From the Guidelines
There is no direct evidence suggesting a significant association between Aeromonas infection and Inflammatory Bowel Disease (IBD) in the provided guidelines. The British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults 1 discuss enteric infections associated with IBD, but do not specifically mention Aeromonas as a common or significant pathogen.
- The guidelines highlight that the risk of enteric infections is higher in IBD than controls, with a focus on infections such as Clostridium difficile, norovirus, and Campylobacter.
- A retrospective study mentioned in the guidelines found a low rate of bacterial infection (less than 3%) by culture and PCR in IBD patients, excluding C. difficile infections, but does not specify Aeromonas as one of the pathogens.
- Another study using multiplex PCR for gastrointestinal pathogens reported findings on various bacterial infections, including Campylobacter, Plesiomonas, and Escherichia coli, in Crohn’s disease and UC patients, but does not mention Aeromonas.
- Given the lack of direct evidence linking Aeromonas infection to IBD in the provided guidelines, it is essential to consider comprehensive infection screening in evaluating IBD disease flares, taking into account the patient's history and local infectious epidemiology 1.
- In clinical practice, if an Aeromonas infection is suspected in an IBD patient, treatment with appropriate antibiotics, such as fluoroquinolones or trimethoprim-sulfamethoxazole, may be considered, but this should be guided by antibiotic susceptibility testing due to concerns about resistance.
From the Research
Association Between Aeromonas Infection and Inflammatory Bowel Disease
- There is evidence to suggest an association between Aeromonas infection and inflammatory bowel disease (IBD) 2, 3, 4, 5, 6.
- Studies have shown that Aeromonas infection can contribute to the manifestation of IBD, with some patients receiving an IBD diagnosis after an acute episode of Aeromonas infection 2.
- The clinical presentation of Aeromonas infection differs between IBD and non-IBD patients, with IBD patients more frequently experiencing bloody diarrhea and abdominal pain, and non-IBD patients presenting with fever 2.
- Aeromonas infection seems to be more severe in IBD patients, with a higher tendency for severe infection rate and higher use of antimicrobial therapy 2, 3.
- Certain strains of Aeromonas, such as A. veronii, are more commonly associated with IBD and worse clinical outcomes 3.
- Immunosuppression is a significant factor in IBD patients with Aeromonas infection, while comorbidity seems to confer a higher risk on patients without IBD 4.
Clinical Presentation and Treatment
- Aeromonas infection can cause a range of symptoms, from mild to severe, including gastrointestinal infection, bloody diarrhea, and abdominal pain 2, 3, 4, 5, 6.
- Treatment with antibiotics, such as ciprofloxacin, can provide rapid improvement in clinical status for patients with Aeromonas infection and IBD 6.
- It is essential to consider Aeromonas infection in the differential diagnosis of colitis and IBD, especially in patients who do not respond to standard treatment regimens 5, 6.
Incidence and Relationship to IBD
- The incidence of gastrointestinal infection caused by Aeromonas is significant, with 32 cases per 105 inhabitants per year reported in one study 4.
- Aeromonas infection can occur in both immunocompetent and immunocompromised patients, with a higher risk associated with comorbidity in non-IBD patients 4.
- The relationship between Aeromonas infection and IBD is complex, with some studies suggesting that Aeromonas infection may trigger or exacerbate IBD symptoms 2, 3, 6.