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Namadi P, Deng Z. Optimum environmental conditions controlling prevalence of vibrio parahaemolyticus in marine environment. MARINE ENVIRONMENTAL RESEARCH 2023; 183:105828. [PMID: 36423461 DOI: 10.1016/j.marenvres.2022.105828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
This literature review presents major environmental indicators and their optimum variation ranges for the prevalence of Vibrio parahaemolyticus in the marine environment by critically reviewing and statistically analyzing more than one hundred studies from countries around the world. Results of this review indicated that the prevalence of Vibrio parahaemolyticus in the marine environment is primarily responsive to favorable environmental conditions that are described with environmental indicators. The importance of environmental indicators to the prevalence of Vibrio parahaemolyticus can be ranked from the highest to lowest as Sea Surface Temperature (SST), salinity, pH, chlorophyll a, and turbidity, respectively. It was also found in this study that each environmental indicator has an optimum variation range favoring the prevalence of Vibrio parahaemolyticus. Specifically, the SST range of 25.67 ± 2 °C, salinity range of 27.87 ± 3 ppt, and pH range of 7.96 ± 0.1 were found to be the optimum conditions for the prevalence of Vibrio parahaemolyticus. High vibrio concentrations were also observed in water samples with the chlorophyll a range of 16-25 μg/L. The findings provide new insights into the importance of environmental indicators and their optimum ranges, explaining not only the existence of both positive and negative associations reported in the literature but also the dynamic associations between the Vibrio presence and its environmental drivers.
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Affiliation(s)
- Peyman Namadi
- Department of Civil and Environmental Engineering, Louisiana State University, Baton Rouge, LA, 70803, United States
| | - Zhiqiang Deng
- Department of Civil and Environmental Engineering, Louisiana State University, Baton Rouge, LA, 70803, United States.
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Kling K, Trinh SA, Leyn SA, Rodionov DA, Rodionov ID, Herrera A, Cervantes K, Pankey G, Ashcraft D, Ozer EA, Godzik A, Satchell KJF. Genetic Divergence of Vibrio vulnificus Clinical Isolates with Mild to Severe Outcomes. mBio 2022; 13:e0150022. [PMID: 36169197 PMCID: PMC9600620 DOI: 10.1128/mbio.01500-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/20/2022] Open
Abstract
The marine bacterium Vibrio vulnificus infects humans via food or water contamination, leading to serious manifestations, including gastroenteritis, wound infections, and septic shock. Previous studies suggest phylogenetic Lineage 1 isolates with the vcgC allele of the vcg gene cause human infections, whereas Lineage 2 isolates with the vcgE allele are less pathogenic. Mouse studies suggest that some variants of the primary toxin could drive more serious infections. A collection of 109 V. vulnificus United States human clinical isolates from 2001 to 2019 with paired clinical outcome data were assembled. The isolates underwent whole-genome sequencing, multilocus-sequence phylogenetic analysis, and toxinotype analysis of the multifunctional autoprocessing repeats-in-toxin (MARTX) toxin. In contrast to prior reports, clinical isolates were equally distributed between lineages. We found no correlation between phylogenetic lineage or MARTX toxinotype and disease severity. Infections caused by isolates in Lineage 1 demonstrated a borderline statistically significant higher mortality. Lineage 1 isolates had a trend toward a higher proportion of M-type MARTX toxins compared with Lineage 2, although this was not statistically significant. IMPORTANCE Vibrio vulnificus is an aquatic pathogen that is capable of causing severe disease in humans. Previous studies have suggested that pathogenic isolates were restricted to certain phylogenetic lineages and possibly toxinotype. Our study demonstrated that phylogenetic lineage and multifunctional autoprocessing repeats-in-toxin (MARTX) toxinotype do not predict severity of infection. V. vulnificus strains capable of causing severe human disease are not concentrated in Lineage 1 but are genetically diverse. Thus, food surveillance based on lineage type or toxinotype may not be an appropriate intervention measure to control this rare but serious infection.
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Affiliation(s)
- Kendall Kling
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sonya A. Trinh
- Division of Infectious Diseases, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Semen A. Leyn
- Sanford Burnham Prebys Medical Discovery Institute, LaJolla, California, USA
| | - Dmitry A. Rodionov
- Sanford Burnham Prebys Medical Discovery Institute, LaJolla, California, USA
| | | | - Alfa Herrera
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kasey Cervantes
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - George Pankey
- Infectious Disease Translational Research, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - Deborah Ashcraft
- Infectious Disease Translational Research, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - Egon A. Ozer
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Adam Godzik
- Biosciences Division, University of California Riverside School of Medicine, Riverside, California, USA
| | - Karla J. F. Satchell
- Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Kim JS, Lee EG, Chun BC. Epidemiologic Characteristics and Case Fatality Rate of Vibrio vulnificus Infection: Analysis of 761 Cases From 2003 to 2016 in Korea. J Korean Med Sci 2022; 37:e79. [PMID: 35257530 PMCID: PMC8901877 DOI: 10.3346/jkms.2022.37.e79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/07/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Vibrio vulnificus infection is a highly fatal disease resulting from the consumption of raw or undercooked seafood and exposure to seawater containing the organism. It has been a nationally notifiable disease since 2000 in Korea. The aims of this study were to assess the trends in the incidence of V. vulnificus infection and its case fatality rate and to determine the epidemiologic characteristics to effectively prevent infection and lower mortality. METHODS We analyzed the incidence trends of V. vulnificus infection by year, month, and region in 913 cases reported to the Korea Centers for Disease Control and Prevention (KCDC, currently Korea Disease Control and Prevention Agency) by the National Infectious Disease Surveillance System from 2001 to 2016. We analyzed the number of patients with V. vulnificus infection who were under the National Health Insurance Service (NHIS) and whose coastal seawater temperature data were provided by the Korea Oceanographic Data Center of the National Institute of Fisheries Science. Epidemiological investigations were followed up and analyzed for 761 patients from 2003 to 2016. A total of 152 patients who were not followed up were excluded from the analysis. The case fatality rate was analyzed for 325 cases reported to the KCDC from 2011 to 2016. RESULTS The mean incidence of V. vulnificus infection was 0.12 per 100,000 people, and the highest incidence was reported in September (41.1%) during the study period. The incidence rate per 100,000 people was the highest in Jeonnam (8.23). The number of patients who claimed to the NHIS was the highest in September (105 patients). The average seawater temperature was the highest at 24.1°C in August, and the average seawater temperature from August to October, when many cases occurred, was 22.4°C. The male-to-female ratio was 6:1, and 96.4% of the patients were aged ≥ 40 years. Of the patients, 96.1% had underlying diseases, the most common of which was liver cirrhosis (56.3%). The case fatality rate was 48.9%. CONCLUSION The occurrence of V. vulnificus infection showed distinct seasonality, with a large number of cases occurring in the months when the seawater temperature was high; there were also distinct geographical characteristics. The incidence of V. vulnificus infection and mortality rates have not decreased for decades, and it is still an important public health problem with a high fatality rate.
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Affiliation(s)
- Jung Sook Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Eun Gyu Lee
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
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Elnahla A, Attia AS, Toraih E, Guidry C, Akkera M, Schroll R, Killackey M, Nichols R, Kandil E. Prognostic Factors of Mortality in Vibrio vulnificus Sepsis and Soft Tissue Infections: Meta-Analysis. Surg Infect (Larchmt) 2021; 22:928-939. [PMID: 33970025 DOI: 10.1089/sur.2020.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Vibrio vulnificus is a rare but life-threatening infection that effects the population near warm coastal areas. This infection could be fulminant and rapidly progress to severe sepsis and necrotizing soft tissue infection. Early diagnosis and treatment are critical to saving patients' lives. With multiple studies reporting discrepancies in prognostic factors and different treatment protocols, we aimed through this meta-analysis to assess these factors and protocols and the impact on the outcome of the infection. Materials and Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, Embase, and Cochrane Library databases by two independent reviewers was reported. Studies evaluating prognostic factors and treatment outcomes of Vibrio vulnificus infections were included. Comprehensive Meta-Analysis, version 3.0 was used. Results: Two hundred eleven studies were identified. Of those, eight studies met our inclusion criteria. The following factors on presentation were associated with higher mortality rates; concomitant liver disease (odds ratio [OR], 4.38; 95% confidence interval [CI], 2.43-7.87; p < 0.001), renal disease (OR, 3.90; 95% CI, 1.37-11.12; p = 0.011), septic shock (OR, 2.82; 95% CI, 1.84-4.31; p < 0.001), higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 3.40; 95% CI, 2.26-5.12; p < 0.001), elevated band cells count (OR, 2.61; 95% CI, 1.13-6.0; p = 0.024), hypoalbuminemia (OR, 3.41; 95% CI, 1.58-7.35; p = 0.002), and infection involving multiple limbs (OR, 4.36; 95% CI, 1.72-11.07; p = 0.002). Interestingly, different antibiotic regimens did not have any impact on outcomes, however, delayed surgical intervention after the first 12 or 24 hours was associated with higher mortality rates (OR, 2.64; 95% CI, 1.39-5.0; p = 0.003 and OR, 2.99; 95% CI, 1.54-5.78; p = 0.001, respectively). Conclusion: The presence of liver or renal disease, higher APACHE II scores, septic shock, hypoalbuminemia, or elevated band cell on presentation should alert the physician to the higher risk of mortality. Different antibiotic regimens did not impact the outcomes in these patients and delayed surgical intervention is associated with worsening of mortality.
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Affiliation(s)
| | | | - Eman Toraih
- Tulane University, New Orleans, Louisiana, USA.,Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | | | | | | | | | - Emad Kandil
- Tulane University, New Orleans, Louisiana, USA
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Cai R, Zhen M, Guan Z, Li M, Liao Q, Liu X, Wu Y, Lai W, Shu B, Qi S. New atypical manifestations and prognostic factors of Vibrio vulnificus infection: A 10-year retrospective study. Jpn J Infect Dis 2021; 74:549-553. [PMID: 33952769 DOI: 10.7883/yoken.jjid.2020.843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Vibrio vulnificus (V. vulnificus) infection is rare but potentially fatal. This study explored the new atypical manifestations and prognostic factors of V. vulnificus-infected patients throughout hospitalization. we retrospectively reviewed 33 patients diagnosed as having V. vulnificus infection in Guangdong Province, China between 2010 and 2020. Medical records were analyzed. Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were performed. New atypical manifestations were found, including cholangitis, urinary tract infection, and suppurative otitis media. Eleven of thirty-three (33.3%) V. vulnificus-infected patients died eventually. By univariate analysis, patients with cardio-cerebro-vascular diseases, lower platelet counts, higher levels of C-reactive protein and procalcitonin (PCT) had a statistically higher mortality. However, multivariate analysis showed that only PCT (P = 0.036) reached statistical significance. Also, the area under the ROC value estimate for PCT was 0.8816 (95% CI, 0.759-1.000; P = 0.0009). More than half of patients with V. vulnificus infection would die when PCT ＞20 ng/ml, while no patient dies when PCT ≤ 20 ng/ml. This study found new atypical manifestations of V. vulnificus infection. Also, PCT is an effective and independent predictor of mortality of V. vulnificus infection, and is suitable for clinicians to make early risk stratification and best therapeutic strategies.
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Affiliation(s)
- Ruizhao Cai
- Department of Burns, The First Affiliated Hospital, Sun Yat-sen University, China.,Guangdong Engineering & Technology Research Center for Precise Diagnosis and Treatment of Burns and Wounds, China
| | - Miao Zhen
- Department of Burns, The First Affiliated Hospital, Sun Yat-sen University, China.,Guangdong Engineering & Technology Research Center for Precise Diagnosis and Treatment of Burns and Wounds, China
| | - Zhiguang Guan
- Department of Burn and Plastic Surgery, The People's Hospital of Taishan, China
| | - Menghe Li
- Department of Burn and Plastic Surgery, GuangDong Yangjiang People's Hospital, China
| | - Qiangyun Liao
- Department of Burn and Plastic Surgery, Binhaiwan Central Hospital of Dongguan, China
| | - Xing Liu
- Department of Burn and Plastic Surgery, Zhongshan City People's Hospital, China
| | - Ying Wu
- The Clinical Laboratory of Foshan Hospital of Traditional Chinese Medicine, China
| | - Wen Lai
- Department of Burns and Wound Repair Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), China
| | - Bin Shu
- Department of Burns, The First Affiliated Hospital, Sun Yat-sen University, China.,Guangdong Engineering & Technology Research Center for Precise Diagnosis and Treatment of Burns and Wounds, China
| | - Shaohai Qi
- Department of Burns, The First Affiliated Hospital, Sun Yat-sen University, China.,Guangdong Engineering & Technology Research Center for Precise Diagnosis and Treatment of Burns and Wounds, China
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Hepatic disease and the risk of mortality of Vibrio vulnificus necrotizing skin and soft tissue infections: A systematic review and meta-analysis. PLoS One 2019; 14:e0223513. [PMID: 31652263 PMCID: PMC6814278 DOI: 10.1371/journal.pone.0223513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/22/2019] [Indexed: 12/14/2022] Open
Abstract
Background Vibrio vulnificus necrotizing skin and soft tissue infections (VNSSTIs) are associated with a high mortality rate that varies remarkably with host susceptibility. Hepatic disease (HD) is considered the key risk factor for high VNSSTIs incidence and mortality; however, there is limited evidence in the literature to support this observation. Methodology We examined all reported cases of VNSSTIs and associated mortality rates between 1966 and mid-2018. The PubMed, Medline and Cochrane Library databases were systematically searched for observational studies on patients with VNSSTIs. Twelve studies with 1157 total patients with VNSSTIs were included in the analysis. From the pooled dataset, nearly half (46.8%) of the patients with VNSSTIs had HD. The mortality rate in HD patients with VNSSTIs was 53.9% (n = 292/542), which was considerably higher than the mortality rate of 16.1% (n = 99/615) in non-HD patients. Patients with HD contracted VNSSTIs were found to be two or more times (RR = 2.61, 95% CI = 2.14–3.19) as likely to die compared with those without HD. Besides, liver cirrhosis (LC), the end-stage HD, was confirmed to be a significant risk factor, with risk ratios of 1.84 (95% CI 1.21–2.79) and 2.00 (95% CI 1.41–2.85) when compared to non-LC and non-HD, respectively. Conclusions HD with or without LC can be associated with infections and complications from V. vulnificus. Clinicians should aggressively approach care and management of acutely and/or critically ill patients with VNSSTIs.
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Guerrero A, Licea-Navarro AF, González-Sánchez R, Lizárraga-Partida ML. Whole-genome comparison between reference sequences and oyster Vibrio vulnificus C-genotype strains. PLoS One 2019; 14:e0220385. [PMID: 31361763 PMCID: PMC6667273 DOI: 10.1371/journal.pone.0220385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 07/15/2019] [Indexed: 01/22/2023] Open
Abstract
Whole-genome sequences of Vibrio vulnificus clinical genotype (C-genotype) from the CICESE Culture Collection, isolated from oysters, were compared with reference sequences of CMCP6 and YJ016 V. vulnificus C-genotype strains of clinical origin. The RAST web server estimated the whole genome to be ~4.8 Mb in CICESE strain 316 and ~4.7 Mb in CICESE strain 325. No plasmids were detected in the CICESE strains. Based on a phylogenetic tree that was constructed with the whole-genome results, we observed high similarity between the reference sequences and oyster C-genotype isolates and a sharp contrast with environmental genotype (E-genotype) reference sequences, indicating that the differences between the C- and E-genotypes do not necessarily correspond to their isolation origin. The CICESE strains share 3488 genes (63.2%) with the YJ016 strain and 3500 genes (63.9%) with the CMCP6 strain. A total of 237 pathogenicity associated genes were selected from reference clinical strains, where—92 genes were from CMCP6, 126 genes from YJ016, and 19 from MO6-24/O; the presence or absence of these genes was recorded for the CICESE strains. Of the 92 genes that were selected for CMCP6, 67 were present in both CICESE strains, as were as 86 of the 126 YJ016 genes and 13 of the 19 MO6-24/O genes. The detection of elements that are related to virulence in CICESE strains—such as the RTX gene cluster, vvhA and vvpE, the type IV pili cluster, the XII genomic island, and the viuB genes, suggests that environmental isolates with the C-genotype, have significant potential for infection.
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Affiliation(s)
- Abraham Guerrero
- Centro de Investigación Científica y de Educación Superior de Ensenada Baja California, México, CICESE, Ensenada Baja California, México
| | - Alexei Fedorovish Licea-Navarro
- Centro de Investigación Científica y de Educación Superior de Ensenada Baja California, México, CICESE, Ensenada Baja California, México
| | - Ricardo González-Sánchez
- Centro de Investigación Científica y de Educación Superior de Ensenada Baja California, México, CICESE, Ensenada Baja California, México
| | - Marcial Leonardo Lizárraga-Partida
- Centro de Investigación Científica y de Educación Superior de Ensenada Baja California, México, CICESE, Ensenada Baja California, México
- * E-mail:
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Vasagar B, Jain V, Germinario A, Watson HJ, Ouzts M, Presutti RJ, Alvarez S. Approach to Aquatic Skin Infections. Prim Care 2018; 45:555-566. [PMID: 30115341 DOI: 10.1016/j.pop.2018.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Aquatic-based infections can present a treatment challenge for primary care physicians because of the likely polymicrobial nature of the infection and the possibility of uncommon pathogenic organisms. Although Staphylococcus and Streptococcus species that colonize the skin are the most common etiologic agents associated with saltwater and freshwater skin and soft tissue infections, other significant pathogens can include Vibrio, Aeromonas, Edwardsiella, Erysipelothrix, and Mycobacterium. Early detection and appropriate management of aquatic infections can significantly decrease morbidity and mortality. This article reviews the pathophysiology, presentation, and management for the most common water-borne pathogens causing skin and soft tissue infections.
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Affiliation(s)
- Brintha Vasagar
- Department of Family Medicine, Medical University of South Carolina, 5 Charleston Center, Charleston, SC 29425, USA.
| | - Vasudha Jain
- Department of Family Medicine, Tidelands Health MUSC Family Medicine Residency Program, 4320 Holmestown Road, Myrtle Beach, SC 29578, USA
| | - Anthony Germinario
- Department of Family Medicine, Tidelands Health MUSC Family Medicine Residency Program, 4320 Holmestown Road, Myrtle Beach, SC 29578, USA
| | - Heber J Watson
- Department of Family Medicine, Tidelands Health MUSC Family Medicine Residency Program, 4320 Holmestown Road, Myrtle Beach, SC 29578, USA
| | - Michael Ouzts
- Department of Family Medicine, Tidelands Health MUSC Family Medicine Residency Program, 4320 Holmestown Road, Myrtle Beach, SC 29578, USA
| | - Richard John Presutti
- Department of Family Medicine, Mayo School of Medicine, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Salvador Alvarez
- Department of Internal Medicine, Mayo School of Medicine, 4500 San Pablo Road, Jacksonville, FL 32224, USA
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Efficacy of Ceftriaxone, Cefepime, Doxycycline, Ciprofloxacin, and Combination Therapy for Vibrio vulnificus Foodborne Septicemia. Antimicrob Agents Chemother 2017; 61:AAC.01106-17. [PMID: 28971862 DOI: 10.1128/aac.01106-17] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/23/2017] [Indexed: 12/17/2022] Open
Abstract
Foodborne Vibrio vulnificus infections are associated with higher rates of sepsis and mortality than wound infections; however, antibiotic efficacy studies have not been performed in foodborne infection models. The efficacies of ceftriaxone, cefepime, doxycycline, ciprofloxacin, and combination therapy were assessed in V. vulnificus intestinal infection in mice in order to model foodborne infections. In accordance with prior studies of cefotaxime, cefepime was synergistic with doxycycline and ciprofloxacin in vitro; combination therapy significantly decreased bacterial growth, by ≥2 log10 units, from that with antibiotic monotherapy (P < 0.01). In vivo, survival rates in the ceftriaxone (50%), doxycycline (79%), and ciprofloxacin (80%) groups were significantly higher than those in the control group (0%) (P < 0.0001). Survival was significantly higher with ceftriaxone-doxycycline (91%) or ceftriaxone-ciprofloxacin (100%) therapy than with ceftriaxone (50%) (P ≤ 0.05). Survival with cefepime-doxycycline (96%) or cefepime-ciprofloxacin (90%) therapy was significantly higher than that with cefepime alone (20%) (P < 0.001). There was no difference in survival between the combination therapy groups. Thus, we conclude that combination therapy was the most effective treatment for foodborne V. vulnificus septicemia. In a septic patient with a recent ingestion of raw seafood, cefepime in combination with doxycycline or ciprofloxacin should be initiated for coverage of resistant Gram-negative organisms and V. vulnificus pending a microbiological diagnosis. Once a diagnosis of foodborne V. vulnificus septicemia is established, treatment can safely transition to ceftriaxone in combination with doxycycline or ciprofloxacin.
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Bonnin-Jusserand M, Copin S, Le Bris C, Brauge T, Gay M, Brisabois A, Grard T, Midelet-Bourdin G. Vibrio species involved in seafood-borne outbreaks (Vibrio cholerae, V. parahaemolyticus and V. vulnificus): Review of microbiological versus recent molecular detection methods in seafood products. Crit Rev Food Sci Nutr 2017; 59:597-610. [DOI: 10.1080/10408398.2017.1384715] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Maryse Bonnin-Jusserand
- Univ. Littoral Côte d'Opale, convention ANSES, EA 7394 – ICV – Institut Charles Viollette, Boulogne-sur-Mer, France
- INRA, France
- Univ. Lille, Lille, France
- ISA, Lille, France
- Univ. Artois, Arras, France
| | - Stéphanie Copin
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Laboratory for Food Safety, Boulevard du Bassin Napoléon, Boulogne-sur-Mer, France
| | - Cédric Le Bris
- Univ. Littoral Côte d'Opale, convention ANSES, EA 7394 – ICV – Institut Charles Viollette, Boulogne-sur-Mer, France
| | - Thomas Brauge
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Laboratory for Food Safety, Boulevard du Bassin Napoléon, Boulogne-sur-Mer, France
| | - Mélanie Gay
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Laboratory for Food Safety, Boulevard du Bassin Napoléon, Boulogne-sur-Mer, France
| | - Anne Brisabois
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Laboratory for Food Safety, Boulevard du Bassin Napoléon, Boulogne-sur-Mer, France
| | - Thierry Grard
- Univ. Littoral Côte d'Opale, convention ANSES, EA 7394 – ICV – Institut Charles Viollette, Boulogne-sur-Mer, France
| | - Graziella Midelet-Bourdin
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Laboratory for Food Safety, Boulevard du Bassin Napoléon, Boulogne-sur-Mer, France
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Izumiya H, Furukawa M, Ogata K, Isobe J, Watanabe S, Sasaki M, Ichinose K, Arakawa E, Morita M, Kurane I, Ohnishi M. A double-quadratic model for predicting Vibrio species in water environments of Japan. Arch Microbiol 2017. [PMID: 28646477 DOI: 10.1007/s00203-017-1402-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Vibrio spp. are natural inhabitants of marine and estuarine environments. Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus are the major infectious agents for humans. Their densities are affected by environmental factors such as water temperature and salinity. The detailed contribution of each factor still remains to be elucidated. Here we conducted multi-coastal study in a 21-month period to examine relationships between environmental factors and V. cholerae, V. parahaemolyticus and V. vulnificus densities in sea surface water in eight coastal sites of four prefectures in Japan. Vibrio densities were measured by a most-probable-number with PCR method which is highly sensitive and quantitative (3/100 ml of detection limit). Vibrio densities were analyzed with environmental factors including water temperature, salinity, total dissolved substance, and pH, and their quadratics. A linear regression model suited best for prediction of V. cholerae density. A novel double-quadratic model suited best for the prediction of V. parahaemolyticus and V. vulnificus densities.
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Affiliation(s)
| | - Masato Furukawa
- Kumamoto Prefectural Institute of Public-Health and Environmental Science, Kumamoto, Japan
| | - Kikuyo Ogata
- Oita Prefectural Institute of Health and Environment, Oita, Japan
| | | | - Setsu Watanabe
- Miyagi Prefectural Institute of Public Health and Environment, Miyagi, Japan
| | - Mari Sasaki
- Oita Prefectural Institute of Health and Environment, Oita, Japan
| | - Kazuya Ichinose
- Oita Prefectural Institute of Health and Environment, Oita, Japan
| | - Eiji Arakawa
- National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Ichiro Kurane
- National Institute of Infectious Diseases, Tokyo, Japan
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Heng SP, Letchumanan V, Deng CY, Ab Mutalib NS, Khan TM, Chuah LH, Chan KG, Goh BH, Pusparajah P, Lee LH. Vibrio vulnificus: An Environmental and Clinical Burden. Front Microbiol 2017; 8:997. [PMID: 28620366 PMCID: PMC5449762 DOI: 10.3389/fmicb.2017.00997] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/17/2017] [Indexed: 12/14/2022] Open
Abstract
Vibrio vulnificus is a Gram negative, rod shaped bacterium that belongs to the family Vibrionaceae. It is a deadly, opportunistic human pathogen which is responsible for the majority of seafood-associated deaths worldwide. V. vulnificus infection can be fatal as it may cause severe wound infections potentially requiring amputation or lead to sepsis in susceptible individuals. Treatment is increasingly challenging as V. vulnificus has begun to develop resistance against certain antibiotics due to their indiscriminate use. This article aims to provide insight into the antibiotic resistance of V. vulnificus in different parts of the world as well as an overall review of its clinical manifestations, treatment, and prevention. Understanding the organism's antibiotic resistance profile is vital in order to select appropriate treatment and initiate appropriate prevention measures to treat and control V. vulnificus infections, which should eventually help lower the mortality rate associated with this pathogen worldwide.
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Affiliation(s)
- Sing-Peng Heng
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University MalaysiaBandar Sunway, Malaysia
| | - Vengadesh Letchumanan
- Division of Genetics and Molecular Biology, Faculty of Science, Institute of Biological Sciences, University of MalayaKuala Lumpur, Malaysia
- Novel Bacteria and Drug Discovery Research Group, School of Pharmacy, Monash University MalaysiaBandar Sunway, Malaysia
| | - Chuan-Yan Deng
- Zhanjiang Evergreen South Ocean Science and Technology CorporationGuangdong, China
| | - Nurul-Syakima Ab Mutalib
- UKM Medical Centre, UKM Medical Molecular Biology Institute, Universiti Kebangsaan MalaysiaKuala Lumpur, Malaysia
| | - Tahir M. Khan
- Novel Bacteria and Drug Discovery Research Group, School of Pharmacy, Monash University MalaysiaBandar Sunway, Malaysia
- Department of Pharmacy, Absyn University PeshawarPeshawar, Pakistan
| | - Lay-Hong Chuah
- Novel Bacteria and Drug Discovery Research Group, School of Pharmacy, Monash University MalaysiaBandar Sunway, Malaysia
| | - Kok-Gan Chan
- Division of Genetics and Molecular Biology, Faculty of Science, Institute of Biological Sciences, University of MalayaKuala Lumpur, Malaysia
| | - Bey-Hing Goh
- Novel Bacteria and Drug Discovery Research Group, School of Pharmacy, Monash University MalaysiaBandar Sunway, Malaysia
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of PhayaoPhayao, Thailand
| | - Priyia Pusparajah
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University MalaysiaBandar Sunway, Malaysia
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group, School of Pharmacy, Monash University MalaysiaBandar Sunway, Malaysia
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of PhayaoPhayao, Thailand
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Simultaneous detection of Vibrio cholerae, Vibrio alginolyticus, Vibrio parahaemolyticus and Vibrio vulnificus in seafood using dual priming oligonucleotide (DPO) system-based multiplex PCR assay. Food Control 2017. [DOI: 10.1016/j.foodcont.2016.06.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Huang KC, Weng HH, Yang TY, Chang TS, Huang TW, Lee MS. Distribution of Fatal Vibrio Vulnificus Necrotizing Skin and Soft-Tissue Infections: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2016; 95:e2627. [PMID: 26844475 PMCID: PMC4748892 DOI: 10.1097/md.0000000000002627] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/17/2015] [Accepted: 01/05/2016] [Indexed: 12/14/2022] Open
Abstract
Vibrio vulnificus necrotizing skin and soft tissue infections (VNSSTIs), which have increased significantly over the past few decades, are still highly lethal and disabling diseases despite advancing antibiotic and infection control practices. We, therefore, examined the spatiotemporal distribution of worldwide reported episodes and associated mortality rates of VNSSTIs between 1966 and 2014. The PubMed and Cochrane Library databases were systematically searched for observational studies on patients with VNSSTIs. The primary outcome was all-cause mortality. We did random-effects meta-analysis to obtain estimates for primary outcomes; the estimates are presented as means plus a 95% confidence interval (CI). Data from the selected studies were also extracted and pooled for correlation analyses.Nineteen studies of 2227 total patients with VNSSTIs were analyzed. More than 95% of the episodes occurred in the subtropical western Pacific and Atlantic coastal regions of the northern hemisphere. While the number of cases and the number of deaths were not correlated with the study period (rs = 0.476 and 0.310, P = 0.233 and 0.456, respectively), the 5-year mortality rate was significantly negatively correlated with them (rs = -0.905, P = 0.002). Even so, the pooled estimate of total mortality rates from the random-effects meta-analysis was as high as 37.2% (95% CI: 0.265-0.479).These data suggest that VNSSTIs are always an important public health problem and will become more critical and urgent because of global warming. Knowing the current distribution of VNSSTIs will help focus education, policy measures, early clinical diagnosis, and appropriate medical and surgical treatment for them.
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Affiliation(s)
- Kuo-Chin Huang
- From the College of Medicine, Chang Gung University, Taoyuan (K-CH, H-HW, T-SC, T-WH, MSL); Department of Orthopaedic Surgery (K-CH, T-YY, T-WH); Department of Diagnostic Radiology (H-HW); Department of Gastroenterology, Chang Gung Memorial Hospital, Chaiyi (T-SC); and Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan (MSL)
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Hirai Y, Asahata-Tago S, Ainoda Y, Fujita T, Kikuchi K. Edwardsiella tarda bacteremia. A rare but fatal water- and foodborne infection: Review of the literature and clinical cases from a single centre. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2015; 26:313-8. [PMID: 26744588 PMCID: PMC4692300 DOI: 10.1155/2015/702615] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Edwardsiella tarda bacteremia (ETB) can be a fatal disease in humans. OBJECTIVES To determine the significant risk factors associated with death caused by ETB, and to examine the geographical, seasonal, environmental and dietary factors of the disease. METHODS A retrospective, observational, case control study was performed. The PubMed MEDLINE and Japanese Medical Abstract Society (www.jamas.or.jp) databases were searched for ETB case reports and meeting abstracts. In additon, retrospective chart reviews of patients with ETB at the Tokyo Women's Medical University Hospital (Tokyo, Japan) were conducted to evaluate the risk factors associated with death using multivariate analyses. RESULTS The literature search yielded 46 publications, comprising 72 cases from the English (n=30), French (n=1), Spanish (n=1) and Japanese (n=14) literature. Five cases at the Tokyo Women's Medical University Hospital were also included. Of the included 77 cases, the mean age was 61 years and 39% of patients were female; 77.2% of the cases occurred between June and November, and 45.5% were reported in Japan. Dietary factors (raw fish/meat exposure) were reported for 10.4% of patients and 12.9% reported environmental (ie, brackish water) exposure. The overall mortality rate was 44.6%; however, this rate increased to 61.1% for ETB patients with soft tissue infections. Liver cirrhosis was determined to be an independent risk factor associated with death (OR 12.0 [95% CI 2.46 to 58.6]; P=0.00213) using multivariate analyses. DISCUSSION To our knowledge, the present analysis was the first and largest multi-language review of ETB. Clinical characteristics of ETB resemble those of Aeromonas, typhoid fever and Vibrio vulnificus infections, in addition to sharing similar risk factors. CONCLUSION ETB should be categorized as a severe food- and waterborne infection, which results in high mortality for patients with liver cirrhosis.
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Affiliation(s)
- Yuji Hirai
- Department of Infectious Diseases, Tokyo Women’s Medical University
- Department of General Medicine, Faculty of Medicine, Juntendo University, Toyko, Japan
| | | | - Yusuke Ainoda
- Department of Infectious Diseases, Tokyo Women’s Medical University
| | - Takahiro Fujita
- Department of Infectious Diseases, Tokyo Women’s Medical University
| | - Ken Kikuchi
- Department of Infectious Diseases, Tokyo Women’s Medical University
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Kotton Y, Soboh S, Bisharat N. Vibrio Vulnificus Necrotizing Fasciitis Associated with Acupuncture. Infect Dis Rep 2015; 7:5901. [PMID: 26500738 PMCID: PMC4593884 DOI: 10.4081/idr.2015.5901] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 06/16/2015] [Accepted: 06/25/2015] [Indexed: 12/19/2022] Open
Abstract
Necrotizing fasciitis is a severe life-threatening infection of the deep subcutaneous tissues and fascia. Infection with Vibrio vulnificus, a halophilic Gram-negative bacillus found worldwide in warm coastal waters, can lead to severe complications, particularly among patients with chronic liver diseases. We herein present an unusual case of necrotizing fasciitis caused by V. vulnificus triggered by acupuncture needle insertion. The patient, who suffered from diabetes mellitus and nonalcoholic fatty liver disease and worked at a fish hatchery, denied any injury prior to acupuncture. This is the first ever reported case of V. vulnificus infection triggered by acupuncture needle insertion, clearly emphasizing the potential hazards of the prolonged survival of V. vulnificus on the skin. The potential infectious complications of acupuncture needle insertion are discussed.
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Affiliation(s)
- Yael Kotton
- Department of Medicine D, Emek Medical Center , Afula, Israel ; The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology , Haifa, Israel
| | - Soboh Soboh
- Department of Medicine B, Baruch Padeh Medical Center , Poriya, Tiberias, Israel
| | - Naiel Bisharat
- Department of Medicine D, Emek Medical Center , Afula, Israel ; The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology , Haifa, Israel
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Koton Y, Gordon M, Chalifa-Caspi V, Bisharat N. Comparative genomic analysis of clinical and environmental Vibrio vulnificus isolates revealed biotype 3 evolutionary relationships. Front Microbiol 2015; 5:803. [PMID: 25642229 PMCID: PMC4295529 DOI: 10.3389/fmicb.2014.00803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 12/29/2014] [Indexed: 12/19/2022] Open
Abstract
In 1996 a common-source outbreak of severe soft tissue and bloodstream infections erupted among Israeli fish farmers and fish consumers due to changes in fish marketing policies. The causative pathogen was a new strain of Vibrio vulnificus, named biotype 3, which displayed a unique biochemical and genotypic profile. Initial observations suggested that the pathogen erupted as a result of genetic recombination between two distinct populations. We applied a whole genome shotgun sequencing approach using several V. vulnificus strains from Israel in order to study the pan genome of V. vulnificus and determine the phylogenetic relationship of biotype 3 with existing populations. The core genome of V. vulnificus based on 16 draft and complete genomes consisted of 3068 genes, representing between 59 and 78% of the whole genome of 16 strains. The accessory genome varied in size from 781 to 2044 kbp. Phylogenetic analysis based on whole, core, and accessory genomes displayed similar clustering patterns with two main clusters, clinical (C) and environmental (E), all biotype 3 strains formed a distinct group within the E cluster. Annotation of accessory genomic regions found in biotype 3 strains and absent from the core genome yielded 1732 genes, of which the vast majority encoded hypothetical proteins, phage-related proteins, and mobile element proteins. A total of 1916 proteins (including 713 hypothetical proteins) were present in all human pathogenic strains (both biotype 3 and non-biotype 3) and absent from the environmental strains. Clustering analysis of the non-hypothetical proteins revealed 148 protein clusters shared by all human pathogenic strains; these included transcriptional regulators, arylsulfatases, methyl-accepting chemotaxis proteins, acetyltransferases, GGDEF family proteins, transposases, type IV secretory system (T4SS) proteins, and integrases. Our study showed that V. vulnificus biotype 3 evolved from environmental populations and formed a genetically distinct group within the E-cluster. The unique epidemiological circumstances facilitated disease outbreak and brought this genotype to the attention of the scientific community.
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Affiliation(s)
- Yael Koton
- Department of Medicine D, Emek Medical Center Afula, Israel ; Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology Haifa, Israel
| | - Michal Gordon
- Bioinformatics Core Facility, National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev Beer-Sheva, Israel
| | - Vered Chalifa-Caspi
- Bioinformatics Core Facility, National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev Beer-Sheva, Israel
| | - Naiel Bisharat
- Department of Medicine D, Emek Medical Center Afula, Israel ; Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology Haifa, Israel
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Liu XF, Zhang H, Liu X, Gong Y, Chen Y, Cao Y, Hu C. Pathogenic analysis of Vibrio alginolyticus infection in a mouse model. Folia Microbiol (Praha) 2013; 59:167-71. [DOI: 10.1007/s12223-013-0279-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 09/13/2013] [Indexed: 10/26/2022]
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Yokochi N, Tanaka S, Matsumoto K, Oishi H, Tashiro Y, Yoshikane Y, Nakashima M, Kanda K, Kobayashi G. Distribution of virulence markers among Vibrio vulnificus isolates of clinical and environmental origin and regional characteristics in Japan. PLoS One 2013; 8:e55219. [PMID: 23383115 PMCID: PMC3559389 DOI: 10.1371/journal.pone.0055219] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 12/20/2012] [Indexed: 12/20/2022] Open
Abstract
Background Vibrio vulnificus is an opportunistic human pathogen that is widely distributed in estuarine environments and is capable of causing necrotizing fasciitis and sepsis. In Japan, based on epidemiological research, the incidences of V. vulnificus were concentrated in Kyusyu, mainly in coastal areas of the Ariake Sea. To examine the virulence potential, various genotyping methods have recently been developed. This study aimed to investigate the distribution of virulence markers among V. vulnificus isolates of clinical and environmental origin in three coastal areas with different infection incidences and to determine whether these isolates have the siderophore encoding gene viuB. Methodology/Principal Findings We examined the distribution of genotypes of the 16S ribosomal ribonucleic acid (rRNA) gene, vvhA, vcg, and capsular polysaccharide (CPS), and the presence of viuB in 156 isolates collected from patients and environmental samples in Japan. The environmental samples were collected from three coastal areas: the Ariake Sea, Ise & Mikawa Bay, and Karatsu Bay. The results showed disparity in the ratios of genotypes depending on the sample origins. V. vulnificus isolates obtained from patients were classified into the clinical type for all genotypes. In the environmental isolates, the ratios of the clinical type for genotypes of the 16S rRNA gene, vvhA, and vcg were in the order of the Ariake Sea>Ise & Mikawa Bay>Karatsu Bay. Meanwhile, CPS analysis showed no significant difference. Most isolates possessed viuB. Conclusions Many V. vulnificus belonging to the clinical type existed in the Ariake Sea. Three coastal areas with different infection incidences showed distinct ratios of genotypes. This may indicate that the distribution of clinical isolates correlates with the incidence of V. vulnificus infection.
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Affiliation(s)
- Nana Yokochi
- Department of Applied Biochemistry and Food Science, Faculty of Agriculture, Saga University, Saga, Japan
| | - Shigemitsu Tanaka
- Biomaterials and Commodity Chemicals Research Division, Osaka Municipal Technical Research Institute, Osaka, Japan
| | - Kouichi Matsumoto
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hirotaka Oishi
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yukihiro Tashiro
- Institute of Advanced Study, Kyusyu University, Higashi-ku, Fukuoka, Japan
| | - Yu Yoshikane
- Tosa Food Business Creator Project Team, Kochi University, Nankoku, Kochi, Japan
| | - Mikio Nakashima
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Kohzo Kanda
- Department of Applied Biochemistry and Food Science, Faculty of Agriculture, Saga University, Saga, Japan
| | - Genta Kobayashi
- Department of Applied Biochemistry and Food Science, Faculty of Agriculture, Saga University, Saga, Japan
- * E-mail:
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Matsuoka Y, Nakayama Y, Yamada T, Nakagawachi A, Matsumoto K, Nakamura K, Sugiyama K, Tanigawa Y, Kakiuchi Y, Sakaguchi Y. Accurate diagnosis and treatment of Vibrio vulnificus infection: a retrospective study of 12 cases. Braz J Infect Dis 2013; 17:7-12. [PMID: 23332442 PMCID: PMC9427351 DOI: 10.1016/j.bjid.2012.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 07/26/2012] [Accepted: 07/30/2012] [Indexed: 12/17/2022] Open
Abstract
Background and aims Vibrio vulnificus causes an infectious disease that has extremely poor convalescence and leads to necrotic fasciitis. In this study, we sought to define the characteristic epidemiology of V. vulnificus infection and clarify its diagnosis at the global level. Methods Over a period of 10 years, we investigated the appearance of symptoms, underlying conditions, treatment, and mortality in 12 patients (eight men, four women; >50 years old; average age, 66 years,) infected with V. vulnificus. Results The development of symptoms occurred primarily between June and September, a period during which seawater temperature rises and the prevalence of V. vulnificus increases. All patients had underlying diseases, and seven patients reported a history of consuming fresh fish and uncooked shellfish. The patients developed sepsis and fever with sharp pain in the limbs. Limb abnormalities were observed on visual examination. All patients underwent debridement; however, in the survival group, the involved limb was amputated early in 80% patients. The mortality rate was 58.3%. Conclusion Recognition of the characteristic epidemiology and clinical features of this disease is important, and positive debridement should be performed on suspicion. When the illness reaches an advanced stage, however, amputation should be the immediate treatment of choice.
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Affiliation(s)
- Yoshinori Matsuoka
- Department of Critical Care Medicine, Saga Medical School Hospital, Saga, Japan.
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Inoue T, Kitai S, Hayaishi S, Kudo M. Septicemia due to Vibrio cholerae serogroup non-O1/non-O139 strain in a cirrhotic patient. Clin J Gastroenterol 2012; 5:383-7. [DOI: 10.1007/s12328-012-0332-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 08/28/2012] [Indexed: 12/20/2022]
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Bunchorntavakul C, Chavalitdhamrong D. Bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. World J Hepatol 2012; 4:158-68. [PMID: 22662285 PMCID: PMC3365435 DOI: 10.4254/wjh.v4.i5.158] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 09/08/2011] [Accepted: 04/25/2012] [Indexed: 02/06/2023] Open
Abstract
Cirrhotic patients are immunocompromised with a high risk of infection. Proinflammatory cytokines and hemodynamic circulation derangement further facilitate the development of serious consequences of infections. Other than spontaneous bacterial peritonitis, bacteremia and bacterial infections of other organ systems are frequently observed. Gram-negative enteric bacteria are the most common causative organism. Other bacterial infections, such as enterococci, Vibrio spp., Aeromonas spp., Clostridium spp., Listeria monocytogenes, Plesiomonas shigelloides and Mycobacterium tuberculosis are more prevalent and more virulent. Generally, intravenous third generation cephalosporins are recommended as empirical antibiotic therapy. Increased incidences of gram-positive and drug-resistant organisms have been reported, particularly in hospital-acquired infections and in patients receiving quinolones prophylaxis. This review focuses upon epidemiology, microbiology, clinical features and treatment of infections in cirrhosis other than spontaneous bacterial peritonitis, including pathogen-specific and liver disease-specific issues.
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Affiliation(s)
- Chalermrat Bunchorntavakul
- Chalermrat Bunchorntavakul, Division of Gastroenterology and Hepatology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok 12000, Thailand
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Tajiri T, Tate G, Masunaga A, Miura K, Masuda S, Kunimura T, Mitsuya T, Morohoshi T. Autopsy cases of fulminant bacterial infection in adults: clinical onset depends on the virulence of bacteria and patient immune status. J Infect Chemother 2012; 18:637-45. [PMID: 22350403 DOI: 10.1007/s10156-012-0384-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 01/29/2012] [Indexed: 12/19/2022]
Abstract
To assist physicians in recognizing the potentially fatal onset of symptoms in cases of fulminant bacterial infection, we analyzed 11 autopsy cases of such infection (four caused by Streptococcus pneumoniae, four by S. pyogenes, one by S. dysgalactiae subsp. equisimilis, one by Staphylococcus aureus, and one by Vibrio vulnificus). Clinicohistopathologic features were evaluated. All patients experienced sudden onset of hypotension and multiple organ failure, leading to unexpected death. Blood culture confirmed bacteremia. The main chief complaints were gastrointestinal symptoms (45%) and limb pain (36%). All had an underlying chronic illness (82%), e.g., a hematologic disorder (36.3%) or liver cirrhosis (27.2%). Necrotizing fasciitis occurred in only 55% of cases, with none involving pneumococcal infection. Laboratory tests typically showed C-reactive protein elevation but without leukocytosis, indicating a high-level inflammatory state. In ten cases, death was attributed to circulatory collapse due to sepsis; severe pulmonary congestion and hemorrhage were present in these cases. The onset of fulminant bacterial infection depends on both virulence of the bacterium and status of the host defense system.
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Affiliation(s)
- Takuma Tajiri
- Department of Pathology, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan.
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Izumiya H, Matsumoto K, Yahiro S, Lee J, Morita M, Yamamoto S, Arakawa E, Ohnishi M. Multiplex PCR assay for identification of three major pathogenic Vibrio spp., Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus. Mol Cell Probes 2011; 25:174-6. [DOI: 10.1016/j.mcp.2011.04.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 04/11/2011] [Accepted: 04/13/2011] [Indexed: 10/18/2022]
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