Aeromonas Infection from Sushi Consumption
Yes, you can get Aeromonas infection from consuming sushi, particularly from raw seafood components that have not undergone heat treatment. This risk is supported by recent research demonstrating the presence of potentially pathogenic Aeromonas species in retail sushi 1, 2.
Aeromonas in Sushi and Seafood
- Studies have found mesophilic Aeromonas species in fresh retail sushi, with A. salmonicida (74%), A. bestiarum (9%), and A. dhakensis (5%) being the most prevalent species 1
- Raw oysters show particularly high prevalence of A. hydrophila (57.1%), while flatfish sashimi (54.8%) and salmon sushi (51.4%) are also significant sources 2
- Frozen sushi generally has better microbiological quality (2.7 log CFU/g) compared to fresh sushi from sushi bars (6.3 log CFU/g) 3
Pathogenicity and Virulence
Almost all Aeromonas isolates from sushi contain genes encoding virulence factors:
- Hemolysin (hlyA) - 99%
- Aerolysin (aerA) - 98%
- Cytotoxic enterotoxin (act) - 86%
- Heat-labile cytotonic enterotoxin (alt) - 99%
- Heat-stable cytotonic enterotoxin (ast) - 31% 1
The infective dose of Aeromonas is relatively low, similar to other enteropathogens like Salmonella and Campylobacter 4
Clinical Implications
- Aeromonas can cause gastroenteritis, bacteremia, and wound infections in humans 4
- Specific Aeromonas infections from seafood may require targeted antibiotic treatment, with doxycycline plus ciprofloxacin or ceftriaxone recommended for A. hydrophila infections 5
High-Risk Groups
- Immunocompromised individuals, including those with HIV, should be particularly cautious about consuming raw seafood 5
- The WHO and Infectious Diseases Society of America guidelines recommend that HIV-infected persons avoid eating raw oysters and other raw seafood due to the risk of various infections 5
Prevention Measures
- Proper food handling practices, refrigeration, and clean preparation surfaces can reduce risk 6
- High-risk individuals should avoid raw or undercooked fish and shellfish entirely 6
- Frozen seafood products show lower prevalence of Aeromonas compared to fresh products 2
- Heat treatment (cooking) effectively eliminates Aeromonas risk, as the bacteria was not detected in frozen or dried seafood products 2
Seasonal Considerations
- Interestingly, the prevalence of virulent Aeromonas strains in sashimi is lower during summer but higher in prepared sushi during the same season, suggesting contamination may occur during the manufacturing or distribution processes 2
For the general population with normal immune function, the risk of serious Aeromonas infection from sushi consumption is relatively low but present. However, immunocompromised individuals should avoid raw seafood entirely to prevent potentially serious infections.