Clinical characteristics and antibiotic sensitivity & resistance analysis of cases of orthopedic infections caused by Aeromonas hydrophila.

Abstract

Objective: This study was to elucidate the clinical characteristics and antibiotic susceptibility of orthopedic infections caused by Aeromonas hydrophila, thereby providing a suggestion for early clinical recognition and optimized managementof such infections in orthopedic clinical practice.

Methods: A retrospective investigation was conducted by collecting general patient information, specimen sources, culture results, and antibiotic susceptibility data from 58 cases of Aeromonas hydrophila infections treated at our hospital between November 2020 and April 2024.

Results: The 58 patients with Aeromonas hydrophila infections had a mean age of (50.05 ± 14.97) years, and the majority were workers. 56 cases were associated with traumatic open wounds, with injuries primarily caused by mechanical crushing or lacerations. The patients had an average hospital stay of approximately 33.97 days and underwent an average of 2.66 surgical procedures. In 5.17% of the cases, due to severe limb damage rendering replantation impossible, emergency amputations were performed shortly after admission. 23 cases eventually met the clinical cure criteria, and after improvement, were discharged; however, 5 cases experienced recurrences. 18 cases were monomicrobial A. hydrophila infections, while the remaining 40 cases showed polymicrobial involvement with at least one additional pathogen. Antibiotic susceptibility tests indicated low resistance rates of A. hydrophila to amikacin, aztreonam, cefpirome, and cefoperazone, whereas resistance rates to cefazolin and ampicillin were higher, with all specimens being resistant to ampicillin.

Conclusion: Orthopedic infections caused by Aeromonas hydrophila predominantly affect middle-aged male industrial and agricultural workers, with the infection risk strongly associated with environmental exposure complexity during injury, particularly during mechanical operations and farming activities. Once infected, the disease progresses rapidly and severely, necessitating multiple surgical interventions. For antibiotic therapy, aminoglycosides and third- or fourth-generation cephalosporins are recommended treatment options, whereas first-generation cephalosporins should be avoided as first-line anti-infective agents.