Abstract
Aeromonads have been isolated from varied environmental sources such as polluted and drinking water, as well as from tissues and body fluids of cold and warm-blooded animals. A phenotypically and genotypically heterogenous bacteria, aeromonads can be successfully identified by ribotyping and/or by analysing gyrB gene sequence, apart from classical biochemical characterization. Aeromonads are known to cause scepticemia in aquatic organisms, gastroenteritis and extraintestinal diseases such as scepticemia, skin, eye, wound and respiratory tract infections in humans. Several virulence and antibiotic resistance genes have been identified and isolated from this group, which if present in their mobile genetic elements, may be horizontally transferred to other naive environmental bacteria posing threat to the society. The extensive and indiscriminate use of antibiotics has given rise to many resistant varieties of bacteria. Multidrug resistance genes, such as NDM1, have been identified in this group of bacteria which is of serious health concern. Therefore, it is important to understand how antibiotic resistance develops and spreads in order to undertake preventive measures. It is also necessary to search and map putative virulence genes of Aeromonas for fighting the diseases caused by them. This review encompasses current knowledge of bacteriological, environmental, clinical and virulence aspects of the Aeromonas group and related diseases in humans and other animals of human concern.
Key words: Aeromonad, diarrhea, multi-drug, resistance, virulence
Introduction
Aeromonads are recognized not only as an important disease-causing pathogen of fish and other coldblooded organisms but also as a causative organism in a variety of infectious complications in both immunocompetent and immunocompromised humans. The name Aeromonas is derived from Greek noun aeros (air, gas) and monas (unit). Members of the genus Aeromonas can be referred to as aeromonad. Aeromonads (Phylum Proteobacteria, Class Gammaproteobacteria, Order Aeromonadales, Family Aeromonadaceae) are Gram-negative, non-spore forming, rod shaped, facultative anaerobic bacteria that occur in natural water bodies of the environment. They are similar in many characters to Enterobacteriaceae family.
The DNA-DNA hybridization studies showed the presence of 33 DNA hybridization groups, including 19 genospecies. Aeromonas hydrophila, A. caviae, A. sobria, A. veronii, and A. schubertii are mesophilic, whereas, A. salmonicida are non-motile and psychrophilic. Widely distributed, aeromonads have been isolated from various sources like freshwater fishes, drinking water supply, environmental samples, polluted waters, food items like meat, fish, milk, ready to eat items and oysters (Abeyta et al., 1986; Altwegg et al., 1990; Manna et al., 2013, Figueras et al., 2017). Aeromonas have been found in the Aedes aegyptii and Culex quinque fasciatus mosquitoes’ midgut, in monkey faeces and bivalve molluscs (Pidiyar et al., 2002), larvae of Chironomus plumosus (Rouf and Rigney, 1993).
Over the past few years, researchers have renewed interest in the genus Aeromonas as an emergent human pathogen (Janda and Abbott, 1998). Aeromonads have been implicated in septicaemia in variety of aquatic organisms and gastrointestinal/extra-intestinal diseases in humans (Janda and Duffey, 1988; Janda and Abbott, 1996). Several species of genus Aeromonas have been implicated in pathogenic cases in human, like cellulitis, surgical wound infections, nosocomial pneumonia, hemolytic-uremic syndrome, sepsis, peritonitis, meningitis, urinary tract infections, and severe muscle degeneration. In all the cases it seems that Aeromonas-mediated pathogenesis occurs both in cases of immunosuppression and immunocompetence (Wang et al., 2003). However, Aeromonas-mediated mechanism of pathogenesis in both aquatic organisms and in human subjects remains to be elucidated.
Aeromonas spp. possess multifactorial virulence genes and systems. Several groups have demonstrated the presence of aerolysin (Chakraborty et al., 1986), hemolysin (Wang et al., 1996), extracellular lipase (Anguita et al., 1993), cytolytic enterotoxin (Chopra et al., 1993), haemolytic toxin genes (Khan et al., 1998), acetylcholinesterase (Nieto et al., 1991) and proteases (Leung and Stevenson, 1988). Genome level scans have identified virulence factors in potential open reading frames (ORFs) and few putative genes, like O-antigen and capsule, gene cluster in phage and type III secretion system have been associated with virulent aeromonads. Several genomic islands (GIs) with unusual G-C content, have also been identified that carry mobility-associated genes, such as integrases or transposes and other putative virulence genes (Yu et al., 2005). Aeromonas luxRI quorum sensing gene homologs and Ribonuclease R (Vac B) have also been implicated in modulation and expression of these virulence genes (Jangid et al., 2007; Erova et al., 2008). The NDM-1 gene (blaNDM-1) has been found in aeromonads of North India (New Delhi) (Walsh et al., 2011).
Aeromonads are found to inhabit a variety of niches including soil, aquatic habitats, aquatic animals, terrestrial animals, birds, insects, and human beings (Table I). A. hydrophila are found to inhabit a wide range of thermal and pH conditions, except in extremely polluted and saline water and hot water springs. Estuaries are ideal for Aeromonas, where they either exist freely or associated with crustaceans (Fiorentini et al., 1998). Most of the aeromonads come into human systems through ingestion of water or food contaminated with Aeromonas. In India, Aeromonas spp. have been detected in 13.4% of animal-origin food samples, the highest being in fish (Kumar et al., 2000). Aeomonads mostly infect the gastrointestinal tract, urinary tract and blood of human beings. Three Aeromonas species viz., A. hydrophila, A. caviae and A. veronii bv. Sobria are known to infect human beings (Janda and Abbott, 1998). Some other species like A. jandaei, A. veronii bv. veronii, A. schubertii, A. popoffi are also known to infect human (Janda et al., 1994; Hua et al., 2004). Hua et al. (2004) isolated A. popoffi from the urine of a patient with urinary tract infection (Hua et al., 2004). A. salmonicida, generally known to infect cold blooded animals, has also been isolated from blood sample of a patient in India (Tewari et al., 2014). A. salmonicida was identified by Vitek 2 compact automated system. Non-culturable Aeromonas can be found in drinking water in various concentrations. The first report of Aeromonas from drinking water was confirmed by sequencing 16S rRNA (Figueras et al., 2005). Different concentrations of Aeromonas have been detected in consumable products from markets (Isonhood and Drake, 2002).
Table I.
DNA Hybridization group | Type Strain/Reference | Genospecies | Phenospecies | Remarks | Reference |
---|---|---|---|---|---|
1 | ATCC 7966 | A. hydrophila | A. hydrophila | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
1 | BCCM/LMG 19562 | A. hydrophila subsp. dhakensis | A. hydrophila subsp. dhakensis | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
1 | BCCM/LMG 19707 | A. hydrophila subsp. ranae | A. hydrophila subsp. ranae | Pathogenic for frogs | Martin-Carnahan and Joseph, 2005 |
2 | ATCC 14715 | A. bestiarum | A. hydrophila-like | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
3 | ATCC 33658 | A. salmonicida | A. salmonicida subsp. Salmonicida | Nonmotile fish pathogen | Martin-Carnahan and Joseph, 2005 |
3 | ATCC 33659 | A. salmonicida | A. salmonicida subsp. Achromogenes | Nonmotile fish pathogen | Martin-Carnahan and Joseph, 2005 |
3 | ATCC 27013 | A. salmonicida | A. salmonicida subsp. Masoucida | Nonmotile fish pathogen | Martin-Carnahan and Joseph, 2005 |
3 | ATCC 49393 | A. salmonicida | A. salmonicida subsp. Smithia | Nonmotile fish pathogen | Martin-Carnahan and Joseph, 2005 |
3 | CDC 0434-84, Popoff C316 | Unnamed | A. hydrophila-like | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
4 | ATCC 15468 | A. caviae | A. caviae | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
5A | CDC 0862-83 | A. media | A. caviae-like | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
5B | CDC 0435-84 | A. media | A. media | – | Martin-Carnahan and Joseph, 2005 |
6 | ATCC 23309 | A. eucrenophila | A. eucrenophila | – | Martin-Carnahan and Joseph, 2005 |
7 | CIP 7433, NCMB 12065 | A. sobria | A. sobria | – | Martin-Carnahan and Joseph, 2005 |
8X | CDC 0437-84 | A. veronii | A. sobria | – | Martin-Carnahan and Joseph, 2005 |
8Y | ATCC 9071 | A. veronii | A. veronii biovar sobria | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
9 | ATCC 49568 | A.jandaei | A.jandaei | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
10 | ATCC 35624 | A. veronii biovar veronii | A. veronii biovar veronii | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
11 | ATCC 35941 | Unnamed | Aeromonas spp. (ornithine Positive | – | Martin-Carnahan and Joseph, 2005 |
12 | ATCC 43700 | A. schubertii | A. schubertii | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
13 | ATCC 43946 | Aeromonas Group 501 | A. schubertii-like | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
14 | ATCC 49657 | A. trota | A. trota | Isolated from clinical specimens | Martin-Carnahan and Joseph, 2005 |
15 | ATCC 51208, CECT 4199 | A. allosaccharophila | A. allosaccharophila | – | Martin-Carnahan and Joseph, 2005 |
16 | ATCC 51020 | A. encheleia | A. encheleia | Pathogenic for eels | Martin-Carnahan and Joseph, 2005 |
17 | BCCM/LMG 1754 | A. popoffii | A. popoffii | – | Martin-Carnahan and Joseph, 2005 |
UA | MTCC 3249, NCIM 5147 | A. culicicola | A. culicicola | Isolated from mosquitoes | Martin-Carnahan and Joseph, 2005 |
UA | – | A. eucrenophila | A. tecta | Isolated from clinical and environmental sources | Demarta et al., 2008 |
UA | – | A. trota | A. aquariorum | Isolated from monkey faeces | Harf-Monteil et al., 2004 |
UA | – | A. popoffii | A. bivalvium | Isolated from aquaria of ornamental fish | Martinez-Murcia et al., 2008 |
UA | – | Unnamed | A. sharmana | Isolated from bivalve molluscs | Minana-Galbis et al., 2004 |
UA | 868ET (= CECT 7113T = LMG 23376T) | A. bivalvium sp. nov. | – | Isolated from bivalve molluscs | Minana-Galbis et al., 2007 |
UA | – | A. schubertii | A. simiae | Isolated from midgut of Mosquitoes | Pidiyar et al., 2002 |
UA | – | A. sharmana sp. nov. | A. sobria | Isolated from a warm spring | Saha and Chakrabarti, 2006 |
UA | 266T (5CECT 8023T 5LMG 26707T) | Aeromonas australiensis sp. nov. | Aeromonas fluvialis, Aeromonas veronii and Aeromonas allosaccharophila | Isolated from irrigation water system | Aravena-Roman et al., 2013 |
UA | A.11/6T (= DSMZ 24095T, = CECT 7828T) | Aeromonas lusitana sp. nov. | – | Isolated frm untreated water and vegetables (lettuce/celery) | Martinez-Murcia et al., 2016 |
UA | ATCC 49803 | Aeromonas enteropelogenes | Aeromonas trota | Isolated from human stool | Schubert et al., 1990 |
UA | CECT 4254T | Aeromonas diversa | Aeromonas schubertii | Isolated from leg wound of a patient | Farfan et al., 2013 |
UA | 717T (= CECT 7401T = LMG 24681T) | Aeromonas fluvialis | Aeromonas veronii | Isolated from river water | Alperi et al., 2010b |
UA | 848TT (= CECT 5864T = LMG 22214T) | Aeromonas molluscorum sp. nov. | – | Isolated from Wedge-shells | Minana-Galbis et al., 2004 |
UA | WB4.1-19T (CECT 7518T DSM 22539T MDC 2511T) | Aeromonas rivuli sp. nov. | – | Isolated from a karst hard water creek | Figueras et al., 2011 |
UA | S1.2T (= CECT 7443T = LMG 24783T) | Aeromonas piscicola sp. nov. | – | Isolated from wild diseased Salmon | Beaz-Hidalgo et al., 2009 |
UA | A2-50T (= CECT 7403T = LMG 24683T) | Aeromonas taiwanensis sp. nov. | – | Isolated from wound infection of a patient | Alperi et al., 2010a |
UA | A2-67T (= CECT 7402T = LMG 24682T) | Aeromonas sanarellii sp. nov. | – | Isolated from a wound culture from a patient | Alperi and Figueras, 2010 |
UA | A. hydrophila | – | Isolated from wild birds | Glunder and Seigmann, 1989 |
UA-Unassigned; – Un Named
Epidemiology
Mesophilic bacteria grow well at higher temperatures and therefore an increase in bacterial load may be attributed to their increase in concentration in both freshwater environments and drinking water sources with the increase of ambient temperature (Moyer, 1987; Edberg et al., 2007; Khardori and Fainstein, 1988). The seasonality is also seen in extra-intestinal infections such as septicemia, where 42% to 67% of bacteremic diseases appear during the summer season (Tsai et al., 2006). The elevated levels of these bacteria in aquatic environments during the summer season increases the opportunities of human or aquatic organisms of getting exposed to them and thus the risk of getting infected by these bacteria also gets higher. Infections caused by aeromonads seem to be rather more prevalent in developing countries like India, Bangladesh, Brazil, China, Cuba, Egypt, Iran, Libya, Nigeria, Venezuala and Vietnam (Ghenghesh et al., 2008). Prevalence of Aeromonas related disease is more during rainy seasons when the water salinity is low than at high salinity during dry season (Marcel et al., 2002).
Infections and Symptoms
Gastrointestinal tract is the most common site of Aeromonas infection. Evidences show that Aeromonasassociated diarrhoea or cholera-like disease occurs in some patients, whereas no symptom may appear in cases of low-level infections (Gurwith et al., 1977; Holmberg et al., 1984). Kelly et al. (1993) isolated Aeromonas from non-fecal samples from 58 patients, suffering from gangrene, septicemia, osteomyelitis and peritonitis. Aeromonas-related diarrhoea may be watery and self-limiting. In other cases, fever, abdominal pain and bloody diarrhea may develop along with dehydration (Ghenghesh et al., 1999). Hematologic cancer patients, patients with tumours in their gastrointestinal tract or having alimentary canal diseases are more likely to be infected by Aeromonas. In rare cases of segmental colitis Aeromonas segmental colitis may occur that seem to be ischemic colitis or Crohn’s disease (Bayerdorffer et al., 1986). Although any portion of the colon may be affected, it mostly affects the ascending or transverse sections. Iileal ulceration has also been linked to Aeromonas enteritis (Yamamoto et al., 2004). It may also cause intra-mural intestinal hemorrhage including small bowel obstruction (Block et al., 1994), and refractory inflammatory bowel disease (Doman et al., 1989). Gastrointestinal tract infection symptoms may mimic cholera (Mohan et al., 2017).
The second most common area of Aeromonas- related infection in our body is the skin and the soft tissues underlying the skin. Aeromonads may cause several types of skin and soft tissue infections, ranging from mild problems like pustular lesions to dangerous conditions that can cause morbidity in infected person. Some of these conditions include cellulitis, necrotizing fasciitis, myonecrosis, septic arthritis and septic shock (Lai et al., 2007). Some medical treatment procedures like medicinal leech therapy, appendectomies, colectomy, cholecystectomy and elective surgery enhance the chances of Aeromonas-associated wound infections (Moawad and Zelderman, 2002; Tena et al., 2009). A. hydrophila and A. caviae were isolated from five burn patients admitted in Royal Brisbane hospital, where the patients had been immersed in water immediately after getting burnt, putatively contaminated with Aeromonas (Kienzle et al., 2000).
A. hydroplila sensu stricto, A. caviae and A. veronii bv. Sobria have been implicated in blood borne infections. Less frequently, three other species namely, A. jandaei, A. veronii bv. veronii and A. schubertii are known to cause sepsis (Janda et al., 1994). Aeromonassepticemia is more prevalent in immunocompromised conditions viz. myeloproliferative disorders, chronic liver disease, neoplasia, biliary disease, AML, myeloplastic syndromes, non-Hodgkin’s lymphoma and acute lymphocytic leukemia (Ko et al., 2000; Tsai et al., 2006). Aeromonas septicemia is also related to diseases like diabetes mellitus, renal and cardiac problems, thallasemia, multiple myeloma, aplastic anemia and Waldenstrom’s macroglobulinemia (Janda and Abbott, 1996; Padmaja et al., 2013). Aeromonad-contaminated catheters and dialysis chambers may serve as points of entry into human blood. Aeromonas cause peritonitis and cholangitis as intra-abdominal disease. Aeromonasassociated cholangitis may result in pancreatic carcinoma, cholangiocarcinoma, cholelithiasis patients or patients with non-malignant biliary disease by the invasion of the bacteria from the gastrointestinal tract to the biliary tract via surgery or endoscopy (Chan et al., 2000). A. hydrophila, A. veronii bv. Sobria, A. popoffi and A. caviae infections have been implicated in UTI, aspiration pneumonia, keratitis, endophthalmitis, corneal ulceration and blood stream infections through biofilm formation (Ender et al., 1996; Hsueh et al., 1998; Miyake et al., 2000; Hua et al., 2004; Pinna et al., 2004; Hondur et al., 2008; Tang et al., 2014). First case of neonatal meningitis in a premature baby has been reported recently caused by A. hydrophila (Kali et al., 2016).
Aeromonas affects both cold and warm-blooded non-human animals. Mass deaths in fishes occur every year due to Aeromonas-associated diseases resulting in huge economic loss to the fish industry (Monette et al., 2006). Furunculosis in the salmonids, caused by A. salmonicida sensu stricto is characterized by symptoms like heamorrhages at fin bases, muscles and internal organs; loss of appetite, disordered melanin production, loss of energy and exopthalmia (Austin, 1997). Secondly, septicemia in carps, tilapia, catfishes, salmons, cods, bass and freshwater prawns is caused by A. hydrophila and A. veronii (Joseph and Carnahan, 1994). A. hydrophila has been detected in tissues like kidney, liver and blood of carps in farms (Mohanty et al., 2008). Incidences of A. hydrophila seem to be more prevalent than A. caviae and A. sobria, which indicates that A. hydrophila, is more virulent than the other (Daood, 2012). In a very recent study it was shown that A. caviae infection causes thrombocytopenia which contributes to elongation of clotting time which leads to hamorrhages in internal organs, muscles and bases of fins (Baldissera et al., 2018). Diseases in other ectothermic animals include ulcers (Lizards and snakes), “red leg” disease (frogs), septicemia (dogs), septic arthritis (calves), vesiculitis (bulls) (Gosling, 1996).
Pathogenicity
The identified virulence factors in Aeromonas are haemolysins, cytotoxins, enterotoxins, proteases [serine protease (AspA), elastase (AhpB)], lipases (Pla and Plc, Sat), DNAses, adhesins [type IV pili, polar flagella (FlaA and FlaB)] (Agarwal et al., 1998; Cascon et al., 2000; Rabaan et al., 2001), capsule and T3SS (Grim et al., 2013). Genome sequencing and annotation can be used to detect these virulence factors in Aeromonas (Grim et al., 2013). Enterotoxins, Act and Ast (Sha et al., 2002), elastase (Cascon et al., 2000), flagellin (Rabaan et al., 2001), and Stx1 and Stx2 (Alperi and Figueras, 2010) are directly involved in the pathogenesis. In a study Aeromonas isolates from well, tap and bottled water samples were found to have aer and ast genes, which poses a serious health concern for the human society (Didugu et al., 2015).
Aeromonas inections are mostly polymicrobial (Figueras and Beaz-Hidalgo, 2015), in which there is competition and cooperation between the bacterial cells (Armbruster et al., 2016). Virulence when checked in C. elegans was found to be higher in paired Aeromonas infections than in single strain (Mosser et al., 2015). The dual strain A. hydrophila infection showed synergistic effect by local tissue damage and antagonistic effect by elimination (Ponnusamy et al., 2016). The pathogenic potential of A. veronii isolates from clinical samples when tested were found to be like the drinking water and environmental isolates (Lye, 2011). The protein secretion systems of Aeromonas play important roles in pathogenesis caused by them. The type II secretion system is associated with the extracellular release of proteases, amylases, DNases and aerolysin (Pang et al., 2015). Type III secretion system, which is found in greater frequency in clinical isolates than environmental ones (Pang et al., 2015) functions by inserting effective toxins inside the host cells (Sierra et al., 2010). The type VI secretion system allows insertion of virulence factors into host cells through valine-glycine repeat protein and hemolysin-coregulated proteins. These proteins when secreted show antimicrobial pore-forming properties or remain as structural proteins (Bingle et al., 2008).
Gastroenteritis. Aeromonads enter the human gut via oral cavity, escape the effects of gastric acidity and produce bacteriocin-like compounds, which facilitate colonization of the intestine. They attach themselves to gastrointestinal epithelium, form biofilm, colonize and elaborate virulence factors to cause infection. Bacterial flagella and pili play important roles in gastric pathogenicity (Kirov et al., 2000).
Wound infections. Virulence caused by Aeromonas and the virulence factors possessed by them are similar to those of Gram-negative P. aeruginosa. The first step is settlement of the bacteria in wound site with the help of adhesion factors such as OmpA protein (Namba et al., 2008). The second step involves production of proteases (metalloproteases, serine proteases and aminopeptidases) and the breakdown of proteinaceous material of the host cells to gain energy, for multiplication of bacilli (Janda, 2001). The third step includes the entry of aeromonads into deeper tissues via chemotactic motility (Janda, 1985).
Septicemia. Most cases of primary Aeromonas septicaemia apparently arise through transfer of bacteria from the gastrointestinal tract into the blood circulatory system. They may also travel to the bloodstream from infected wounds, peritonitis, or biliary disease. Most of the Aeromonas septicemias are caused by a small number of species. Specific strains having certain markers are only responsible for most of the blood-borne diseases. Aeromonads of sergroups O:11, O:16, O:18, and O:34 are responsible for most cases of septicemia, which shows that lipo-polysaccharide (LPS) antigens are important in causing systemic diseases. The presence of LPS or the S layers makes most Aeromonas isolates resistant to the lytic effects of the host’s classical complement pathway (Janda et al., 1994).
Genes involved in virulence
Cytotoxic enterotoxin (act), haemolysin (hlyA)/aerolysin (aerA). The act gene of A. hydrophila encodes cytotoxic enterotoxin, which has many functions viz., cytotoxic, haemolytic and enterotoxic activities (Chopra and Houston, 1999). Other aeromonads have haemolytic activities due to the presence of other genes, namely hlyA and aerA, and these strains may have one or more of these genes (Heuzenroeder et al., 1999). The mature aerolysin binds to host cells, aggregates there and forms holes in their cell membrane destroying the permeability barrier of the membrane, which ultimately leads to osmotic lysis of the cells (Howard and Buckley, 1982). The haemolysin induces accumulation of fluids in intestinal loops (Asao et al., 1986), release of certain inflammation promoting factors from the granulocytes (Scheffer et al., 1988) and apoptosis of the host cells (Nelson et al., 1999). A study showed that about 50% of the marine fish samples were positive for the haemolysin gene hyl in India (Reshma et al., 2015). In another study, both environmental and clinical isolates from Kolkata (erstwhile Calcutta) in India were found to be positive for act and the enteropathogenic potential of these isolates were found to be comparable to V. cholerae (Bhowmik et al., 2009).
Cytotonic enterotoxins (ast, alt). The cytotonic enterotoxins do not degenerate the small intestine. The clones of E. coli having cytotonic enterotoxin genes have been showed to cause elongation of Chinese hamster ovary (CHO) cells, which also produces cyclic AMP, and these are enterotoxic responses. The Alt enterotoxin is heat labile, whereas Ast is heat stable at 56°C (Chopra and Houston, 1999). These genes have strong roles in causing diarrhoea (Sha et al., 2002).
Elastase (ahpB). The knocking out of the ahpB gene in A. hydrophila causes a high rise in the LD50 value of A. hydrophila in fishes, which indicates that elastase, a zinc metalloprotease, is an important virulence factor to cause disease in organisms (Cascon et al., 2000). The ahpB gene in A. hydrophila encodes protease with both elastolytic and caseinolytic activities (Cascon et al., 2000).
Flagella. Most of the Aeromonas species and all of the species responsible for human pathogenesis are motile having polar flagella. The polar flagellum has five flagellin subunits Fla A, Fla B, Fla G, Fla H and Fla J. The flaA and flaB genes have been cloned and sequenced from A. salmonicida (Umelo and Trust, 1997). All the five genes (flaA, flaB, flaG, flaH and flaJ) were identified in polar flagellin locus of A. caviae. Motility is known as an important virulence factor in the aeromonads. Mutation in either flaA or flaB did not affect development of flagellum but did reduce adherence and motility by approximately 50%. Mutations in flaH, flaJ or both cause complete loss of motility, development of flagellum and ability to get attached to HEp-2 cells. Thus, the ability to get attached to Hep-2 cells depends on motility and presence of flagella of aeromonads (Rabaan et al., 2001).
Lipase. Lipases change the plasma membrane of the host, increasing the severity of disease (Nawaz et al., 2010). Lipase gene has been recovered from multidrug-resistant virulent aeromonads capable of forming biofilms isolated from cattle feaces (Igbinosa et al., 2015).
Shiga toxins (Stx1 and Stx2). Shiga toxins are protein toxins, which have two parts A and B. One part has enzymatic property and the other binds to the surface of the host cells. These toxins inhibit protein synthesis of the host cells (Sandvig, 2001) and also induce apoptosis (Jones et al., 2000).
Enolase. Enolase is a glycolytic enzyme expressed in cell surfaces, which binds to human plasminogen leading to the production of plasmin which degrade plasma proteins. Enolase is also a heat-shock protein, which regulated transcription and is also necessary for cell viability (Sha et al., 2009).
Others. Other virulence factors include adhesins (Huang et al., 2015), nucleases (Ji et al., 2015), pore forming toxins (Saurez et al., 2012) and catalysts.
Antimicrobial Susceptibility
All species of Aeromonas show similar antibiotic susceptibility profiles, which are also independent of the origin of the isolates (Kampfer et al., 1999). Most of the aeromonads have inducible chromosomal lactamases, which are their main resistance mechanisms. Among these, metallo-β-lactamases, which work against carbapenems, are of major concern (Janda, 2001; Zhiyong et al., 2002). The Clinical and Laboratory Standards Institute (CLSI) have published consensus guideline for testing Aeromonas (Jorgensen and Hindler, 2007). The susceptibility status of Aeromonas isolates for therapeutically active drugs also seem to be species independent with one exception of Aeromonas trota, which is susceptible to ampicillin (Carnahan et al., 1991). In a study antibiotic resistance status of Aeromonas isolates from diseased fishes were found to be similar to those isolated from the freshwater fish farm (Daood, 2012). In another study Aeromonas strains resistant to mercury and arsenite were found and these got transferred to E. coli when conjugation experiments were performed (Huddleston et al., 2006).
Resistance Mechanisms. Three major classes of β-lactamases are present in Aeromonas species, viz, C cephalosporinase, D penicillinase, and a class B metallo-β-lactamase (MBL) (Libisch et al., 2008). Fosse et al. (2003) classified strains expressing these β-lactamases into five groups as A. hydrophila: class B, C, and D β-lactamases, A. caviae: class C and D β-lactamases, A. veronii: class B and D lactamases, A. schubertii: class D lactamases and A. trota: class C β-lactamases. Many A. veronii bv. Sobria isolates also express a class C cephalosporinase. In few cases, infecting Aeromonas strains expressed a class A β-lactamase of the TEM family of ESBLs (Extended Spectrum β-Lactamases), a character similar to the Enterobacteriaceae (Marchandin et al., 2003). The β-lactamases are involved in detoxification of antibiotics, changes in the drug binding site of the target and inhibiting the entry of the drug into the bacterial cells by causing changes in structure and function of the cytoplasmic and cell membranes (Benveniste and Davies, 1973). Each strain can produce a maximum of three β-lactamases, which work in a coordinated manner (Walsh et al., 1997). Class C cephalosporinases of the AmpC family are resistant to cephamycins, extended spectrum cephalosporins and β-lactamase inhibitor compounds, like clavulanic acid, tazobactam, and sulbactam, which hydrolyse the CO-NH bond in the lactum ring of cephalosporin to inactivate it (Fosse et al., 2003).
“CphA”, is the most common MBL produced by Aeromonas species, which is largely found in A. hydrophila and A. veronii isolates (Walsh et al., 1997). Two other MBLs (VIM and IMP) are also found in A. hydrophila and A. caviae strains, which encode an integron and a plasmid, respectively (Libisch et al., 2008). These MBL-producing strains are resistant to ceftazidime, cefepime, imipenem, and piperacillin-tazobactam; both strains are found to be susceptible to aztreonam in vitro. MBLs work in a two-step process: firstly, the C-N bond of the beta-lactam antibiotic is cleaved and then the binding nitrogen is protonated (Crowder et al., 2006).
Recently, NDM-1 (blaNDM-1) gene has been detected in this group of bacteria (Walsh et al., 2011). The spread of mobile NDM-1, also known as carbapenemase, is of great concern, not only because these enzymes confer resistance to carbapenems and other β-lactam antibiotics, but also because such pathogens typically are resistant to multiple antibiotic classes, making treatment difficult. Plasmids having the sequence encoding this carbapenemase can have up to 14 other antibiotic-resistance determinants and can make other bacteria also resistant, resulting in multi-drug resistant or extreme drug-resistant phenotypes. Resistance of this scale could have serious public health implications because modern medicine is dependent on the ability to treat infection (Livermore, 2009).
Quinolone resistance in Aeromonas strains isolated from two European rivers is a matter of rising concern because quinolone was previously known to be effective in combating Aeromonas infections (Goni-Urriza et al., 2000). Several A. caviae strains showed resistance to nalidixic acid, ciprofloxacin, and norfloxacin (Sinha et al., 2004). Aeromonads pathogenic to fish are found to be resistant to amoxicillin, ampicillin-sulbactum and streptomycin (Abu-Elala et al., 2015). These antibiotic resistant bacteria come into the environment through improper septic systems, agriculture and wastewater treatment plants (Rosenblatt-Farrell, 2009). River sediments adsorb antibiotics (Zhou et al., 2011) some of which may remain there for months (Lai et al., 2011). These impart antibiotic resistance to bacterial populations at that location. Biofilm formation increases resistance to antimicrobial substances (Acker et al., 2014), disinfectants (Jahid and Ha, 2014). Biofilm formation in Aeromonas is affected differently in different strains under several food related stresses. However, low temperature and pH conditions were found to facilitate biofilm formation in a recent study, which is the first study of this kind regarding Aeromonas (Nagar et al., 2017).
Role of plamids, integron systems and transposons in disease transmission
In Aeromonas, gene transfer mainly occurs through conjugation and transformation, in which type IV pili play a vital role (Huddleston et al., 2013). In a study, seven ESBL and two AmpCBL-producing Aeromonas strains were able to transfer their antibiotic resistance genes to E. coli (Bhaskar et al., 2015). Bacterial conjugative plasmids, transposable elements and integron systems are the panoply on which bacteria depend for their resistance to anti-bacterial compounds. Plasmids in particular serve as a platform on which useful resistance genes are assembled and subsequently disseminated (Bennett, 2008). Plasmid profiling and molecular characterization of aeromonad plasmids were undertaken by several research groups to address to the problems of generation and transmission of antibiotic resistance genes (Toranzo et al., 1983; Rhodes et al., 2000). Studies in eastern India focussed on the characterization of Aeromonas spp. isolated from cyprinid and silurid fishes affected with ulcerative disease (EUS) and the involvement of a low molecular weight plasmid has been implicated in the etiology of this disease in fishes (Pradhan and Pal, 1990; Majumdar et al., 2006; Majumdar et al., 2007). Subsequent investigations have also proved that, the degree of antibiotic resistance in these bacterial isolates is gradually increasing through the years (Pradhan and Pal, 1993; Saha and Pal, 2002; Das et al., 2009; Pal and Bhattacharjee, 2011).
Our laboratory tested antibiotic resistance status in few environmental Aeromonas isolates and the results showed an increase in antibiotic resistance in case of some antibiotics, while decrease in resistance in others (Dey Bhowmick and Bhattacharjee, 2017). Since antibiotic resistance is increasing in Aeromonas, aquaculture should resort to alternate means such as probiotics, essential oils and phage therapy to combat this problem.
In contrast to bacterial conjugative plasmids, which tend to be larger, mobilizable resistance plasmids tend to be relatively smaller (~10 to 20 kb) and encode only a handful of genes including the resistance gene(s) (Bennet, 2008). Therefore, resistance to multi-drugs and presence of small-sized plasmids in environmental isolates of this medically important bacteria group may indicate potential threat to human and culture fisheries (Pal and Bhattacharjee, 2011). Through horizontal gene transfer R-plasmids are spread between different species of Aeromonas, which spread multi-drug resistance (Indra et al., 2015). Transfer of antibiotic resistance genes from Aeromonas to other environmental and clinical bacteria makes treatment of both fish and humans difficult. Presence of multidrug resistance genes on mobile genetic elements is therefore a serious threat to society (Piotrowska and Popowska, 2015).
Conclusion
Phenotypically and genotypically a heterogenous group, aeromonads have been detected, isolated and characterized from varied sources such as brackish, fresh, estuarine, marine waters, chlorinated and unchlorinated water supplies, heavily polluted waters, cold and warm-blooded animals and humans alike. In contrast to the traditional morphological and biochemical differentiation, identification of aeromonads from clinical and environmental sources are presently based on PCR-based genotyping approach such as ribotyping and analysis of gyrB.
In the post World War II period, extensive use (or abuse) of antibiotics have given rise to drug-resistant varieties of bacteria, owing to the success and speed of bacterial adaptation. Bacteria apply many mechanisms to show antibiotic resistance. These resistance genes get accumulated in plasmids and are thought to spread among other bacteria through them. In order to find solution to this problem many researchers have undertaken plasmid profiling and molecular characterization of aeromonad plasmids (Toranzo et al., 1983). Therefore, assessment of antimicrobial drug resistance and possible involvement of bacterial plasmids in this resistance, in the locally isolated clinically and agriculturally important aeromonads, may be rewarding. To understand fully the virulence potential of any pathogen, it is imperative to understand pathogenic factors and/or mechanisms that are involved in their virulence. This is crucial since the expression of different virulence genes could contribute to infection depending upon the anatomical niche where the pathogenic organisms colonize and the microenvironment that dictates the differential expression of genes.
So far, many virulence factors have been discovered and characterized from Aeromonas group, especially from A. hydrophila, the causative organism of septicemia, wound infections and diarrhoea in humans and in animals. Novel putative virulence factors and/or virulence transfer systems, such as the NDM-1 gene, are being discovered on a regular basis in this diverse and ubiquitous group of bacteria. Although its emergence and distribution is controversial, the detection of NDM-1 gene in this clinically and agriculturally important bacteria group calls for a detailed surveillance of antibiotic resistance and also mode of transferability of NDM-1 gene in this bacteria group.
Plasmid-mediated horizontal gene transfer and acquisitions are thought to be one of the many adaptive ways by which bacteria acquire genes that may be useful periodically in combating environmental stresses, e.g., confronting potentially hazardous anti-bacterial agents, such as antibiotics (Bennett, 2008). Useful genes are thought to be selected and persist that ultimately confer better adaptability to microorganisms. Plasmid profiling in pathogenic isolates of A. hydrophila from fishes with ulcers, had been done to investigate plasmid-mediated virulence potential of the bacterium. Plasmid profiling, plasmid-mediated antibiotic resistance and pathogenesis in aeromonads have been investigated by several groups but further works are necessary to investigate the mode of transmission of virulence and drug-resistance genes in this bacterial group. This is imperative in heavily populated tropical countries like India, especially where sanitary requirements are not upto the standard.
Moreover, knowledge on how antibiotic resistance develops and is spread by mobile genetic elements is necessary for designing and developing prevention strategies intended to minimize the threat of bacterial infections. Considering the great adaptive ability of these bacteria vis-a-vis the environmental stresses and increasing use of anti-bacterial agents in combating Aeromonas-associated pathogenesis, newer virulence genes may be acquired by these organisms. Therefore, a search and mapping for putative virulence genes of Aeromonas should be undertaken.
Acknowledgements
The authors are grateful to Department of Zoology, University of North Bengal for providing all the research facilities and the University Grants Commission for providing the funds to carry out the study presented here. We are also thankful to Shubhashis Paul for helping in collecting environmental samples. The work was partially funded by the UGC-BSR fellowship scheme, University Grants Commission, New Delhi, India [Award No.F.25-1/2013-14(BSR)/7-134/2007(BSR)].
Literature
- Abeyta C. Jr., Kaysner C.A., Wekell M.M., Sullivan J.J. and Stelma G.N.. 1986. Recovery of Aeromonas hydrophila from oysters implicated in an outbreak of food borne illness. J. Food Prot. 49: 643–646. [DOI] [PubMed] [Google Scholar]
- Abu-Elala N., Abdelsalam M., Marouf Sh. and Setta A.. 2015. Comparative analysis of virulence genes, antibiotic resistance and gyrB-based phylogeny of motile Aeromonas species isolates from Nile tilapia and domestic fowl. Lett. Appl. Microbiol. 61: 429–436. [DOI] [PubMed] [Google Scholar]
- Acker H.V., Dijck P.V. and Coenye T.. 2014. Molecular mechanisms of antimicrobial tolerance and resistance in bacterial and fungal biofilms. Trends. Microbiol. 22: 326–333. [DOI] [PubMed] [Google Scholar]
- Agarwal R.K., Kapoor K.N. and Kumar A.J.. 1998. Virulence factors of aeromonads-an emerging food borne pathogen problem. A. J. Commun. Dis. 30: 71–78. [PubMed] [Google Scholar]
- Alperi A. and Figueras M.J.. 2010. Human isolates of Aeromonas possess shiga toxin genes (stx1 and stx2) highly similar to the most virulent gene variants of Escherichia coli. Clin. Microbiol. Infect. 16: 1563–1567. [DOI] [PubMed] [Google Scholar]
- Alperi A., Martinez-Murcia A.J., Monera A., Saavedra M.J. and Figueras M.J.. 2010b. Aeromonas fluvialis sp. nov., isolated from a Spanish river. Int. J. Syst. Evol. Micobiol. 60: 72–77. [DOI] [PubMed] [Google Scholar]
- Alperi A., Martinez-Murcia A.J., Ko W.C., Monera A., Saavedra M.J. and Figueras M.J.. 2010a. Aeromonas taiwanensis sp. nov. and Aeromonas sanarellii sp. nov., clinical species from Taiwan. Int. J. Syst. Evol. Microbiol. 60: 2048–2055. [DOI] [PubMed] [Google Scholar]
- Altwegg M., Lucchini G. Martinetti, Luthy-Hottenstein J. and Rohrbach M.. 1990. Aeromonas-associated gastroenteritis after consumption of contaminated shrimp. Eur. J. Clin. Microbiol. Infect. Dis. 10: 44–45. [DOI] [PubMed] [Google Scholar]
- Anguita J., Aparicio L.B.R. and Naharro G.. 1993. Purification, gene cloning, amino acid sequence analysis and expression of an extracellular lipase from an Aeromonas hydrophila human isolate. Appl. Environ. Microbiol. 59: 2411–2417. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Aravena-Roman M., Hidalgo R., Inglis T.J.J., Riley T.V., Martinez-Murcia A.J., Chang B.J. and Figueras M.J.. 2013. Aeromonas australiensis sp. nov., isolated from irrigation water. Int. J. Sys. Evol. Microbiol. 63: 2270–2276. [DOI] [PubMed] [Google Scholar]
- Armbruster C.A., Wolter D.J., Mishra M., Hayden H.S., Radey M.C., Merrihew G., MacCoss M.J., Burns J., Wozniak D.J., Parsek M.R.. and others 2016. Staphylococcus aureus Protein A mediates interspecies interactions at the cell surface of Pseudomonas aeruginosa. mBio. 7: 00538–16. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Asao T., Kozaki S., Kato K., Kinoshita Y., Otsu K., Uemura T., and Sakaguchi G.. 1986. Purification and characterization of an Aeromonas hydrophila hemolysin. J. Clin. Microbiol. 24: 228–232. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Austin B. 1997. Progress in understanding the fish pathogen Aeromonas salmonicida. Mar. Biotechnol. 15: 131–134. [Google Scholar]
- Baldissera M.D., Souza C.F., Verdi C.M., Vizzotto B.S., Santos R.C.V. and Baldisserotto B.. 2018. Aeromonas caviae alters the activities of ecto-enzymes that hydrolyze adenine neucleotides in fish thrombocytes. Microb. Pathog. 115: 64–67. [DOI] [PubMed] [Google Scholar]
- Bayerdorffer E., Schwarzkopf-Steinhauser G. and Ottenjann R.. 1986. New unusual forms of colitis: report of four cases with known and unknown etiology. Hepatogastroenterology 33: 187–190. [PubMed] [Google Scholar]
- Beaz-Hidalgo R., Alperi A., Figueras M.J. and Romalde J.L.. 2009. Aeromonas piscicola sp. nov., isolated from diseased fish. Syst. Appl. Microbiol. 32: 471–479. [DOI] [PubMed] [Google Scholar]
- Bennett P.M. 2008. Plasmid encoded antibiotic resistance: acquisition and transfer of antibiotic resistance genes in bacteria. Br. J. Pharmacol. 153: S347–S357. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Benveniste R. and Davies J.. 1973. Mechanims of antibiotic resistance in bacteria. Annu. Rev. Biochem. 42: 471–506. [DOI] [PubMed] [Google Scholar]
- Bhaskar M., Dinoop K.P. and Mandal J.. 2015. Characterization of ceftriaxone-resistant Aeromonas spp. isolates from stool samples of both children and adults in Southern India. J. Health Popul. Nutr. 33: 1–5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dey Bhowmick U. and Bhattachrjee S.. 2017. Status of antibiotic resistance in the Aeromonads of North Bengal with a special reference to change in resistance pattern through altitudinal gradient. NBU J. Anim. Sc. 11: 51–59. [Google Scholar]
- Bhowmik P., Bag P.K., Hajra T.K., De R., Sarkar P. and Ramamurthy T.. 2009. Pathogenic potential of Aeromonas hydrophila isolated from surface waters in Kolkata, India. J. Med. Microbiol. 58: 1549–1558. [DOI] [PubMed] [Google Scholar]
- Bingle L.E.H., Bailey C.M. and Pallen M.J.. 2008. Type VI secretion: a beginner’s guide. Curr. Opin. Microbiol. 11: 3–8. [DOI] [PubMed] [Google Scholar]
- Block K., Braver J.M. and Farraye F.A.. 1994. Aeromonas infection and intramural hemorrhage as a cause of small bowel obstruction. Am. J. Gastroenterol. 89: 1902–1903. [PubMed] [Google Scholar]
- Carnahan A.M., Chakraborty T., Fanning G.R., Verma D., Ali A., Janda J.M. and Joseph S.W.. 1991. Aeromonas trota sp. nov., an ampicilin-susceptible species isolated from clinical specimens. J. Clin. Microbiol. 29: 1206–1210. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cascon A., Yugueros J., Temprano, Temprano A., Sanchez M., Hernanz C., Luengo J.M. and Naharro G.. 2000. A major secreted elastase is essential for pathogenicity of Aeromonas hydrophila. Infect. Immun. 68: 3233–3241. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chakraborty T., Huhle B., Bergbaur H. and Goebel W.. 1986. Cloning, expression, and mapping of the Aeromonas hydrophila aerolysin gene determinant in Escherichia coli K-12. J. Bacteriol. 167: 368–374. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chan F.K.L., Ching J.Y.L., Ling T.K.W., Chung S.C.S. and Sung J.J.Y.. 2000. Aeromonas infection in acute suppurative cholangitis: review of 30 cases. J. Infect. 40: 69–73. [DOI] [PubMed] [Google Scholar]
- Chopra A.K. and Houston C.W.. 1999. Enterotoxins in Aeromonas-associated gastroenteritis. Microb. Infect. 1: 1129–1137. [DOI] [PubMed] [Google Scholar]
- Chopra A.K., Houston C.W., Peterson J.W. and Jin G.F.. 1993. Cloning, expression, and sequence analysis of a cytolytic enterotoxin gene from Aeromonas hydrophila. Can. J. Microbiol. 39: 513–23. [DOI] [PubMed] [Google Scholar]
- Crowder M.W., Spencer J. and Vila A.J.. 2006. Metallo-lactamases: Novel weaponry for antibiotic resistance in bacteria. Acc. Chem. Res. 39: 721–728. [DOI] [PubMed] [Google Scholar]
- Daood N. 2012. Isolation and antibiotic susceptibility of Aeromonas spp. from freshwater fish farm and farmed carp (Dam of 16 Tishreen, Lattakia). Damascus Univ. J. Basic Sci. 28: 27–39. [Google Scholar]
- Das A., Saha D. and Pal J.. 2009. Antimicrobial resistance and in vitro gene transfer in bacteria Isolated from ulcers of EUS-affected fishes in India. Lett. Appl. Microbiol. 49: 497–502. [DOI] [PubMed] [Google Scholar]
- Demarta A., Kupfer M., Riegel P., Harf-Monteil C., Tonolla M., Peduzzi R., Monera A., Saavedra M.J. and Martinez-Murcia A.. 2008. Aeromonas tecta sp. nov., isolated from clinical and environmental sources. Syst. Appl. Microbiol. 3: 278–286. [DOI] [PubMed] [Google Scholar]
- Didugu H., Thirtham M., Nelapati K., Reddy K.K., Kumbhar B.S., Poluru A. and Pothanaboyina G.. 2015. A study on the prevalence of Aeromonas spp. and its enterotoxin genes in samples of well water, tap water, and bottled water. Vet. World 8: 1237–1242. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Doman D.B., Golding M.I., Goldberg H.J. and Doyle R.B.. 1989. Aeromonas hydrophila colitis presenting as medically inflammatory bowel disease. Am. J. Gastroenterol. 84: 83–85. [PubMed] [Google Scholar]
- Edberg S.C., Browne F.A. and Allen M.J.. 2007. Issues for microbial regulation: Aeromonas as a model. Crit. Rev. Microbiol. 33: 89–100. [DOI] [PubMed] [Google Scholar]
- Ender P.T., Dolan M.J., Dolan D., Farmer J.C. and Melcher G.P.. 1996. Near-drowning-associated Aeromonas pneumonia. J. Emerg. Med. 14: 737–741. [DOI] [PubMed] [Google Scholar]
- Erova T.E., Kosykh V.G., Fadl A.A., Sha J., Horneman A.J. and Chopra A.K.. 2008. Cold Shock Exoribonuclease R (VacB) Is Involved in Aeromonas hydrophila Pathogenesis. J. Bacteriol. 190: 3467–3474. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Farfan M., Spataro N., Sanglas A., Albarral V., Loren J.G., Bosch E. and Fustea M.C.. 2013. Draft Genome Sequence of the Aeromonas diversa Type Strain. Genome Announc. 1: 1–2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Figueras M.J. and Beaz-Hidalgo R.. 2015. Aeromonas infections in humans, pp. 65–68. In Graf J. (ed.), Aeromonas. Norfolk Caister Academic Press. [Google Scholar]
- Figueras M.J., Alperi A., Beaz-Hidalgo R., Stackebrandt E., Brambilla E., Monera A. and Martínez-Murcia A.J.. 2011. Aeromonas rivuli sp. nov., isolated from the upstream region of a karst water rivulet. Int. J. Syst. Evol. Microbiol. 61: 242–248. [DOI] [PubMed] [Google Scholar]
- Figueras M.J., Saurez-Franquet A., Chacon M.R., Soler L., Navarro M., Alejandre C., Grasa B., Martinez-Murcia A.J. and Guarro J.. 2005. First record of the rare species Aeromonas culicicola from a drinking water supply. Appl. Environ. Microbiol. 71: 538–541. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Figueras M.J., Latif-Eugenin F., Ballester F., Pujol I., Tena D., Berg K., Hossain M.J., Beaz-Hidalgo R. and Liles M.R.. 2017. ‘Aeromonas intestinalis’ and ‘Aeromonas enterica’ isolated from human faeces, ‘Aeromonas crassostreae’ from oyster and ‘Aeromonas aquatilis’ isolated from lake water represent novel species. New Microbes New Infect. 15: 74–76. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fiorentini C., Barbieri E., Falzano L., Baffone W., Pianetti A., Katouli M., Kuhn I., Mollby R., Bruscolini F., Casiere A.. and others 1998. Occurrence, diversity and pathogenicity of mesophilic Aeromonas in estuarine waters of the Italian coast of the Adriatic Sea. J. Appl. Microbiol. 85: 501–511. [DOI] [PubMed] [Google Scholar]
- Fosse T., Giraud-Morin C., Madinier I. and Labia R.. 2003. Sequence analysis and biochemical characterization of chromosomal CAV-1 (Aeromonas caviae), the parental cephalosporinase of plasmid-mediated AmpC ‘FOX’ cluster. FEMS Microbiol. Lett. 222: 93–98. [DOI] [PubMed] [Google Scholar]
- Ghenghesh K.S., Ahmed S.F., Ei-Khalek R.A., Ai-Gendy A. and Klena J.. 2008. Aeromonas Associated Infections in Developing Countries. J. Infect. Dev. Ctries. 2: 81–98. [PubMed] [Google Scholar]
- Ghenghesh K.S., Bara F., Bukris B., El-Surmani A. and Abeid S.S.. 1999. Characterization of virulence factors of Aeromonas isolated from children with and without diarrhoea in Tripoli, Libya. J. Diarrhoeal Dis. Res. 17: 75–80. [PubMed] [Google Scholar]
- Goni-Urizza M., Pineau L., Capdepuy M., Roques C., Caumette P. and Quentin C.. 2000. Antimicrobial resistance of mesophilic Aeromonas spp. isolated from two European rivers. J. Antimicrob. Chemother. 46: 297–301. [DOI] [PubMed] [Google Scholar]
- Gosling P.J. 1996. Aeromonas species in disease of animals, p. 175–195. In Austin B., Altwegg M., Gosling P. J., and Joseph S. (ed.), The genus Aeromonas. John Wiley & Sons Ltd., West Sussex, England. [Google Scholar]
- Grim C.J., Kozlova E.V., Sha J., Fitts E.C., Lier C.J.V., Kirtley M.L., Joseph S.J., Read T.D., Burd E.M., Tall B.D.. and others 2013. Characterization of Aeromonas hydrophila Wound Pathotypes by Comparative Genomic and Functional Analyses of Virulence Genes. mBio. 4: 00064–13. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gurwith M., Bourque C., Cameron E., Forrest G. and Green M.. 1977. Cholera-like diarrhea in Canada. Report of a case associated with enterotoxigenic Escherichia coli and a toxin producing Aeromonas hydroplila. Arch. Intern. Med. 137: 1461–1464. [DOI] [PubMed] [Google Scholar]
- Harf-Monteil C., Le Fleche A., Riegel P., Prevost G., Bermond D., Grimont P.A.D. and Monteil H.. 2004. Aeromonas simiae sp. nov., isolated from monkey faeces. Int. J. Syst. Evol. Microbiol. 54: 481–485. [DOI] [PubMed] [Google Scholar]
- Heuzenroeder M.W., Wong C.Y.F. and Flower R.L.P.. 1999. Distribution of two hemolytic toxin genes in clinical and environmental isolates of Aeromonas spp.: correlation with virulence in a suckling mouse model. FEMS Microbiol. Lett. 174: 131–136. [DOI] [PubMed] [Google Scholar]
- Holmberg S.D. and Farmer J.J. III. 1984. Aeromonas hydrophila and Plesiomonas shigelloides as causes of intestinal infection. Rev. Infect. Dis. 6: 633–639. [DOI] [PubMed] [Google Scholar]
- Hondur A., Bilgihan K., Clark, Clark M.Y., Dogan O., Erdinc A. and Hasanreisoglu B.. 2008. Microbiologic study of soft contact lenses after laser subepithelial keratectomy for myopia. Eye Contact Lens. 34: 24–27. [DOI] [PubMed] [Google Scholar]
- Howard S.P. and Buckley J.T.. 1982. Membrane glycoprotein receptor and hole-forming properties of a cytolytic protein toxin. Biochemistry 21: 1662–1667. [DOI] [PubMed] [Google Scholar]
- Hsueh P.R., Teng L.J., Lee L.N., Yang P.C., Chen Y.C., Ho S.W. and Luh K.T.. 1998. Indwelling device-related and recurrent infections due to Aeromonas species. Clin. Infect. Dis. 26: 651–658. [DOI] [PubMed] [Google Scholar]
- Hua H.T., Bollet C., Tercian S., Drancourt M. and Raoult D.. 2004. Aeromonas popoffii urinary tract infection. J. Clin. Microbiol. 42: 5427–5428. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Huang L., Qin Y., Yan Q., Lin G., Huang L., Huang B. and Huang W.. 2015. MinD plays an important role in Aeromonas hydrophila adherence to Anguilla japonica mucus. Gene 565: 275–281. [DOI] [PubMed] [Google Scholar]
- Huddleston J.R., Brokaw J.M., Zak J.C. and Jeter R.M.. 2013. Natural transformation as a mechanism of horizontal gene transfer among environmental Aeromonas species. Syst. Appl. Microbiol. 36: 224–234. [DOI] [PubMed] [Google Scholar]
- Huddleston J.R., Zak J.C. and Jeter R.M.. 2006. Antimicrobial susceptibilities of Aeromonas spp. isolated from environmental sources. Appl. Environ. Microbiol. 72: 7036–7042. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Igbinosa I.H., Igbinosa E.O. and Okoh A.I.. 2015. Detection of antibiotic resistance, virulence gene determinants and biofilm formation in Aeromonas species isolated from cattle. Environ. Sci. Pollut. Res. 22: 17596–17605. [DOI] [PubMed] [Google Scholar]
- Indra U., Sureshkumar M., Kumar B.L. and Vivekanandhan G.. 2015. Virulence determinants, drug and metal resistance of clinical and environmental Aeromonas species. Int. J. Adv. Res. 3: 573–587. [Google Scholar]
- Isonhood J.H. and Drake M.. 2002. Aeromonas species in foods. J. Food Prot. 65: 575–582. [DOI] [PubMed] [Google Scholar]
- Jahid I.K. and Ha S.D.. 2014. Inactivation Kinetics of Various Chemical Disinfectants on Aeromonas hydrophila Planktonic Cells and Biofilms. Food-borne Pathog. Dis. 0: 1–8. [DOI] [PubMed] [Google Scholar]
- Janda J.M. 1985. Biochemical and exoenzymatic properties of Aeromonas species. Diagn. Microbiol. Infect. Dis. 3: 223–232. [DOI] [PubMed] [Google Scholar]
- Janda J.M. 2001. Aeromonas and Plesiomonas, pp. 1237–1270. In Sussman M. (ed.), Molecular medical microbiology, vol. 2 Academic Press, London, United Kingdom: Chapter 59. [Google Scholar]
- Janda J.M. and Duffey P.S.. 1988. Mesophilic aeromonads in human disease: current taxonomy, laboratory identification, and infectious disease spectrum. Rev. Infect. Dis. 10: 980–987. [DOI] [PubMed] [Google Scholar]
- Janda J.M. and Abbott S.L.. 1996. Human pathogens, pp. 151–173. In: Austin B. et al. (eds). The genus Aeromonas. Wiley, London. [Google Scholar]
- Janda J.M. and Abbott S.L.. 1998. Evolving concepts regarding the genus Aeromonas: an expanding panorama of species, disease presentation, and unanswered questions. Clin. Infect. Dis. 27: 332–344. [DOI] [PubMed] [Google Scholar]
- Janda J.M., Guthertz L.S., Kokka R.P. and Shimada T.. 1994. Aeromonas species in septicemia: laboratory characteristics and clinical observations. Clin. Infect. Dis. 19:77–83. [DOI] [PubMed] [Google Scholar]
- Jangid K., Kong R., Patole M.S. and Shouche Y.S.. 2007. luxRI homologs are universally present in the genus Aeromonas. BMC Microbiol. 7: 93. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ji Y., Li J., Qin Z., Li A., Gu Z., Liu X., Lin L. and Zhou Y.. 2015. Contribution of nuclease to the pathogenesis of Aeromonas hydrophila. Virulence 6: 515–522. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jones N.L., Islur A., Haq R., Mascarenhas M., Karmali M.A., Perdue M.H., Zanke B.W. and Sherman P.M.. 2000. Eschericia coli Shiga toxins induce apoptosis in epithelial cells that is regulated by the Bcl-2 family. Am. J. Physiol. Gastrointest. Liver Physiol. 278: G811-G819. [DOI] [PubMed] [Google Scholar]
- Jorgensen J.H. and Hindler J.F.. 2007. New consensus guidelines from the Clinical and Laboratory Standards Institute for antimicrobial susceptibility testing of infrequently isolated or fastidious bacteria. Clin. Infect. Dis. 44: 280–286. [DOI] [PubMed] [Google Scholar]
- Joseph S.W. and Carnahan A.. 1994. The isolation, identification, and systematics of the motile Aeromonas species. Annu. Rev. Fish Dis. 4: 315–343. [Google Scholar]
- Kali A., Kalaivani R., Charles P.M.V. and Seetha K.S.. 2016. Aeromonas hydrophila meningitis and fulminant sepsis in preterm newborn: A case report and review of literature. Indian J. Med. Microbiol. 34: 544–547. [DOI] [PubMed] [Google Scholar]
- Kampfer P., Christmann C., Swings J. and Huys G.. 1999. In vitro susceptibilities of Aeromonas genomic species to 69 antimicrobial agents. Syst. Appl. Microbiol. 22: 662–669. [DOI] [PubMed] [Google Scholar]
- Kelly K.A., Koehler J.M. and Ashdown L.R.. 1993. Spectrum of extraintestinal disease due to Aeromonas species in tropical Queensland, Australia. Clin. Infect. Dis. 16: 574–579. [DOI] [PubMed] [Google Scholar]
- Khan A.A., Kim E. and Cerniglia C.E.. 1998. Molecular cloning, nucleotide sequence, and expression in Escherichia coli of a haemolytic toxin (aerolysin) gene from Aeromonas trota. Appl. Environ. Microbiol. 64: 2473–2478. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Khardori N. and Fainstein V.. 1988. Aeromonas and Plesiomonas as etiological agents. Annu. Rev. Microbiol. 42: 395–419. [DOI] [PubMed] [Google Scholar]
- Kienzle N., Muller M. and Pegg S.. 2000. Aeromonas wound infections in burns. Burns. 26: 478–482. [DOI] [PubMed] [Google Scholar]
- Kirov S.M., Barnett T.C., Pepe C.M., Strom M.S. and Albert M.J.. 2000. Investigation of the role of type IV Aeromonas pilus (Tap) in the pathogenesis of Aeromonas gastrointestinal infection. Infect. Immun. 68: 4040–4048. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ko W.C., Lee H.C., Chuang Y.C., Liu C.C. and Wu J.J.. 2000. Clinical features and therapeutic implications of 104 episodes of monomicrobial Aeromonas bacteraemia. J. Infect. 40: 267–273. [DOI] [PubMed] [Google Scholar]
- Kumar A., Bachhil V.N., Bhilegaonakar K.N. and Agarwal R.K.. 2000. Occurrence of enterotoxigenic Aeromnas species in foods. J. Common. Dis. 32: 169–74. [PubMed] [Google Scholar]
- Lai C.C., Dingand L.W. Hsueh P.R.. 2007. Wound infection and septic shock due to Aeromonas trota in a patient with liver disease. Clin. Infect. Dis. 44: 1523–1524. [DOI] [PubMed] [Google Scholar]
- Lai H.T., Wang T.S. and Chou C.C.. 2011. Implication of light sources and microbial activities on degradation of sulfonamides in water and sediment from a marine shrimp pond. Bior. Tech. 102: 5017–5023. [DOI] [PubMed] [Google Scholar]
- Leung K.Y. and Stevenson R.M.W.. 1988. Characteristics and distribution of extracellular proteases from Aeromonas hydrophila. J. Gen. Microbiol. 134: 151–160. [Google Scholar]
- Libisch B., Giske C.G., Kovacs B., Toth T.G. and Fuzi M.. 2008. Identification of the first VIM metallo-β-lactamase-producing multiresistant Aeromonas hydrophila strain. J. Clin. Microbiol. 46: 1878–1880. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Livermore D.M. 2009. Has the era of untreatable infections arrived? J. Antimicrob. Chemother. 64: i29–i36. [DOI] [PubMed] [Google Scholar]
- Lye D.J. 2011. Gastrointestinal colonization rates for human clinical isolates of Aeromonas veronii using a mouse model. Curr. Microbiol. 63: 332–336. [DOI] [PubMed] [Google Scholar]
- Majumdar T., Ghosh D., Datta S., Sahoo C., Pal J. and Mazumder S.. 2007. An attenuated plasmid-cured strain of Aeromonas hydrophila elicits protective immunity in Clarias battrachus L. Fish Shellfish Immunol. 23: 222–230. [DOI] [PubMed] [Google Scholar]
- Majumdar T., Ghosh S., Pal J. and Majumder S.. 2006. Possible role of a plasmid in the pathogenesis of a fish disease caused by Aeromonas hydrophila. Aquaculture 256: 95–104. [Google Scholar]
- Manna S.K., Maurye P., Dutta C. and Samanta G.. 2013. Occurrence and virulence characteristics of Aeromonas species in meat, milk and fish in india. J. Food. Saf. 33: 461–469. [Google Scholar]
- Marcel K.A., Antoinette A.A. and Mireille D.. 2002. Isolation and characterization of Aeromonas species from an eutrophic tropical estuary. Marine Pollut. Bull. 44: 1341–1444. [DOI] [PubMed] [Google Scholar]
- Marchandin H., Godreuil S., Darbas H., Pierre H.J., Bilak E.J., Chanal C. and Bonnet R.. 2003. Extended-spectrum β-lactamase TEM-24 in an Aeromonas clinical strain: acquisition from the prevalent Enterobacter aerogenes clone in France. Antimicrob. Agents Chemother. 47: 3994–3995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Martin-Carnahan A. and Joseph S.W.. 2005. Genus I. Aeromonas Stanier 1943, 213AL, pp. 557–578. In Brenner D.J., Krieg N.R., Staley J.T., and Garrity G.M. (eds). Bergey’s manual of systematic bacteriology, 2nd ed., vol. 2, Part B Springer, New York, NY. [Google Scholar]
- Martinez-Murcia A.J., Saavedra M.J., Mota V.R., Maier T., Stackebrandt E. and Cousin S.. 2008. Aeromonas aquariorum sp. nov., isolated from aquaria of ornamental fish. Int. J. Syst. Evol. Microbiol. 58: 1169–1175. [DOI] [PubMed] [Google Scholar]
- Martinez-Murcia A., Beaz-Hidalgo R., Navarro A., Carvalho M.J., Aravena-Roman M., Correia A., Figueras M.J. and Saavedra M.J.. 2016. Aeromonas lusitana sp. nov., isolated from untreated water and vegetables. Curr. Microbiol. 72: 795–803. [DOI] [PubMed] [Google Scholar]
- Minana-Galbis D., Farfan M., Fuste M.C. and Loren J.G.. 2004. Aeromonas molluscorum sp. nov., isolated from bivalve molluscs. Int. J. Syst. Evol. Microbiol. 54: 2073–2078. [DOI] [PubMed] [Google Scholar]
- Minana-Galbis D., Farfan M., Fuste M.C. and Loren J.G.. 2007. Aeromonas bivalvium sp. nov., isolated from bivalve molluscs. Int. J. Syst. Evol. Microbiol. 57: 582–587. [DOI] [PubMed] [Google Scholar]
- Miyake M., Iga K., Izumi C., Miyagawa A., Kobashi Y. and Konishi T.. 2000. Rapidly progressive pneumonia due to Aeromonas hydrophila shortly after near-drowning. Intern. Med. 39: 1128–1130. [DOI] [PubMed] [Google Scholar]
- Moawad M.R. and Zelderman M.. 2002. Aeromonas hydrophila wound infection in elective surgery. J. Wound Care. 11: 210–211. [DOI] [PubMed] [Google Scholar]
- Mohan B., Sethuraman N., Verma R. and Taneja N.. 2017. Speciation, clinical profile & antibiotic resistance in Aeromonas species isolated from cholera-like illnesses in a tertiary care hospital in north India. Indian J. Med. Res. 146: 53–58. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mohanty B.R., Mishra J., Das S., Jena J.K. and Sahoo P.K.. 2008. An outbreak of Aeromoniasis in an organized composite carp culture farm in India: experimental pathogenicity and antibiogram study. J. Aqua. 16: 27–37. [Google Scholar]
- Monette S., Dallaire A.D., Mingelbier M., Groman D., Uhland C., Richard J.P., Paillard T.G., Johannson L.M., Chivers D.P., Ferguson H.W., Leighton F.A. and Simko E.. 2006. Massive mortality of common carp (Cyprinus carpio carpio) in the St. Lawrence river in 2001: diagnostic investigation and experimental induction of lymphocytic encephalitis. Vet. Pathol. 43: 302–310. [DOI] [PubMed] [Google Scholar]
- Mosser T., Reboul E.T., Colston S.M., Graf J., Figueras M.J., Bilak E.J. and Lamy B.. 2015. Exposure to pairs of Aeromonas strains enhances virulence in the Caenorhabditis elegans infection model. Front. Microbiol. 6: 12218. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moyer N.P. 1987. Clinical significance of Aeromonas species isolated from patients with diarrhea. J. Clin. Microbiol. 25: 2044–2048. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nagar V., Godambe L.P., Bandekar J.R. and Shashidhar R.. 2017. Biofilm formation by Aeromonas strains under food-related environmental stress conditions. J. Food Process Preserv. 41: 13182. [Google Scholar]
- Namba A., Mano N., Takano H., Beppu T., Ueda K. and Hirose H.. 2008. OmpA is an adhesion factor of Aeromonas veronii,an optimistic pathogen that habituates in carp intestinal tract. J. Appl. Microbiol. 105: 1441–1451. [DOI] [PubMed] [Google Scholar]
- Nawaz M., Khan S.A., Khan A.A., Sung K., Tran Q., Kerdahi K. and Steele R.. 2010. Detection and characterization of virulence genes and integrons in Aeromonas veronii isolated from catfish. Food Microbiol. 27: 327–331. [DOI] [PubMed] [Google Scholar]
- Nelson K.L., Brodsky R.A. and Buckley J.T.. 1999. Channels formed by subnanomolar concentrations of the toxin aerolysin trigger apoptosis of T lymphomas. Cell Microbiol. 1: 69–74. [DOI] [PubMed] [Google Scholar]
- Nieto T.P., Santos Y., Rodriguez L.A. and Ellis A.E.. 1991. An extracellular acetylcholinesterase produced by Aeromonas hydrophila is a major lethal toxin for fish. Microb. Pathog. 1: 101–110. [DOI] [PubMed] [Google Scholar]
- Padmaja K., Lakshmi V. and Murthy K.V.D.. 2013. Sepsis due to Aeromonas hydrophila. Int. J. Infect. Control 9: 1–4. [Google Scholar]
- Pal A. and Bhattacharjee S.. 2011. Isolation and characterization of aeromonads from North Bengal, India. NBU J. Anim. Sc. 5: 47–56. [Google Scholar]
- Pang M., Jiang J., Xie X., Wu Y., Dong Y., Kwok A.H.Y., Zhang W., Yao H., Lu C., Leung F.C.. and others 2015. Novel insights into the pathogenicity of epidemic Aeromonas hydrophila ST251 clones from comparative genomics. Sci. Rep. 5: 9833. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pidiyar V., Kaznowski A., Narayan N.B., Patole M. and Shouche Y.S.. 2002. Aeromonas culicicola sp. nov., from the midgut of Culex quinquefasciatus. Int. J. Syst. Evol. Microbiol. 52: 1723–1728. [DOI] [PubMed] [Google Scholar]
- Pinna A., Sechi L.A., Zanetti S., Usai D. and Carta F.. 2004. Aeromonas caviae keratitis associated with contact lens wear. Ophthalmology 111: 348–351. [DOI] [PubMed] [Google Scholar]
- Piotrowska M. and Popowska M.. 2015. Insight into the mobilome of Aeromonas strains. Front. Microbiol. 6: 1–16. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ponnusamy D., Kozlova E.V., Sha J., Erova T.E., Azar S.R., Fitts E.C., Kirtley M.L. Tiner B.L., Andersson J.A., Grim C.J.. and others 2016. Cross-talk among flesh-eating Aeromonas hydrophila strains in mixed infection leading to necrotizing fasciitis. Proc. Natl. Acad. Sci. 113: 722–727. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pradhan K. and Pal J.. 1990. Drug sensitivity testing of bacteria isolated from ulcerative diseases of air breathing fishes. J. Parasitol. App. Anim. Biol. 2: 15–18. [Google Scholar]
- Pradhan K. and Pal J.. 1993. Drug sensitivity testing of bacteria isolated from ulcerative disease of air-breathing fishes. J. Parasitol. Appl. Anim. Biol. 2: 15–18. [Google Scholar]
- Rabaan A.A., Gryllos I., Tomas J.M. and Shaw J.G.. 2001. Motility and the polar flagellum are required for Aeromonas caviae adherence Hep-2 cells. Infect. Immun. 69: 4257–4267. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reshma J.M., Amsaveni R., Sureshkumar M., Vivekanandhan G.. 2015. Screening of haemolytic Aeromonas sp. Isolated from marine fish samples. Int. J. Adv. Res. 3: 1004–1008. [Google Scholar]
- Rhodes G., Huys G., Swings J., Mcgann P., Hiney M., Smith P. and Pickup R.W.. 2000. Distribution of Oxytetracycline Resistance Plasmids between Aeromonads in Hospital and Aquaculture Environments: Implication of Tn1721 in Dissemination of the Tetracycline Resistance Determinant Tet A. Appl. Environ. Microbiol. 66: 3883–3890. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rosenblatt-Farrell N. 2009. The landscape of antibiotic resistance. Environ. Health Perspec. 117: 245–250. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rouf M.A. and Rigney M.M.. 1993. Bacterial Florae in Larvae of the Lake Fly Chironomus plumosus. Appl. Environ. Microbiol. 59: 1236–1241. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Saha D. and Pal J.. 2002. In vitro antibiotic susceptibility of bacteria isolated from EUS-affected fishes in India. Lett. Appl. Microbiol. 34: 311–316. [DOI] [PubMed] [Google Scholar]
- Saha P. and Chakrabarti T.. 2006. Aeromonas sharmana sp. nov., isolated from a warm spring. Int. J. Syst. Evol. Microbiol. 56: 1905–1909. [DOI] [PubMed] [Google Scholar]
- Sandvig T. 2001. Shiga toxins. Toxicon. 39: 1629–1635. [DOI] [PubMed] [Google Scholar]
- Saurez G., Khajanchi B.K., Sierra J.C., Erova T.E., Sha J. and Chopra A.K.. 2012. Actin cross linking domain of Aeromonas hydrophila repeat in toxin A (RtxA) induces host cell rounding and apoptosis. Gene 506: 369–376. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scheffer J., Konig W., Braun V. and Goebel W.. 1988. Comparison of four hemolysin producing organisms (Escherichia coli, Serratia marcescens, Aeromonas hydrophila, and Listeria monocytogenes) for release of inflammatory mediators from various cells. J. Clin. Microbiol. 26: 544–551. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schubert R.H.W., Hegaz M. and Wahlig W.. 1990. Aeromonas enteropelogenes species nova. Hyg. Med. 15: 471–472. [Google Scholar]
- Sha J., Kozlova E.V. and Chopra A.K.. 2002. Role of various enterotoxins in Aeromonas hydrophila-induced gastroenteritis: generation of enterotoxin gene-deficient mutants and evaluation of their enterotoxic activity. Infect. Immun. 70: 1924–1935. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sha J., Erova T.E., Alyea R.A., Wang S., Olano J.P., Pancholi V. and Chopra A.K.. 2009. Surface-Expressed Enolase Contributes to the Pathogenesis of Clinical Isolate SSU of Aeromonas hydrophila. J. Bacteriol. 191: 3095–3107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sierra J.C., Suarez G., Sha J., Baze W.B., Foltz S.M. and Chopra A.K.. 2010. Unraveling the mechanism of action of a new type III secretion system effector AexU from Aeromonas hydrophila. Microb. Pathog. 49: 122–134. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sinha S., Chattopadhyay S., Bhattacharya S.K., Nair G.B. and Ramamurthy T.. 2004. An unusually high level of quinolone resistance associated with type II topoisomerase mutations in quinolone resistance-determining regions of Aeromonas caviae isolated from diarrhoeal patients. Res. Microbiol. 155: 827–829. [DOI] [PubMed] [Google Scholar]
- Tang H.J., Lai C.C., Lin H.L. and Chao C.M.. 2014. Clinical Manifestations of Bacteremia caused by Aeromonas Species in Southern Taiwan. Plos One. 9: 91642. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tena D., Aspiroz C., Figueras M.J., Gonzalez-Praetorius A., Aldea M.J., Alperi A. and Bisquert J.. 2009. Surgical site infection due to Aeromonas species: report of nine cases and literature review. Scand. J. Infect. Dis. 41: 164–170. [DOI] [PubMed] [Google Scholar]
- Tewari R., Dudeja M., Nandy S. and Das A.K.. 2014. Isolation of Aeromonas salmonicida from human blood sample: a case report. J. Clin. Diag. Res. 8: 139–140. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Toranzo A.E., Barja J.L., Colwell R.R. and Hetrick F.M.. 1983. Characterization of Plasmids in Bacterial Fish Pathogens. Infect. Immun. 39: 184–192. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tsai M.S., Kuo C.Y., Wang M.C., Wu H.C., Chien C.C. and Liu J.W.. 2006. Clinical features and risk factors for mortality in Aeromonas bacteremic adults with hematologic malignancies. J. Microbiol. Immunol. Infect. 39: 150–154. [PubMed] [Google Scholar]
- Umelo E. and Trust T.J.. 1997. Identification and molecular characterization of two tandemly located flagellin genes from Aeromonas salmonicida A449. J. Bacteriol. 179: 5292–5299. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Walsh T.R., Weeks J., Livermore D.M. and Toleman M.A.. 2011. Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study. Lancet. Infect. Dis. 11: 355–362. [DOI] [PubMed] [Google Scholar]
- Walsh T.R., Stunt R.A., Nabi J.A., MacGowan A.P. and Bennett P.M.. 1997. Distribution and expression of β-lactamase genes among Aeromonas spp. J. Antimicrob. Chemother. 40: 171–178. [DOI] [PubMed] [Google Scholar]
- Wang G., Tyler K.D., Munro C.K. and Johnson W.M.. 1996. Characterization of cytotoxic, haemolytic Aeromonas caviae clinical isolates and their identification by determining presence of a unique hemolysin gene. J. Clin. Microbiol. 34: 3203–3205. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wang G., Clark C.G., Liu C., Pucknell C., Munro C.K., Kruk T.M.A.C., Caldeira R., Woodward D.L. and Rodgers F.G.. 2003. Detection and characterization of the Hemolysin Genes in Aeromonas hydrophila and Aeromonas sobria by multiplex PCR. J. Clin. Microbiol. 41: 1048–1054. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yamamoto T., Ishii T., Sanaka M., Saitoh M. and Kuyama Y.. 2004. Ileal ulcers due to Aeromonas hydrophila infection. J. Clin. Gastroenterol. 38: 911. [DOI] [PubMed] [Google Scholar]
- Yu H.B., Zhang Y.L., Lau Y.L., Yao F., Vilches S., Merino S., Tomas J.M., Howard S.P. and Leung K.Y.. 2005. Identification and Characterization of Putative Virulence Genes and Gene Clusters in Aeromonas hydrophila PPD134/91. Appl. Environ. Microbiol. 71: 4469–4477. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zhiyong Z., Xiaoju L. and Yanyu G.. 2002. Aeromonas hydrophila infection: clinical aspects and therapeutic options. Rev. Med. Microbiol. 13: 151–162. [Google Scholar]
- Zhou L.J., Ying G.G., Zhao J.L., Yang J.F., Wang L., Yang B. and Liu S.. 2011. Trends in the occurrence of human and veterinary antibiotics in the sediments of the Yellow River, Hai River and Liao River in northern China. Environ. Pollut. 159: 1877–1885. [DOI] [PubMed] [Google Scholar]