Infection Status, Etiological Analysis of <i>Aeromonas</i> spp. in Foodborne Diarrhea Patients from 2019 to 2023 in Wenzhou

The infection status and etiological analysis of <i>Aeromonas</i> spp. from foodborne diarrhea patients in Wenzhou were carried out to provide the etiological basis for healthy diet and clinical treatment. <i>Aeromonas</i> isolates (<i>n</i> = 41) collected from foodborne diarrhea patients were identified using the automatic bacteriologic analyzer and mass spectrometer. Species identification, multilocus sequence typing, prediction of virulence genes, and antimicrobial resistance genes were analyzed by the data of whole genome sequencing. The antibiotic resistance of these isolates was determined using miniaturization of the broth dilution susceptibility test. A total of 1829 stool samples of diarrhea patients were collected, and the detection rate of <i>Aeromonas</i> spp. was 2.24% (41/1829). Moreover, <i>Aeromonas</i> spp. are more easily detected in warmer months (from June to August), which were identified as follows: <i>A. veronii</i> (53.66%, 22/41), <i>A. caviae</i> (21.95%, 9/41), <i>A. hydrophila</i> (9.76%, 4/41), <i>A. dhakensis</i> (4.88%, 2/41), <i>A. rivipollensis</i> (4.88%, 2/41), <i>A. enteropelogenes</i> (2.44%, 1/41), and <i>A. media</i> (2.44%, 1/41). All strains can be divided into 38 sequence types, 31 of which were novel, suggesting that <i>Aeromonas</i> spp. had high genetic diversity, multiple clones, and various sources in diarrhea patients. High number of genetic diversity and resistance were found in the <i>Aeromonas</i> isolates. In addition, the category distribution of the virulence genes was significantly different among the seven species of <i>Aeromonas</i>. <i>Aeromonas</i> spp. had different degrees of resistance to antibiotics, and tetracycline was the most serious, with a resistance rate of 27%. What's more, for some antimicrobial classes <i>in silico</i> antimicrobial resistance gene detection was highly correlated with phenotypic antimicrobial resistance patterns with an overall sensitivity of 93.3% and a specificity of 66.7%. The findings from this research highlighted the importance for development of prevention and control strategies to reduce the risk of foodborne diarrhea caused by <i>Aeromonas</i> spp.