Skin and soft tissue infection caused by Aeromonas species in cancer patients.

We read with great interest the article by Papadakis et al, published in the Journal of Microbiology, Immunology, and Infection, who reported a patient with fulminate Aeromonas hydrophila soft tissue infection and septicemia during acute lymphoblastic leukemia treatment. After combination therapy with antibiotics and surgical management, the patient recovered well. The case reminds us of the possibility of Aeromonas infection in cancer patients; however, knowledge about this clinical entity is limited. This study was intended to investigate retrospectively the clinical manifestation of Aeromonas-related skin and soft tissue infections (SSTIs) in cancer patients to understand this issue better. This study was conducted at the Chi Mei Medical Center, a 900-bed hospital. This hospital is located in southern Taiwan, where the Aeromonas infection is endemic, and most of the patients treated at the hospital are cancer patients. This retrospective study enrolled patients with culture-confirmed Aeromonas infection during the period January 2009eDecember 2011. SSTIs were diagnosed in patients who presented with pain, swelling of the involved site, and patchy, edematous, erythematous, or bullous skin lesions. Necrotizing fasciitis was defined as necrosis of the subcutaneous tissue and adjacent fascia due to severe infection. All isolates were identified by conventional methods and verified further following the procedure described in our previous study. Polymicrobial infections were diagnosed in patients from whom Aeromonas species, in addition to other pathogens, were isolated from cutaneous specimens. In-hospital mortality was defined as death due to any cause during hospitalization. A total of 129 patients with SSTIs caused by Aeromonas species were enrolled in the study, including 12