Aeromonas infection of the hepatobiliary system: report of 15 cases and review of the literature. Clin. Infect. Dis

Aeromonas species cause both intestinal and extraintestinal disease. We reviewed hospital laboratory and medical records to identify patients with Aeromonas infection of the hepatobiliary or pancreatic system. Analysis of data from our hospital, as well as a review of the published literature, yielded a total of 41 episodes in 39 patients, and the features of these episodes are described. The most common manifestation of Aeromonas hepatobiliary infection among all reported cases was cholangitis (29 of 41 episodes). The majority of infections in our hospital occurred in patients with underlying immunosuppression or malignancy (13 of 15 patients), including 4 liver transplant recipients, and nosocomial infection was not infrequent (8 of 17 episodes). Infection occurred most commonly in patients with obstruction of the biliary tract due to stones, tumor, or stricture and was associated with a relatively high mortality rate (11.8%). Antibiotic susceptibility testing revealed that gentamicin, imipenem, and ciprofloxacin had the highest activity against the Aeromonas species isolated. Aeromonas species are the etiologic agents of a variety of illnesses; gastrointestinal infection is the most com-mon presentation [1, 2]. Extraintestinal illnesses at-tributed to Aeromonas species have included soft-tissue infection [3], peritonitis [4], meningitis [5], and bac