Clinical Features and Prognostic Factors of Aeromonas Bacteremia / 감염과화학요법

ABSTRACT

BACKGROUND: Aeromonas is not a common cause of bacteremia, but can result in a grave outcome when present. In this study, clinical characteristics and prognostic factors of Aeromonas bacteremia were analysed. We also compared the clinical characteristics of community-acquired and nosocomial Aeromonas bacteremia. MATERIALS AND METHODS: We retrospectively reviewed 182 cases of Aeromonas bacteremia at Asan Medical Center from 1991 to 2000. RESULTS: Male patients predominated (67.0%) and the majority of cases occurred in the warmer months of the year. Almost all the patients (97.8%) had underlying conditions; liver disease (48.9%), biliary disease (30.2%), hematologic malignancy (10.9%), diabetes mellitus (10.9%), congestive heart failure (10.9%), and solid tumor (7.1%). An accompanying infection focus was found in 112 (61.5%) cases and the biliary tract was the most common site of infection. Compared to nosocomial bacteremia, patients with community-acquired Aeromonas bacteremia were more likely to have liver cirrhosis and complications (septic shock, altered consciousness). Nosocomial bacteremia occurred more often in patients with hematologic malignancy. Mortality directly related to Aeromonas bacteremia was 24.1%. Mortality was significantly associated with old age (> or =65 years), skin and soft tissue infection, septic shock, and altered consciousness by univariate analysis. Multivariate analysis revealed septic shock and altered consciousness as independent prognostic factors. CONCLUSION: Aeromonas bacteremia usually occurred in patients with hepatobiliary disease or malignancy and heralded a poor prognosis, especially when associated with complications (septic shock or altered consciousness).