Janda J Michael, Abbott Sharon L, McIver Christopher J
Kern County Public Health Laboratory, Department of Public Health Services, Bakersfield, California, USA
Microbial Diseases Laboratory, California Department of Public Health, Richmond, California, USA.
Clin Microbiol Rev. 2016 Apr;29(2):349-74. doi: 10.1128/CMR.00103-15.
After many years in the family Vibrionaceae, the genus Plesiomonas, represented by a single species, P. shigelloides, currently resides in the family Enterobacteriaceae, although its most appropriate phylogenetic position may yet to be determined. Common environmental reservoirs for plesiomonads include freshwater ecosystems and estuaries and inhabitants of these aquatic environs. Long suspected as being an etiologic agent of bacterial gastroenteritis, convincing evidence supporting this conclusion has accumulated over the past 2 decades in the form of a series of foodborne outbreaks solely or partially attributable to P. shigelloides. The prevalence of P. shigelloides enteritis varies considerably, with higher rates reported from Southeast Asia and Africa and lower numbers from North America and Europe. Reasons for these differences may include hygiene conditions, dietary habits, regional occupations, or other unknown factors. Other human illnesses caused by P. shigelloides include septicemia and central nervous system disease, eye infections, and a variety of miscellaneous ailments. For years, recognizable virulence factors potentially associated with P. shigelloides pathogenicity were lacking; however, several good candidates now have been reported, including a cytotoxic hemolysin, iron acquisition systems, and lipopolysaccharide. While P. shigelloides is easy to identify biochemically, it is often overlooked in stool samples due to its smaller colony size or relatively low prevalence in gastrointestinal samples. However, one FDA-approved PCR-based culture-independent diagnostic test system to detect multiple enteropathogens (FilmArray) includes P. shigelloides on its panel. Plesiomonads produce β-lactamases but are typically susceptible to many first-line antimicrobial agents, including quinolones and carbapenems.
在弧菌科中存在多年后,以嗜水气单胞菌(Plesiomonas shigelloides)这一单一物种为代表的气单胞菌属(Plesiomonas)目前归属于肠杆菌科,尽管其最合适的系统发育位置可能仍有待确定。气单胞菌常见的环境储存库包括淡水生态系统和河口以及这些水生环境中的生物。长期以来一直怀疑它是细菌性肠胃炎的病原体,在过去20年中,以一系列仅部分或完全由嗜水气单胞菌引起的食源性疾病暴发的形式,积累了支持这一结论的令人信服的证据。嗜水气单胞菌肠炎的发病率差异很大,东南亚和非洲的报告发病率较高,而北美和欧洲的发病率较低。这些差异的原因可能包括卫生条件、饮食习惯、地区职业或其他未知因素。嗜水气单胞菌引起的其他人类疾病包括败血症和中枢神经系统疾病、眼部感染以及各种杂症。多年来,一直缺乏可识别的可能与嗜水气单胞菌致病性相关的毒力因子;然而,现在已经报道了几个很好的候选因子,包括一种细胞毒性溶血素、铁获取系统和脂多糖。虽然嗜水气单胞菌在生化方面很容易鉴定,但由于其菌落较小或在胃肠道样本中的患病率相对较低,它在粪便样本中经常被忽视。然而,一种经美国食品药品监督管理局(FDA)批准的基于聚合酶链反应(PCR)的非培养诊断测试系统(FilmArray),用于检测多种肠道病原体,其检测面板中包括嗜水气单胞菌。气单胞菌产生β-内酰胺酶,但通常对许多一线抗菌药物敏感,包括喹诺酮类和碳青霉烯类。