Biliary tract disease as a risk factor for Plesiomonas shigelloides bacteraemia: a nine-year experience in a Hong Kong hospital and review of the literature

We report the epidemiology, clinical disease spectrum, treatment, and outcome of Plesiomonas shigelloides bacteraemia in our hospital over a nine-year period and compare the characteristics of patients with P. shigelloides bacteraemia in our hospital with those reported in the literature. During the nine-year period (1995--2003), a total of seven patients developed P. shigelloides bacteraemia. All cases occurred during the late spring, summer, and early autumn (May-October). All patients were over 75 and had underlying diseases (biliary tract diseases in four and malignancies in three). Six had acute cholangitis and five had polymicrobial bacteraemia. Overall two patients died. Compared with patients with P. shigelloides bacteraemia reported in the literature, patients with P. shigelloides bacteraemia in our hospital were associated with old age (P<0.001), underlying biliary tract diseases (P<0.001), acute cholangitis (P<0.001), and polymicrobial bacteraemia (P<0.001). There are major geographical differences of disease association in P. shigelloides bacteraemia. The sources of P. shigelloides in our patients were probably in the gastrointestinal tract.