Abstract

Aeromonas spp. are associated with resistance to penicillins, cephalosporins, and carbapenems due to chromosomal β-lactamases. In this case report, it was aimed to present a patient with acute suppurative cholangitis caused by a carbapenem-resistant A. hydrophila/caviae. A 79-year-old male patient applied to emergency department with complaints of jaundice, abdominal pain, nausea and vomiting. The patient followed with an inoperable malignant tumor of the extrahepatic biliary tract was diagnosed to have an attack of acute suppurative cholangitis by radiological and laboratory findings, and intravenous imipenem was started empirically. Percutaneous abscess drainage was performed, and Gram-stained smear yielded abundant number of leukocytes and Gram-negative bacilli. Gram-negative bacilli grown both in drainage material and in blood culture becoming positive two days later were identified as A. hydrophila/caviae by VITEK® 2 Compact (bioMérieux, Marcy l'Etoile, France) system. Antibiogram results obtained by the same system revealed that the bacteria were resistant to carbapenems and sensitive to colistin, cefepime, amikacin, gentamicin, ciprofloxacin, levofloxacin, trimethoprim-sulfamethoxazole, and tigecycline. It was learned  that the patient was died of sepsis  when the microbiological findings were reported to the Intensive Care Unit. In conclusion, Aeromonas species, albeit rare, can be responsible for hepatobiliary infections in immunosupressed patients, and the choice of antibiotic should be based on their potential resistance profile.