Invasiveness of Aeromonas spp. in relation to biotype, virulence factors, and clinical features.

Of 69 fecal isolates of Aeromonas spp., 18 had the ability to invade HEp-2 cells. Invasiveness correlated with biotype; of the 18 invasive strains, 16 were A. sobria and 2 were A. hydrophila. No invasive strains were found among the A. caviae. Of the 18 invasive strains, 13 were enterotoxigenic. Of the enterotoxigenic and invasive strains, 12 were A. sobria, but enterotoxicity was also more common among noninvasive strains of A. sobria. Fucose-resistant hemagglutination was also more common in A. sobria, but invasive strains were equally divided between fucose-resistant hemagglutination and other patterns. Detailed clinical information was available for 27 of the 69 strains. All 15 strains of A. sobria or A. hydrophila associated with diarrhea were enterotoxigenic; 6 of the 10 strains of A. sobria were also invasive. Blood was present in the stool samples of five of the six patients with invasive A. sobria and in none of the patients with noninvasive strains. Although limited, these observations suggest that dysenteric symptoms may be produced by invasive Aeromonas spp.