• Vibrio cholerae
• cholera
• diarrhea
• seafood
• toxin
• zoonosis

• NLRP3 inflammasome
• Vibrio infection
• alcoholic liver disease
• intestinal epithelial barrier

• Animals
• Liver Diseases, Alcoholic/metabolism
• Liver Diseases, Alcoholic/microbiology
• Liver Diseases, Alcoholic/genetics
• Mice
• NLR Family, Pyrin Domain-Containing 3 Protein/metabolism
• NLR Family, Pyrin Domain-Containing 3 Protein/genetics
• Disease Models, Animal
• Intestinal Mucosa/metabolism
• Intestinal Mucosa/microbiology
• Male
• Gastrointestinal Microbiome
• Mice, Knockout
• Mice, Inbred C57BL
• Inflammasomes/metabolism

• culture
• hepatic space-occupying lesions
• metagenomic next-generation sequencing
• non-O1/non-O139 Vibrio cholerae
• polymerase chain reaction

• immunocompromised
• laboratory risk indicator for necrotizing fasciitis (lrinec) score
• necrotizing fasciitis
• plhiv
• skin blister
• vibrio cholerae

• Escherichia Coli
• bacterial infection
• cirrhosis
• non-O1/non-139 Vibrio cholera
• non-extended spectrum beta lactamase (ESBL)
• spontaneous bacterial peritonitis

• Agglutinable
• Choleragenic
• Somatic antigen agglutinable type-1/139 of Vibrio cholerae (SAAT-1/139- Vc)
• Somatic antigen non-agglutinable strains-1/139 of Vibrio cholerae (SANAS-1/139- Vc)
• Surveillence
• Vibriosis

• Animals
• Cholera/epidemiology
• Diarrhea
• Phylogeny
• Vibrio cholerae
• Water

• SLB2017 Govan Mbeki Research and Development Centrem, University of Fort Hare

Vibrio cholerae, responsible for outbreaks of cholera disease, is a highly motile organism by virtue of a single flagellum. We describe how the flagellum facilitates the secretion of three V. cholerae proteins encoded by a hitherto-unrecognized genomic island. The proteins MakA/B/E can form a tripartite toxin that lyses erythrocytes and is cytotoxic to cultured human cells. A structural basis for the cytolytic activity of the Mak proteins was obtained by X-ray crystallography. Flagellum-facilitated secretion ensuring spatially coordinated delivery of Mak proteins revealed a role for the V. cholerae flagellum considered of particular significance for the bacterial environmental persistence. Our findings will pave the way for the development of diagnostics and therapeutic strategies against pathogenic Vibrionaceae.

The protein MakA was discovered as a motility-associated secreted toxin from Vibrio cholerae. Here, we show that MakA is part of a gene cluster encoding four additional proteins: MakB, MakC, MakD, and MakE. MakA, MakB, and MakE were readily detected in culture supernatants of wild-type V. cholerae, whereas secretion was very much reduced from a flagellum-deficient mutant. Crystal structures of MakA, MakB, and MakE revealed a structural relationship to a superfamily of bacterial pore-forming toxins. Expression of MakA/B/E in Escherichia coli resulted in toxicity toward Caenorhabditis elegans used as a predatory model organism. None of these Mak proteins alone or in pairwise combinations were cytolytic, but an equimolar mixture of MakA, MakB, and MakE acted as a tripartite cytolytic toxin in vitro, causing lysis of erythrocytes and cytotoxicity on cultured human colon carcinoma cells. Formation of oligomeric complexes on liposomes was observed by electron microscopy. Oligomer interaction with membranes was initiated by MakA membrane binding followed by MakB and MakE joining the assembly of a pore structure. A predicted membrane insertion domain of MakA was shown by site-directed mutagenesis to be essential for toxicity toward C. elegans. Bioinformatic analyses revealed that the makCDBAE gene cluster is present as a genomic island in the vast majority of sequenced genomes of V. cholerae and the fish pathogen Vibrio anguillarum. We suggest that the hitherto-unrecognized cytolytic MakA/B/E toxin can contribute to Vibrionaceae fitness and virulence potential in different host environments and organisms.

• Vibrio cholerae
• crystal structure
• tripartite toxin

• Multidrug resistance
• Non-O1/non-O139
• Phylogenetic analysis
• Population structure
• Vibrio cholerae

• Drug Resistance, Multiple
• Humans
• Multilocus Sequence Typing
• Rivers
• Vibrio cholerae non-O1/genetics
• Virulence/genetics

• Animals
• Chironomidae/microbiology
• Cholera/epidemiology
• Cholera/microbiology
• Cholera Toxin/genetics
• Disease Reservoirs/microbiology
• Ecosystem
• Female
• Fresh Water
• Humans
• India/epidemiology
• Israel/epidemiology
• Pandemics
• Polymerase Chain Reaction
• Rivers
• Vibrio cholerae/genetics
• Vibrio cholerae/pathogenicity
• Virulence/genetics

• United States - Israel Binational Science Foundation
• UGC-ISF

Vibrio cholerae is a pathogen known to cause the waterborne epidemic disease cholera. Overall, V. cholerae O1 or O139 strains produce the cholera toxin that cause gastroenteritis, resulting in watery diarrhea. Most of the enterocolitis caused by V. cholerae can be easily treated with fluid therapy and conservative care. However, V. cholerae non-O1/O139 strains can cause extraintestinal infections, such as wound infection or sepsis, in immunocompromised patients. The clinical course of these infections is very similar to that of V. vulnificus infection. We report about a 52-year-old man without previous underlying disease who was diagnosed with V. cholerae non-O1/O139 infection and died within 72 hours after admission to the intensive care unit.

• Non-O1/O139
• Septic shock
• Vibrio cholerae

Vibrio cholerae are oxidase-positive bacteria that are classified into various serotypes based on the O surface antigen. V. cholerae serotypes are divided into two main groups: the O1 and O139 group and the non-O1/non-O139 group. O1 and O139 V. cholerae are related to cholera infection, whereas non-O1/non-O139 V. cholerae (NOVC) can cause cholera-like diarrhea. A PubMed search revealed that only 16 cases of necrotizing fasciitis caused by NOVC have been recorded in the scientific literature to date. We report the case of a Japanese woman who developed necrotizing fasciitis caused by NOVC after traveling to Taiwan and returning to Japan.

A 63-year-old woman visited our hospital because she had experienced left knee pain for the past 3 days. She had a history of colon cancer (Stage IV: T3N3 M1a) and had received chemotherapy. She had visited Taiwan 5 days previously, where she had received a massage. She was diagnosed with septic shock owing to necrotizing fasciitis. She underwent fasciotomy and received intensive care. She recovered from the septic shock; however, after 3 weeks, she required an above-knee amputation for necrosis and infection. Her condition improved, and she was discharged after 22 weeks in the hospital.

With the increase in tourism, it is important for clinicians to check patients’ travel history. Clinicians should be alert to the possibility of necrotizing fasciitis in patients with risk factors. Necrotizing fasciitis caused by NOVC is severe and requires early fasciotomy and debridement followed by intensive postoperative care.

• Massage
• Necrotizing fasciitis
• Polymyxin B
• Septic shock
• Taiwan
• Vibrio cholerae

• Non-O1
• cellulitis
• non-O139 Vibrio cholerae
• soft tissue infection

• Animals
• Bacteremia/diagnosis
• Bacteremia/etiology
• Bivalvia/microbiology
• Diabetes Mellitus, Type 2/complications
• Diagnostic Errors
• Disease Susceptibility
• Food Microbiology
• Gastroenteritis/etiology
• Gastroenteritis/microbiology
• Humans
• Liver Cirrhosis, Alcoholic/complications
• Male
• Middle Aged
• Penaeidae/microbiology
• Respiratory Tract Infections/diagnosis
• Shellfish/adverse effects
• Shellfish/microbiology
• Vibrio Infections/diagnosis
• Vibrio Infections/etiology
• Vibrio Infections/transmission
• Vibrio cholerae/isolation & purification

Background. The non-O1/non-O139 serogroups of Vibrio cholerae occur in diverse natural niches, and usually cause mild and self-limiting gastrointestinal illness. However, they have well-documented potential to cause invasive and extra-intestinal infections among immunocompromised patients. Furthermore, their ability to grow in low-salinity surface water, and the existence of asymptomatic human carriers, suggest novel acquisition routes for this unusual infection, even in people without obvious risk factors.

Case presentation. A 62-year-old man presented with epigastric pain, vomiting and fever. The patient had a history of diabetes and cholecystectomy, although our initial examination did not reveal any significant findings that might indicate V. cholerae infection. However, blood cultures subsequently revealed the presence of V. cholerae, which was positively identified using both conventional and modern non-conventional technologies. The identity of the V. cholerae isolate was confirmed using Vitek MS (matrix–assisted laser desorption ionization-time of flight MS) and the FilmArray system, in addition to its initial identification using the Vitek 2 system. The septicaemia was successfully treated using a 14 day course of ciprofloxacin.

Conclusion. The present case highlights the need to remain highly suspicious of non-O1/non-O139 V. cholerae infections in patients with known risk factors, as well as in healthy individuals with epidemiological exposure and compatible clinical symptoms. Special care should be taken to avoid false-positive results from confirmatory laboratory tests, as the organism can grow in fresh water, and the results should be verified using multiple methods.

• Non-O1/Non-O139 Vibrio cholerae
• septicaemia

• Food borne infections
• Pneumonia
• Vibrio infection

• Administration, Intravenous
• Aged, 80 and over
• Anti-Bacterial Agents/administration & dosage
• Bacteremia/diagnosis
• Bacteremia/drug therapy
• Bacteremia/microbiology
• Bacteremia/pathology
• Blood/microbiology
• Ceftriaxone/administration & dosage
• Feces/microbiology
• Humans
• Italy
• Male
• Pneumonia/complications
• Pneumonia/diagnosis
• Pneumonia/drug therapy
• Pneumonia/microbiology
• Pneumonia/pathology
• Vibrio Infections/diagnosis
• Vibrio Infections/drug therapy
• Vibrio Infections/microbiology
• Vibrio Infections/pathology
• Vibrio cholerae non-O1/isolation & purification

• Ion exchange chromatography
• Metalloprotease
• Septicemia

We report on two cases of necrotizing fasciitis of the lower leg due to nontoxigenic Vibrio cholerae (V. cholerae). A 73-year-old woman (case 1) and an 80-year-old man (case 2) were hospitalized with symptoms of necrotizing fasciitis on July 18 and August 15, 2015, respectively. In both cases, symptoms started the day after swimming in local ponds. Swabs gained intraoperatively and a blood culture from the male patient, yielded V. cholerae non-O1/non-O139, negative for cholera toxin gene ctx and positive for hemolysin genes hlyA and hlyB. Water samples taken from pond A on August 17, 2015 (32 days after exposure of case 1) and from pond B on August 20, 2015 (7 days after exposure of case 2) yielded non-O1/non-O139 V. cholerae in most-probable numbers of > 11,000 per 100 ml each. The occurrence of two cases of necrotizing fasciitis within a 1 month period related to two Austrian non-saline bathing waters, previously not known to harbor V. cholerae, is probably linked to the prevailing extreme weather conditions (heat wave, drought) this summer in Austria. While case 1 was discharged in good clinical condition after 73 days, case 2 died after four months of hospitalization. Public health authorities are challenged to assess the effects of long-term climate change on pathogen growth and survival in continental bodies of fresh water.

• Bathing sites
• Climate change
• Drought
• Heat wave
• Necrotizing fasciitis
• Vibrio cholerae

• Greece
• Non-O1
• bacteremia
• cellulitis
• necrotising fasciitis
• non-O139 Vibrio cholerae
• skin and soft tissue infections

Non-O1, non-O139 Vibrio cholerae (NOVC) are increasingly frequently observed ubiquitous microorganisms occasionally responsible for intestinal and extra-intestinal infections. Most cases involve self-limiting gastroenteritis or ear and wound infections in immunocompetent patients. Bacteraemia, which have been described in patients with predisposing factors, are rare and poorly known, both on the clinical and therapeutic aspects. We describe a case of NOVC bacteraemia and a systematic literature review in PubMed conducted up to November 2014 using a combination of the following search terms: “Vibrio cholerae non-O1” and “bacter(a)emia”. The case was a 70 year-old healthy male subject returning from Senegal and suffering from NOVC bacteraemia associated with liver abscesses. Disease evolution was favourable after 2 months’ therapy (ceftriaxone then ciprofloxacin). Three hundred and fifty cases of NOVC bacteraemia have been identified in the literature. The majority of patients were male (77 %), with a median age of 56 years and presenting with predisposing conditions (96 %), such as cirrhosis (55 %) or malignant disease (20 %). Diarrhoea was inconstant (42 %). Mortality was 33 %. The source of infection, identified in only 25 % of cases, was seafood consumption (54 %) or contaminated water (30 %). Practitioners should be aware of these infections, in order to warn patients with predisposing conditions, on the risk of ingesting raw or undercooked seafood or bathing in potentially infected waters.

• Abscess
• Bacteraemia
• Non-O1 Vibrio cholerae

• Adult
• Aged
• Cholera/mortality
• Cholera/pathology
• Female
• Hospital Mortality
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Vibrio cholerae/physiology

• Vibrio cholerae
• bacteraemia
• non-O1
• non-O139.
• non-toxigenic

The toxigenic bacterium Vibrio cholerae belonging to the O1 and O139 serogroups is commonly associated with epidemic diarrhea in tropical settings; other diseases caused by this environmental pathogen are seldom identified. Here we report two unassociated cases of nonfatal, nontoxigenic V. cholerae non-O1, non-O139 bacteremia in patients with comorbidities in Ho Chi Minh City, Vietnam, that occurred within a 4-week period.

• Aeromonas
• Vibrio
• bacteremia
• liver cirrhosis

• Animals
• Base Sequence
• Caenorhabditis elegans/microbiology
• Cholera/epidemiology
• Cholera/microbiology
• Disease Outbreaks
• Genomics
• High-Throughput Nucleotide Sequencing
• Humans
• Molecular Sequence Data
• Phenotype
• Phylogeny
• Sequence Homology, Nucleic Acid
• United States/epidemiology
• Vibrio cholerae non-O1/classification
• Vibrio cholerae non-O1/isolation & purification
• Vibrio cholerae non-O1/physiology
• Virulence Factors

• RC1 TW008587 FIC NIH HHS
• 1RC1TW008587-01 CCR NIH HHS
• 2R01A1039129-11A2 PHS HHS

Vibrio parahaemolyticus is a leading cause of seafood-related gastroenteritis and is also an autochthonous member of marine and estuarine environments worldwide. One-hundred seventy strains of V. parahaemolyticus were isolated from water and plankton samples collected along the Georgian coast of the Black Sea during 28 months of sample collection. All isolated strains were tested for presence of tlh, trh, and tdh. A subset of strains were serotyped and tested for additional factors and markers of pandemicity. Twenty-six serotypes, five of which are clinically relevant, were identified. Although all 170 isolates were negative for tdh, trh, and the Kanagawa Phenomenon, 7 possessed the GS-PCR sequence and 27 the 850 bp sequence of V. parahaemolyticus pandemic strains. The V. parahaemolyticus population in the Black Sea was estimated to be genomically heterogeneous by rep-PCR and the serodiversity observed did not correlate with rep-PCR genomic diversity. Statistical modeling was used to predict presence of V. parahaemolyticus as a function of water temperature, with strongest concordance observed for Green Cape site samples (Percent of total variance = 70, P < 0.001). Results demonstrate a diverse population of V. parahaemolyticus in the Black Sea, some of which carry pandemic markers, with increased water temperature correlated to an increase in abundance of V. parahaemolyticus.

• Black Sea
• Vibrio parahaemolyticus
• Vibrionaceae
• aquatic microbiology
• predictive modeling

• Aged, 80 and over
• Australia
• Cholera/diagnosis
• Cholera/etiology
• Cholera/therapy
• Humans
• Male
• Seafood
• Vibrio cholerae

• Immunocompromised
• nephrotic syndrome
• non-O1
• non-O139
• sepsis
• vibrio cholera

Pathogenic non-O1/non-O139 Vibrio cholerae strains can cause sporadic outbreaks of cholera worldwide. In this study, multilocus sequence typing (MLST) of seven housekeeping genes was applied to 55 non-O1/non-O139 isolates from clinical and environmental sources. Data from five published O1 isolates and 17 genomes were also included, giving a total of 77 isolates available for analysis. There were 66 sequence types (STs), with the majority being unique, and only three clonal complexes. The V. cholerae strains can be divided into four subpopulations with evidence of recombination among the subpopulations. Subpopulations I and III contained predominantly clinical strains. PCR screening for virulence factors including Vibrio pathogenicity island (VPI), cholera toxin prophage (CTXΦ), type III secretion system (T3SS), and enterotoxin genes (rtxA and sto/stn) showed that combinations of these factors were present in the clinical isolates with 85.7% having rtxA, 51.4% T3SS, 31.4% VPI, 31.4% sto/stn (NAG-ST) and 11.4% CTXΦ. These factors were also present in environmental isolates but at a lower frequency. Five strains previously mis-identified as V. cholerae serogroups O114 to O117 were also analysed and formed a separate population with V. mimicus. The MLST scheme developed in this study provides a framework to identify sporadic cholera isolates by genetic identity.

• Evolution, Molecular
• Genomic Islands/genetics
• Multilocus Sequence Typing
• Phylogeny
• Vibrio cholerae/classification
• Vibrio cholerae/genetics

• Adult
• Bacteremia/complications
• Humans
• Liver Cirrhosis/complications
• Male
• Portugal
• Vibrio Infections/complications
• Vibrio cholerae non-O1

• Azerbaijan
• Chemical Phenomena
• Drinking Water/microbiology
• Environment
• Environmental Monitoring
• Fresh Water/microbiology
• Logistic Models
• Oceans and Seas
• Public Health
• Seasons
• Temperature
• Vibrio cholerae/growth & development
• Vibrio cholerae/isolation & purification
• Water Microbiology

• 1RC1TW008587-01 CCR NIH HHS
• 2R01A1039129-11A2 PHS HHS

• Aeromonas
• Bacteremia
• Incidence
• Taiwan

We report a recent case of non-O1, non-O139, nontoxigenic Vibrio cholerae septicemia in a post-liver-transplant immunocompromised patient associated with prior seafood consumption. Non-O1, non-O139 V. cholerae strains have been reported in several cases of extraintestinal infections and seem to be emerging infectious agents especially in patients with immunocompromising conditions.

A 40-year-old female presented with purulent exudate through the left auditive duct and pain in the left ear region, which intensified during mastication. After collection of the pus from the left ear lesion, amoxicillin-clavulanic acid for seven days was prescribed for a presumed diagnosis of acute otitis. Four days later, the pus culture grew V. fluvialis which is further identified by API 20E identification system (bioMérieux). Following the successful completion of a course of antibiotics, the patient recovered completely and without complication. To the best of our knowledge, this is the first case of Vibrio fluvialis otitis after swimming in an immunocompetent patient.

• Bacterial infection
• Cirrhosis