Aspectos de la resistencia antibiótica constitutiva y adquirida en cepas de Aeromonas hydrophila aisladas de fuentes de agua

Over the last three decades, the literature pointed out the implications of Aeromonas species in human pathology. These species were described as being involved in intestinal (several outbreaks of acute gastroenteritis of choleric/dysenteric form or chronic diarrhoea, ulcerative colitis, etc.) in normal adults or children, as well as in extraintestinal infections in immunocompromised hosts. This last aspect included a large range of cutaneous injuries (micronecrosis, abscesses, bums, cellulites, furunculosis), joint, bones, respiratory, urinary tract, ocular infections up to meningitis, endocarditis, peritonitis, hepatobilliary disease, endotoxic shock and septicemia (as consequence of leech microvascular surgery). During the last decade, the literature reported a high mortality in Aeromonas infections determined by certain phenospecies (A. hydrophila and A. veronii) especially in extraintestinal infections in immunocompromised patients. In microbiologists' opinion this high rate of mortality was probably due to poor knowledge concerning the aspects of antibioresistance in Aeromonas strains, to empiric treatments with antibiotics to which these bacteria exhibiting constitutive resistance lead to insuccessful results, and at last to the increasing trend of aeromonads resistance to certain antibiotics after 1996. The literature mentioned also that for a great number of Beta-lactamase producing Aeromonas strains, the use of microdilution method (by comparison to disk diffusion in agar medium) giving false results made more difficult the true knowledge of Aeromonas antibioresistance patterns. At the same time, in 2002, the literature mentioned 4 ecological compartments considered as "reservoirs for dissemination and transfer of microbial antibioresistance i.e. humans, animals, plants and natural soil and water. In the last time, more and more data of the literature revealed that some bacteria with role of reservoir of antibioresistance in the natural environment, even without a direct medical impact, however they could play an indirect one remaining permanent sources of R genes for bacterial strains with pathogenic abilities implicated in human pathology (i.e. Aeromonas infections in man related to different professional activities such as fishing, surfing, swimming, diving, etc.). The purpose of this work was to determine the aspects related to constitutive and acquired antibioresistance in 35 A. hydrophila strains isolated in aquatic environment of Danube Delta (10 salmaster waters, 5 aquatic plants, 5 fish intestinal content, 5 fish sapling, 5 snake and oyster shells). The strains were biochemically identified by using API20E and API20NE kits. The antibioresistance spectrum was determined by disk diffusion method following NCCLS 2000 recommendations. The choice and disposal of antibiotics on the Mueller Hinton plate was done to allow the interpretive reading and the phenotypic detection of different antibioresistance mechanisms, as follows: beta-lactamases (PEN, ME, AMX, AMC, CAZ) and carbapenemase (IMP) production; porin deficiency (FOX); efflux mechanism (C, TE, NOR). All tested strains exhibited high resistance to penicillin, aspect pleading for constitutive penicillinase production in Aeromonas strains. With reference to other penicillins (ME, AMX, AMC) and cephalosporins (CAZ, FOX) the tested strains exhibited 2 different antibioresistance patterns: AMX-R, AMC-S, CAZ-S (65%) indicating the presence of beta-lactamase sensitive to inhibitors and AMX-R, AMC-R, CAZ-S (22%) indicating the presence of beta-lactamase resistant to inhibitors. Resistance to FOX in 8% of strains signifies a phenotypical marker for the presence of porin deficiency. Only one Aeromonas strain (2.8%) was resistant to IMP. Three strains (8%) were simultaneous resistant to TE and TMP/SMX, NOR and CHL probably due to the presence of a resistance plasmid (codifying an efflux/ enzymatic mechanism). These aspects are pleading for the necessity to investigate the bacterial antibioresistance patterns of bacterial strains isolated from the environment, in the purpose to identify the factors responsible for the spreading of certain antibioresistance mechanisms in the external medium as risk factors for the colonization process with possible impact upon the human pathology.

Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.

El resumen se deja sin traducir para conservar la redacción original de los autores.

Las 35 cepas de Aeromonas hydrophila del delta del Danubio mostraron, por difusión en disco, resistencia elevada a penicilina, indicativa de penicilinasa constitutiva, y dos patrones: AMX-R/AMC-S/CAZ-S en 65 % y AMX-R/AMC-R/CAZ-S en 22 %. La resistencia a FOX (8 %) sugirió déficit de porinas; solo una cepa (2,8 %) resistió a IMP. Tres cepas (8 %) resistieron simultáneamente a TE, TMP/SMX, NOR y CHL, probablemente por un plásmido. Los autores abogan por estudiar la resistencia de aislados ambientales.

Explore cómo esta investigación se conecta con la práctica clínica

Más estudios revisados por pares en la categoría «Seguridad y control de infecciones».

• Mejora de la atención al paciente mediante la hirudoterapia y la gestión de las sanguijuelas desde su recepción hasta su eliminación en Francia — Vaesken C et al. (2023)
• Hirudoterapia (sanguijuelas medicinales) para el tratamiento de la obstrucción de la vía aérea superior en un perro — Trenholme H, Masseau I, Reinero C (2021)
• Análisis de infecciones resistentes a antibióticos asociadas a la hirudoterapia — Brauer P et al. (2024)
• Síndrome de Kounis por hirudoterapia (terapia con sanguijuelas) en el servicio de urgencias; informe de un caso — Çakmak T et al. (2018)
• Complicaciones de la terapia con sanguijuelas — Pourrahimi M, Abdi M, Ghods R (2020)
• Terapia con sanguijuelas medicinales e infección por Aeromonas spp. — Verriere B et al. (2016)
• Replanteamiento de la profilaxis antimicrobiana en pacientes que reciben terapia con sanguijuelas medicinales — McCracken J, Koehler S, Sharma R (2022)
• Uso profiláctico de levofloxacino durante la terapia con sanguijuelas medicinales — Bauters T et al. (2014)
• Hemorragia digestiva alta relacionada con la aplicación de sanguijuelas: caso clínico — Dolek U et al. (2023)
• Un ensayo clínico para evaluar la aplicación de sanguijuelas en el manejo de la vicarcikā (eccema) — Shankar K et al. (2014)

Ver toda la investigación analizada por la ASH →