused similar mortality, but Vibrio bacteremia led to a more severe and fulminant sepsis.
authors: Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan.
authors: Ling-Shan
authors: LS
authors: Syue
authors: Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan; Graduate Institute of Clinical Medicine, National Cheng Kung University, College of Medicine, Tainan, Taiwan.
authors: Po-Lin
authors: PL
authors: Chen
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan.
authors: Chi-Jung
authors: CJ
authors: Wu
authors: Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors: Nan-Yao
authors: NY
authors: Lee
authors: Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors: Ching-Chi
authors: CC
authors: Lee
authors: Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors: Chia-Wen
authors: CW
authors: Li
authors: Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors: Ming-Chi
authors: MC
authors: Li
authors: Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors: Hung-Jen
authors: HJ
authors: Tang
authors: Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
authors: Po-Ren
authors: PR
authors: Hsueh
authors: Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan. Electronic address: winston3415@gmail.com.
authors: Wen-Chien
authors: WC
authors: Ko
mesh_terms: D000328:Adult; D000333:Aeromonas / Q000472:pathogenicity*; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012621:Seasons; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology*; D013624:Taiwan; D014733:Vibrio / Q000472:pathogenicity*; D014735:Vibrio Infections / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality
keywords: Aeromonas; Vibrio; bacteremia; liver cirrhosis