Epidemiology and antimicrobial resistance patterns of Aeromonas species in Europe, 2020-2024 (AEuROMONAS)

Matteo Boattini; Paulo Bastos; Konstantina Gartzonika; Eirini Christaki; Viktoria Eirini Mavromanolaki; Sofia Maraki; Anastasia Spiliopoulou; Nikolaos Giormezis; Gergana Lengerova; Yordan Kalchev; Ana Budimir; Branka Bedenić; Zana Rubic; Antonija Saskor; Karla Milanovic; Monica Licker; Corina Musuroi; Emese Juhász; Katalin Kristóf; Mateja Pirs; Ivana Velimirovic; Michael Berktold; Adriána Krajčíková; Anezka Gryndlerova; Pavel Drevinek; Miroslava Htoutou Sedláková; Milan Kolář; Monika Brzychczy-Wloch; Aldona Olechowska-Jarząb; Małgorzata Brauncajs; Filip Bielec; Dominika Seliga-Gąsior; Edyta Podsiadly; Kristian Riesbeck; Hanna-Sofia Andersson; Tone Tønjum; Johan Christian Berild; Truls Michael Leegaard; Asger Nellemann Rasmussen; Kristian Schønning; Stefan Glöckner; Jürgen Rödel; Sara Posadas-Cantera; Mohamed Tarek Badr; Tim Kintzinger; Frieder Schaumburg; Philipp Thelen; Axel Hamprecht; Anna Dudakova; Jonathan Jantsch; Katharina Hoffmann; Achim J. Kaasch; Damien Jacot; Gilbert Greub; Jessica Landi; Simone Ambretti; Sara Comini; Sofia Chiatamone Ranieri; Enrica Serretiello; Gianluigi Franci; Teresa Fasciana; Rogier Schade; Erlangga Yusuf; Stefanie van Kleef van Koeveringe; Sarah Vandamme; Alexia Verroken; Hector Rodriguez-Villalobos; Gregory Strubbe; Stien Vandendriessche; Pauline Rabeau; Stéphane Corvec; Damien Dubois; Pauline Floch; Delphine Chainier; Olivier Barraud; Assaf Mizrahi; Célia Bacho; Coralie Bouchiat; Tayssir Fatah; Hélène Marchandin; Vincent Jean-Pierre; Saied Ali; Sinead O’ Donnell; Maeve Doyle; Zachary Ramsamaroo; Clarice Egan; Sinead McNicholas; Kristján Orri Helgason; Betigül Öngen; Bahar Akgün Karapınar; Özlem Oyardi; Burak Aksu; Javier Colomina-Rodriguez; Ignacio Torres; Raul Gilarranz Luengo; Maria Nieves Larrosa Escartín; Maria Belen Viñado Perez; Ana Verónica Halperin; Rafael Cantón; Miguel Seruca; Vasco Santos Mendes; Yuliya Volovetska; José Melo Cristino; Cristina Costa; Gabriele Bianco

doi:10.1016/j.diagmicrobio.2026.117384

Epidemiology and antimicrobial resistance patterns of Aeromonas species in Europe, 2020-2024 (AEuROMONAS)

Matteo Boattini^*, Paulo Bastos, Konstantina Gartzonika, Eirini Christaki, Viktoria Eirini Mavromanolaki, Sofia Maraki, Anastasia Spiliopoulou, Nikolaos Giormezis, Gergana Lengerova, Yordan Kalchev, Ana Budimir, Branka Bedenić, Zana Rubic, Antonija Saskor, Karla Milanovic, Monica Licker, Corina Musuroi, Emese Juhász, Katalin Kristóf, Mateja PirsIvana Velimirovic, Michael Berktold, Adriána Krajčíková, Anezka Gryndlerova, Pavel Drevinek, Miroslava Htoutou Sedláková, Milan Kolář, Monika Brzychczy-Wloch, Aldona Olechowska-Jarząb, Małgorzata Brauncajs, Filip Bielec, Dominika Seliga-Gąsior, Edyta Podsiadly, Kristian Riesbeck, Hanna-Sofia Andersson, Tone Tønjum, Johan Christian Berild, Truls Michael Leegaard, Asger Nellemann Rasmussen, Kristian Schønning, Stefan Glöckner, Jürgen Rödel, Sara Posadas-Cantera, Mohamed Tarek Badr, Tim Kintzinger, Frieder Schaumburg, Philipp Thelen, Axel Hamprecht, Anna Dudakova, Jonathan Jantsch, Katharina Hoffmann, Achim J. Kaasch, Damien Jacot, Gilbert Greub, Jessica Landi, Simone Ambretti, Sara Comini, Sofia Chiatamone Ranieri, Enrica Serretiello, Gianluigi Franci, Teresa Fasciana, Rogier Schade, Erlangga Yusuf, Stefanie van Kleef van Koeveringe, Sarah Vandamme, Alexia Verroken, Hector Rodriguez-Villalobos, Gregory Strubbe, Stien Vandendriessche, Pauline Rabeau, Stéphane Corvec, Damien Dubois, Pauline Floch, Delphine Chainier, Olivier Barraud, Assaf Mizrahi, Célia Bacho, Coralie Bouchiat, Tayssir Fatah, Hélène Marchandin, Vincent Jean-Pierre, Saied Ali, Sinead O’ Donnell, Maeve Doyle, Zachary Ramsamaroo, Clarice Egan, Sinead McNicholas, Kristján Orri Helgason, Betigül Öngen, Bahar Akgün Karapınar, Özlem Oyardi, Burak Aksu, Javier Colomina-Rodriguez, Ignacio Torres, Raul Gilarranz Luengo, Maria Nieves Larrosa Escartín, Maria Belen Viñado Perez, Ana Verónica Halperin, Rafael Cantón, Miguel Seruca, Vasco Santos Mendes, Yuliya Volovetska, José Melo Cristino, Cristina Costa, Gabriele Bianco

^*Corresponding author for this work

Department of Clinical Microbiology

Abstract

Introduction:
Aeromonas species are Gram-negative bacilli capable of causing bloodstream infections in both immunocompromised and otherwise healthy individuals. However, data on their epidemiology and antimicrobial resistance remain limited in Europe.

Methods:
We conducted a multicentre, retrospective, observational study that included all Aeromonas species isolates recovered from blood cultures in 56 European hospitals between January 1st 2020 and December 31st 2024. Epidemiological features and antimicrobial susceptibility profiles were analyzed.

Results:
A total of 590 Aeromonas isolates were included. Most were recovered from polymicrobial blood cultures (73.1%), and catheter-related bloodstream infections were frequent (21.7%). The most commonly reported species were A. caviae (30.1%), isolates without conclusive species identification (Aeromonas spp., 24.8%), A. hydrophila (20.7%), and A. veronii (19.1%). At the genus level, susceptibility to aztreonam, ceftazidime, and cefepime exceeded 90%. Resistance to fluoroquinolones (∼10%) and sulfamethoxazole/trimethoprim (up to 11%) was observed. Species-level analyses showed higher resistance rates to fluoroquinolones and sulfamethoxazole/trimethoprim among A. caviae and A. hydrophila, and increased resistance to ceftazidime among Aeromonas spp.

Conclusions:
Aeromonas species in Europe showed high susceptibility to ceftazidime and cefepime, alongside with emerging resistance to fluoroquinolones and sulfamethoxazole/trimethoprim. Species-specific findings should be interpreted cautiously due to limitations in routine identification methods, underscoring the need for sustained surveillance and harmonised diagnostic standards across Europe.

Original language	English
Article number	117384
Journal	Diagnostic Microbiology and Infectious Disease
Volume	115
Issue number	4
ISSN	0732-8893
DOIs	https://doi.org/10.1016/j.diagmicrobio.2026.117384
Publication status	Published - Aug 2026

Keywords

Aeromonasspp
Antimicrobial resistance
Bloodstream infection
Epidemiology
Gram-negative bacilli
Sulfamethoxazole/trimethoprim

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10.1016/j.diagmicrobio.2026.117384

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Boattini, M., Bastos, P., Gartzonika, K., Christaki, E., Mavromanolaki, V. E., Maraki, S., Spiliopoulou, A., Giormezis, N., Lengerova, G., Kalchev, Y., Budimir, A., Bedenić, B., Rubic, Z., Saskor, A., Milanovic, K., Licker, M., Musuroi, C., Juhász, E., Kristóf, K., ... Bianco, G. (2026). Epidemiology and antimicrobial resistance patterns of Aeromonas species in Europe, 2020-2024 (AEuROMONAS). Diagnostic Microbiology and Infectious Disease, 115(4), Article 117384. https://doi.org/10.1016/j.diagmicrobio.2026.117384

Boattini, M, Bastos, P, Gartzonika, K, Christaki, E, Mavromanolaki, VE, Maraki, S, Spiliopoulou, A, Giormezis, N, Lengerova, G, Kalchev, Y, Budimir, A, Bedenić, B, Rubic, Z, Saskor, A, Milanovic, K, Licker, M, Musuroi, C, Juhász, E, Kristóf, K, Pirs, M, Velimirovic, I, Berktold, M, Krajčíková, A, Gryndlerova, A, Drevinek, P, Sedláková, MH, Kolář, M, Brzychczy-Wloch, M, Olechowska-Jarząb, A, Brauncajs, M, Bielec, F, Seliga-Gąsior, D, Podsiadly, E, Riesbeck, K, Andersson, H-S, Tønjum, T, Berild, JC, Leegaard, TM, Rasmussen, AN , Schønning, K, Glöckner, S, Rödel, J, Posadas-Cantera, S, Badr, MT, Kintzinger, T, Schaumburg, F, Thelen, P, Hamprecht, A, Dudakova, A, Jantsch, J, Hoffmann, K, Kaasch, AJ, Jacot, D, Greub, G, Landi, J, Ambretti, S, Comini, S, Ranieri, SC, Serretiello, E, Franci, G, Fasciana, T, Schade, R, Yusuf, E, Koeveringe, SVKV, Vandamme, S, Verroken, A, Rodriguez-Villalobos, H, Strubbe, G, Vandendriessche, S, Rabeau, P, Corvec, S, Dubois, D, Floch, P, Chainier, D, Barraud, O, Mizrahi, A, Bacho, C, Bouchiat, C, Fatah, T, Marchandin, H, Jean-Pierre, V, Ali, S, Donnell, SO, Doyle, M, Ramsamaroo, Z, Egan, C, McNicholas, S, Helgason, KO, Öngen, B, Karapınar, BA, Oyardi, Ö, Aksu, B, Colomina-Rodriguez, J, Torres, I, Luengo, RG, Escartín, MNL, Perez, MBV, Halperin, AV, Cantón, R, Seruca, M, Mendes, VS, Volovetska, Y, Cristino, JM, Costa, C & Bianco, G 2026, 'Epidemiology and antimicrobial resistance patterns of Aeromonas species in Europe, 2020-2024 (AEuROMONAS)', Diagnostic Microbiology and Infectious Disease, vol. 115, no. 4, 117384. https://doi.org/10.1016/j.diagmicrobio.2026.117384

@article{c06e089bbc574276a2673e8a940015ca,

title = "Epidemiology and antimicrobial resistance patterns of Aeromonas species in Europe, 2020-2024 (AEuROMONAS)",

abstract = "AbstractIntroduction: Aeromonas species are Gram-negative bacilli capable of causing bloodstream infections in both immunocompromised and otherwise healthy individuals. However, data on their epidemiology and antimicrobial resistance remain limited in Europe.Methods: We conducted a multicentre, retrospective, observational study that included all Aeromonas species isolates recovered from blood cultures in 56 European hospitals between January 1st 2020 and December 31st 2024. Epidemiological features and antimicrobial susceptibility profiles were analyzed.Results: A total of 590 Aeromonas isolates were included. Most were recovered from polymicrobial blood cultures (73.1\%), and catheter-related bloodstream infections were frequent (21.7\%). The most commonly reported species were A. caviae (30.1\%), isolates without conclusive species identification (Aeromonas spp., 24.8\%), A. hydrophila (20.7\%), and A. veronii (19.1\%). At the genus level, susceptibility to aztreonam, ceftazidime, and cefepime exceeded 90\%. Resistance to fluoroquinolones (∼10\%) and sulfamethoxazole/trimethoprim (up to 11\%) was observed. Species-level analyses showed higher resistance rates to fluoroquinolones and sulfamethoxazole/trimethoprim among A. caviae and A. hydrophila, and increased resistance to ceftazidime among Aeromonas spp.Conclusions: Aeromonas species in Europe showed high susceptibility to ceftazidime and cefepime, alongside with emerging resistance to fluoroquinolones and sulfamethoxazole/trimethoprim. Species-specific findings should be interpreted cautiously due to limitations in routine identification methods, underscoring the need for sustained surveillance and harmonised diagnostic standards across Europe.",

keywords = "Aeromonasspp, Antimicrobial resistance, Bloodstream infection, Epidemiology, Gram-negative bacilli, Sulfamethoxazole/trimethoprim",

author = "Matteo Boattini and Paulo Bastos and Konstantina Gartzonika and Eirini Christaki and Mavromanolaki, \{Viktoria Eirini\} and Sofia Maraki and Anastasia Spiliopoulou and Nikolaos Giormezis and Gergana Lengerova and Yordan Kalchev and Ana Budimir and Branka Bedeni{\'c} and Zana Rubic and Antonija Saskor and Karla Milanovic and Monica Licker and Corina Musuroi and Emese Juh{\'a}sz and Katalin Krist{\'o}f and Mateja Pirs and Ivana Velimirovic and Michael Berktold and Adri{\'a}na Kraj{\v c}{\'i}kov{\'a} and Anezka Gryndlerova and Pavel Drevinek and Sedl{\'a}kov{\'a}, \{Miroslava Htoutou\} and Milan Kol{\'a}{\v r} and Monika Brzychczy-Wloch and Aldona Olechowska-Jarz{\c a}b and Ma{\l}gorzata Brauncajs and Filip Bielec and Dominika Seliga-G{\c a}sior and Edyta Podsiadly and Kristian Riesbeck and Hanna-Sofia Andersson and Tone T{\o}njum and Berild, \{Johan Christian\} and Leegaard, \{Truls Michael\} and Rasmussen, \{Asger Nellemann\} and Kristian Sch{\o}nning and Stefan Gl{\"o}ckner and J{\"u}rgen R{\"o}del and Sara Posadas-Cantera and Badr, \{Mohamed Tarek\} and Tim Kintzinger and Frieder Schaumburg and Philipp Thelen and Axel Hamprecht and Anna Dudakova and Jonathan Jantsch and Katharina Hoffmann and Kaasch, \{Achim J.\} and Damien Jacot and Gilbert Greub and Jessica Landi and Simone Ambretti and Sara Comini and Ranieri, \{Sofia Chiatamone\} and Enrica Serretiello and Gianluigi Franci and Teresa Fasciana and Rogier Schade and Erlangga Yusuf and Koeveringe, \{Stefanie van Kleef van\} and Sarah Vandamme and Alexia Verroken and Hector Rodriguez-Villalobos and Gregory Strubbe and Stien Vandendriessche and Pauline Rabeau and St{\'e}phane Corvec and Damien Dubois and Pauline Floch and Delphine Chainier and Olivier Barraud and Assaf Mizrahi and C{\'e}lia Bacho and Coralie Bouchiat and Tayssir Fatah and H{\'e}l{\`e}ne Marchandin and Vincent Jean-Pierre and Saied Ali and Donnell, \{Sinead O{\textquoteright}\} and Maeve Doyle and Zachary Ramsamaroo and Clarice Egan and Sinead McNicholas and Helgason, \{Kristj{\'a}n Orri\} and Betig{\"u}l {\"O}ngen and Karapınar, \{Bahar Akg{\"u}n\} and {\"O}zlem Oyardi and Burak Aksu and Javier Colomina-Rodriguez and Ignacio Torres and Luengo, \{Raul Gilarranz\} and Escart{\'i}n, \{Maria Nieves Larrosa\} and Perez, \{Maria Belen Vi{\~n}ado\} and Halperin, \{Ana Ver{\'o}nica\} and Rafael Cant{\'o}n and Miguel Seruca and Mendes, \{Vasco Santos\} and Yuliya Volovetska and Cristino, \{Jos{\'e} Melo\} and Cristina Costa and Gabriele Bianco",

note = "Publisher Copyright: {\textcopyright} 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.",

year = "2026",

month = aug,

doi = "10.1016/j.diagmicrobio.2026.117384",

language = "English",

volume = "115",

journal = "Diagnostic Microbiology and Infectious Disease",

issn = "0732-8893",

publisher = "Elsevier Inc.",

number = "4",

}

TY - JOUR

T1 - Epidemiology and antimicrobial resistance patterns of Aeromonas species in Europe, 2020-2024 (AEuROMONAS)

AU - Boattini, Matteo

AU - Bastos, Paulo

AU - Gartzonika, Konstantina

AU - Christaki, Eirini

AU - Mavromanolaki, Viktoria Eirini

AU - Maraki, Sofia

AU - Spiliopoulou, Anastasia

AU - Giormezis, Nikolaos

AU - Lengerova, Gergana

AU - Kalchev, Yordan

AU - Budimir, Ana

AU - Bedenić, Branka

AU - Rubic, Zana

AU - Saskor, Antonija

AU - Milanovic, Karla

AU - Licker, Monica

AU - Musuroi, Corina

AU - Juhász, Emese

AU - Kristóf, Katalin

AU - Pirs, Mateja

AU - Velimirovic, Ivana

AU - Berktold, Michael

AU - Krajčíková, Adriána

AU - Gryndlerova, Anezka

AU - Drevinek, Pavel

AU - Sedláková, Miroslava Htoutou

AU - Kolář, Milan

AU - Brzychczy-Wloch, Monika

AU - Olechowska-Jarząb, Aldona

AU - Brauncajs, Małgorzata

AU - Bielec, Filip

AU - Seliga-Gąsior, Dominika

AU - Podsiadly, Edyta

AU - Riesbeck, Kristian

AU - Andersson, Hanna-Sofia

AU - Tønjum, Tone

AU - Berild, Johan Christian

AU - Leegaard, Truls Michael

AU - Rasmussen, Asger Nellemann

AU - Schønning, Kristian

AU - Glöckner, Stefan

AU - Rödel, Jürgen

AU - Posadas-Cantera, Sara

AU - Badr, Mohamed Tarek

AU - Kintzinger, Tim

AU - Schaumburg, Frieder

AU - Thelen, Philipp

AU - Hamprecht, Axel

AU - Dudakova, Anna

AU - Jantsch, Jonathan

AU - Hoffmann, Katharina

AU - Kaasch, Achim J.

AU - Jacot, Damien

AU - Greub, Gilbert

AU - Landi, Jessica

AU - Ambretti, Simone

AU - Comini, Sara

AU - Ranieri, Sofia Chiatamone

AU - Serretiello, Enrica

AU - Franci, Gianluigi

AU - Fasciana, Teresa

AU - Schade, Rogier

AU - Yusuf, Erlangga

AU - Koeveringe, Stefanie van Kleef van

AU - Vandamme, Sarah

AU - Verroken, Alexia

AU - Rodriguez-Villalobos, Hector

AU - Strubbe, Gregory

AU - Vandendriessche, Stien

AU - Rabeau, Pauline

AU - Corvec, Stéphane

AU - Dubois, Damien

AU - Floch, Pauline

AU - Chainier, Delphine

AU - Barraud, Olivier

AU - Mizrahi, Assaf

AU - Bacho, Célia

AU - Bouchiat, Coralie

AU - Fatah, Tayssir

AU - Marchandin, Hélène

AU - Jean-Pierre, Vincent

AU - Ali, Saied

AU - Donnell, Sinead O’

AU - Doyle, Maeve

AU - Ramsamaroo, Zachary

AU - Egan, Clarice

AU - McNicholas, Sinead

AU - Helgason, Kristján Orri

AU - Öngen, Betigül

AU - Karapınar, Bahar Akgün

AU - Oyardi, Özlem

AU - Aksu, Burak

AU - Colomina-Rodriguez, Javier

AU - Torres, Ignacio

AU - Luengo, Raul Gilarranz

AU - Escartín, Maria Nieves Larrosa

AU - Perez, Maria Belen Viñado

AU - Halperin, Ana Verónica

AU - Cantón, Rafael

AU - Seruca, Miguel

AU - Mendes, Vasco Santos

AU - Volovetska, Yuliya

AU - Cristino, José Melo

AU - Costa, Cristina

AU - Bianco, Gabriele

PY - 2026/8

Y1 - 2026/8

N2 - AbstractIntroduction: Aeromonas species are Gram-negative bacilli capable of causing bloodstream infections in both immunocompromised and otherwise healthy individuals. However, data on their epidemiology and antimicrobial resistance remain limited in Europe.Methods: We conducted a multicentre, retrospective, observational study that included all Aeromonas species isolates recovered from blood cultures in 56 European hospitals between January 1st 2020 and December 31st 2024. Epidemiological features and antimicrobial susceptibility profiles were analyzed.Results: A total of 590 Aeromonas isolates were included. Most were recovered from polymicrobial blood cultures (73.1%), and catheter-related bloodstream infections were frequent (21.7%). The most commonly reported species were A. caviae (30.1%), isolates without conclusive species identification (Aeromonas spp., 24.8%), A. hydrophila (20.7%), and A. veronii (19.1%). At the genus level, susceptibility to aztreonam, ceftazidime, and cefepime exceeded 90%. Resistance to fluoroquinolones (∼10%) and sulfamethoxazole/trimethoprim (up to 11%) was observed. Species-level analyses showed higher resistance rates to fluoroquinolones and sulfamethoxazole/trimethoprim among A. caviae and A. hydrophila, and increased resistance to ceftazidime among Aeromonas spp.Conclusions: Aeromonas species in Europe showed high susceptibility to ceftazidime and cefepime, alongside with emerging resistance to fluoroquinolones and sulfamethoxazole/trimethoprim. Species-specific findings should be interpreted cautiously due to limitations in routine identification methods, underscoring the need for sustained surveillance and harmonised diagnostic standards across Europe.

AB - AbstractIntroduction: Aeromonas species are Gram-negative bacilli capable of causing bloodstream infections in both immunocompromised and otherwise healthy individuals. However, data on their epidemiology and antimicrobial resistance remain limited in Europe.Methods: We conducted a multicentre, retrospective, observational study that included all Aeromonas species isolates recovered from blood cultures in 56 European hospitals between January 1st 2020 and December 31st 2024. Epidemiological features and antimicrobial susceptibility profiles were analyzed.Results: A total of 590 Aeromonas isolates were included. Most were recovered from polymicrobial blood cultures (73.1%), and catheter-related bloodstream infections were frequent (21.7%). The most commonly reported species were A. caviae (30.1%), isolates without conclusive species identification (Aeromonas spp., 24.8%), A. hydrophila (20.7%), and A. veronii (19.1%). At the genus level, susceptibility to aztreonam, ceftazidime, and cefepime exceeded 90%. Resistance to fluoroquinolones (∼10%) and sulfamethoxazole/trimethoprim (up to 11%) was observed. Species-level analyses showed higher resistance rates to fluoroquinolones and sulfamethoxazole/trimethoprim among A. caviae and A. hydrophila, and increased resistance to ceftazidime among Aeromonas spp.Conclusions: Aeromonas species in Europe showed high susceptibility to ceftazidime and cefepime, alongside with emerging resistance to fluoroquinolones and sulfamethoxazole/trimethoprim. Species-specific findings should be interpreted cautiously due to limitations in routine identification methods, underscoring the need for sustained surveillance and harmonised diagnostic standards across Europe.

KW - Aeromonasspp

KW - Antimicrobial resistance

KW - Bloodstream infection

KW - Epidemiology

KW - Gram-negative bacilli

KW - Sulfamethoxazole/trimethoprim

UR - https://www.scopus.com/pages/publications/105034807359

U2 - 10.1016/j.diagmicrobio.2026.117384

DO - 10.1016/j.diagmicrobio.2026.117384

M3 - Journal article

C2 - 41946308

AN - SCOPUS:105034807359

SN - 0732-8893

VL - 115

JO - Diagnostic Microbiology and Infectious Disease

JF - Diagnostic Microbiology and Infectious Disease

IS - 4

M1 - 117384

ER -

Epidemiology and antimicrobial resistance patterns of Aeromonas species in Europe, 2020-2024 (AEuROMONAS)

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