Rapid Fulminant Progression and Mortality Secondary to Aeromonas dhakensis Septicemia with Hepatitis B Virus Infection Following the Ingestion of Snakehead Fish in Mainland China: A Case Report.

• 影响指数: 3.788
• 发表时间: 12 2020
• 来源期刊: Foodborne Pathog Dis
• DOI: 10.1089/fpd.2019.2780
• PMID: 32985901
• 文章类型: Case Reports
• 作者列表: Huang M,Chen H,Li C,Liu Y,Gan C,El-Sayed Ahmed MAE,Liu R,Shen C,Zhong R,Tian GB,Huang X,Xia J

关键词: Aeromonas dhakensis; WGS; fulminant death; hepatitis B virus; septicemia

Mesh: Adult; Aeromonas / classification isolation & purification; Animals; Bacterial Typing Techniques; China; Drug Resistance, Bacterial / genetics; Fatal Outcome; Fishes; Food Contamination; Food Microbiology; Genes, Bacterial; Gram-Negative Bacterial Infections / microbiology mortality; Hepatitis B / complications; Humans; Male; Multilocus Sequence Typing; Sepsis / microbiology mortality; Virulence Factors / genetics

Abstract

Aeromonas dhakensis is an important ubiquitous Gram-negative and freshwater bacterium detected in different reservoirs. It can cause invasive diseases in humans. Herein, we report the first case in Mainland China of a fulminant death of a 29-year-old man as a result of a new, unexpected association between septicemic A. dhakensis and hepatitis B viral infection (HBV). Herein, the patient died from multiple organ failure 5 d postadmission after the ingestion of Snakehead Fish meal. The isolated bacterium was initially misidentified as Aeromonas hydrophila using VITEK-2, while whole-genome sequencing (WGS) revealed that the isolate is A. dhakensis. WGS revealed the occurrence of three antimicrobial genes of resistance: imiH, cphA2, and blaOXA-12; besides, major virulence factors were detected. In silico, multilocus sequence typing (MLST) showed that our A. dhakensis 17FW001 belonged to a novel sequence type (ST557). A comparative genomic analysis of our isolate with nine selected Aeromonas species was done, which elucidated the pathogenicity of our A. dhakensis. In conclusion, we reported for the first time the association between A. dhakensis and HBV in Mainland China. We revealed that septicemic A. dhakensis could result in severe adverse clinical outcomes that end up with unexpected fulminant death especially when it is accompanied with HBV and sheds light on the virulence of A. dhakensis and the high rate of its misdiagnosis that requires to urgently consider screening of all cases of A. dhakensis for HBV in the future. Besides, caution should be taken while dealing with snakeheads which act as a vector for A. dhakensis.