Volume 92, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



, , , and (VACS) are water-associated Gram-negative organisms that can cause a variety of infections. The frequency, patient characteristics, and antimicrobial susceptibilities for 468 isolates from 442 patients from the Northern Territory were reviewed. spp. (312 of 468; 67%) were most commonly isolated followed by spp. (71 of 468; 15%), spp. (61 of 468; 13%), and (24 of 468; 5%). A strong male predominance was found (male to female ratio of 2.3:1). Skin and soft tissue isolations (373 of 468; 80%) from lower limb infections (222 of 371; 60%) were the most common clinical manifestation. The episodes were usually polymicrobial (281 of 468; 60%). Coisolates included (137 of 468; 29%), β-hemolytic streptococci (74 of 468; 16%), enterobacteriaceae (111 of 468; 24%), non-fermentative Gram-negative bacilli (35 of 468; 7%), and other VACS organisms (37 of 468; 8%). Antimicrobial resistance of VACS organisms to ciprofloxacin (0–4%), cefepime (0–3%), and gentamicin (0–0.8%) and spp., spp., and to cotrimoxazole (0–3%) was rarely shown. For water-associated lower limb skin and soft tissue infections in the tropics, clinicians should consider empirical antimicrobial therapy with agents active against and VACS organisms.


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  1. Vignier N, Barreau M, Olive C, Baubion E, Théodose R, Hochedez P, Cabié A, , 2013. Human infection with Shewanella putrefaciens and S. algae: report of 16 cases in Martinique and review of the literature. Am J Trop Med Hyg 89: 151156.[Crossref] [Google Scholar]
  2. Oliver JD, , 2005. Wound infections caused by Vibrio vulnificus and other marine bacteria. Epidemiol Infect 133: 383391.[Crossref] [Google Scholar]
  3. Sirinavin S, Techasaensiri C, Benjaponpitak S, Pornkul R, Vorachit M, , 2005. Invasive Chromobacterium violaceum infection in children: case report and review. Pediatr Infect Dis J 24: 559561.[Crossref] [Google Scholar]
  4. Igbinosa IH, Igumbor EU, Aghdasi F, Tom M, Okoh AI, , 2012. Emerging Aeromonas species infections and their significance in public health. Scientific World Journal 2012: 625023. [Google Scholar]
  5. Newton A, Kendall M, Vugia DJ, Henao OL, Mahon BE, , 2012. Increasing rates of Vibriosis in the United States 1996–2010: review of surveillance data from 2 systems. Clin Infect Dis 54: S391S395.[Crossref] [Google Scholar]
  6. Hiransuthikul N, Tantisiriwat W, Lertutsahakul K, Vibhagool A, Boonma P, , 2005. Skin and soft-tissue infections among tsunami survivors in southern Thailand. Clin Infect Dis 41: e93e96.[Crossref] [Google Scholar]
  7. Crowe AL, Smith P, Ward L, Currie BJ, Baird R, , 2014. Decreasing prevalence of Trichuris trichiura (whipworm) in the Northern Territory from 2002 to 2012. Med J Aust 200: 286289.[Crossref] [Google Scholar]
  8. Lamy B, Kodjo A, colBVH Study Group Laurent F, ; , , 2009. Prospective nationwide study of Aeromonas infections in France. J Clin Microbiol 47: 12341237.[Crossref] [Google Scholar]
  9. Dechet AM, Yu PA, Painter J, , 2008. Nonfoodbourne Vibrio infections: an important cause of morbidity and mortality in the United States, 1997–2006. Clin Infect Dis 46: 970976.[Crossref] [Google Scholar]
  10. Hochedez P, Hope-Rapp E, Olive C, Nicolas M, Beaucaire G, Cabié A, , 2010. Bacteremia caused by Aeromonas species [corrected] complex in the Caribbean Islands of Martinique and Guadeloupe. Am J Trop Med Hyg 83: 11231127.[Crossref] [Google Scholar]
  11. To KK, Wong SS, Cheng VC, Tang BS, Li IW, Chan JF, Seto WK, Tse H, Yuen KY, , 2010. Epidemiology and clinical features of Shewanella infection over an eight-year period. Scand J Infect Dis 42: 757762.[Crossref] [Google Scholar]
  12. Lim IW, Stride PJ, Horvath RL, Hamilton-Craig CR, Chau PP, , 2009. Chromobacterium violaceum endocarditis and hepatic abscesses treated successfully with meropenem and ciprofloxacin. Med J Aust 190: 386387. [Google Scholar]
  13. Yang CH, , 2011. Nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite. J Microbiol Immunol Infect 44: 401405.[Crossref] [Google Scholar]
  14. Bosch FJ, Badenhorst L, Le Roux JA, Louw VJ, , 2008. Successful treatment of Chromobacterium violaceum sepsis in South Africa. J Med Microbiol 57: 12931295.[Crossref] [Google Scholar]
  15. King MD, Humphrey BJ, Wang YF, Kourbatova EV, Ray SM, Blumberg HM, , 2006. Emergence of community-acquired methicillin-resistant Staphylococcus aureus USA 300 clone as the predominant cause of skin and soft-tissue infections. Ann Intern Med 144: 309317.[Crossref] [Google Scholar]
  16. Hou CC, Lai CC, Liu WL, Chao CM, Chiu YH, Hsueh PR, , 2011. Clinical manifestation and prognostic factors of non-cholerae Vibrio infections. Eur J Clin Microbiol Infect Dis 30: 819824.[Crossref] [Google Scholar]
  17. Merkel SM, Alexander S, Zufall E, Oliver JD, Huet-Hudson YM, , 2001. Essential role for estrogen in protection against Vibrio vulnificus-induced endotoxic shock. Infect Immun 69: 61196122.[Crossref] [Google Scholar]
  18. Teoh AY, Hui M, Ngo KY, Wong J, Lee KF, Lai PB, , 2006. Fatal septicaemia from Chromobacterium violaceum: case reports and review of the literature. Hong Kong Med J 12: 228231. [Google Scholar]
  19. Lee J, Kim JS, Nahm CH, Choi JW, Kim J, Pai SH, Moon KH, Lee K, Chong Y, , 1999. Two cases of Chromobacterium violaceum infection after injury in a subtropical region. J Clin Microbiol 37: 20682070. [Google Scholar]
  20. Sureisen M, Choon SK, Tai CC, , 2008. Recurrent Chromobacterium violaceum infection in a patient with chronic granulomatous disease. Med J Malaysia 63: 346347. [Google Scholar]
  21. Aldridge KE, Valainis GT, Sanders CV, , 1988. Comparison of the in vitro activity of ciprofloxacin and 24 other antimicrobial agents against clinical strains of Chromobacterium violaceum . Diagn Microbiol Infect Dis 10: 3139.[Crossref] [Google Scholar]
  22. Aravena-Román M, Inglis TJ, Henderson B, Riley TV, Chang BJ, , 2012. Antimicrobial susceptibilities of Aeromonas strains isolated from clinical and environmental sources to 26 antimicrobial agents. Antimicrob Agents Chemother 56: 11101112.[Crossref] [Google Scholar]
  23. Vila J, Marco F, Soler L, Chacon M, Figueras MJ, , 2002. In vitro antimicrobial susceptibility of clinical isolates of Aeromonas caviae, Aeromonas hydrophila and Aeromonas veronii biotype sobria. J Antimicrob Chemother 49: 701702.[Crossref] [Google Scholar]
  24. Ko WC, Yu KW, Liu CY, Huang CT, Leu HS, Chuang YC, , 1996. Increasing antibiotic resistance in clinical isolates of Aeromonas strains in Taiwan. Antimicrob Agents Chemother 40: 12601262. [Google Scholar]
  25. Chen PL, Ko WC, Wu CJ, , 2012. Complexity of β-lactamases among clinical Aeromonas isolates and its clinical implications. J Microbiol Immunol Infect 45: 398403.[Crossref] [Google Scholar]
  26. Ko WC, Lee HC, Chuang YC, Liu CC, Wu JJ, , 2000. Clinical features and therapeutic implications of 104 episodes of monomicrobial Aeromonas bacteraemia. J Infect 40: 267273.[Crossref] [Google Scholar]
  27. Jang HC, Choi SM, Kim HK, Kim SE, Kang SJ, Park KH, Ryu PY, Lee TH, Kim YR, Rhee JH, Jung SI, Choy HE, , 2014. In vivo efficacy of the combination of ciprofloxacin and cefotaxime against Vibrio vulnificus sepsis. PLoS ONE 9: e101118.[Crossref] [Google Scholar]
  28. Lamy B, Laurent F, Kodjo A, Roger F, Jumas-Bilak E, colBVH Study Group Marchandin H, ; , , 2012. Which antibiotics and breakpoints should be used for Aeromonas susceptibility testing? Considerations from a comparison of agar dilution and disk diffusion methods using Enterobacteriaceae breakpoints. Eur J Clin Microbiol Infect Dis 31: 23692377.[Crossref] [Google Scholar]
  29. Kim DM, Kang CI, Lee CS, Kim HB, Kim EC, Kim NJ, Oh MD, Choe KW, , 2006. Treatment failure due to emergence of resistance to carbapenem during therapy for Shewanella algae bacteremia. J Clin Microbiol 44: 11721174.[Crossref] [Google Scholar]

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  • Received : 13 Nov 2014
  • Accepted : 22 Nov 2014
  • Published online : 04 Mar 2015

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