Aetiology of water-immersed wound infections

Skin infection or sepsis following immersion of a wound in water (eg in fishermen, swimmers or aquarium owners, or with a marine animal bite [including shark or crocodile bites] or coral cut) may involve:

• Aeromonas species (source: fresh or brackish water, and mud; exposure risks: caving, natural disasters and medicinal leech therapy)
• Mycobacterium marinum (most common source: fish tanks)
• Shewanella putrefaciens
• Vibrio vulnificus, Vibrio alginolyticus and other noncholera vibrios (source: salt or brackish water)
• Staphylococcus aureus, including methicillin-resistant strains
• Streptococcus pyogenes (group A streptococcus) (source: coral cuts).