A case report of Vibrio vulnificus sepsis in a diabetic patient
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Vibrio vulnificus is a facultative anaerobic, alkalophilic, halophilic, mesophilic, Gram-negative bacterium that can cause severe wound infection, sepsis and diarrhea. This paper reported a case of 85-year-old male patient infected with Vibrio vulnificus due to being stabbed by a sea shrimp. This patient also had diabetes with a long history of alcoholism. Due to bacterial pathogenicity and the patient's underlying diseases, his condition deteriorated rapidly. Based on the rapid diagnosis of Vibrio vulnificus using the next-generation sequencing（NGS）technology and blood culture method, as well as the selection of the most effective antibiotics via drug sensitivity test, this patient underwent precise antimicrobial treatment, thorough debridement and drainage within the shortest possible time, and thus the prognosis of this patient was greatly improved. In this paper, we have systematically explored the epidemiology, clinical features, diagnosis and treatment of Vibrio vulnificus infection, thus providing a practical reference for the clinicians to quickly identify and treat possible Vibrio vulnificus infection in diabetic patients after contacting with sea water or seafood.Keywords:
Vibrio vulnificus
Vibrio Infections
In this study, we have reevaluated the taxonomic position of biotype 2 of Vibrio vulnificus. For this purpose, we have biochemically and serologically characterized 83 biotype 2 strains from diseased eels, comparing them with 17 biotype 1 strains from different sources. Selected strains were also molecularly analyzed and tested for eel and mouse pathogenicity. Results have shown that biotype 2 (i) is biochemically homogeneous, indole production being the main trait that distinguishes it from biotype 1, (ii) presents small variations in DNA restriction profiles and outer membrane protein patterns, some proteins being immunologically related to outer membrane proteins from biotype 1, (iii) expresses a common lipopolysaccharide (LPS) profile, which is immunologically identical among strains and distinct from that of LPS of tested biotype 1 strains, and (iv) contains at least two high-Mr plasmids. Regarding host range, we have confirmed that both biotypes are pathogenic for mice but only biotype 2 is pathogenic for eels. On the basis of these data, we propose that biotype 2 of V. vulnificus constitutes an LPS-based O serogroup which is phenotypically homogeneous and pathogenic for eels. In this article, the serogroup is designated serogroup E (for eels).
Vibrio vulnificus
Vibrio Infections
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ABSTRACT The bacterial pathogen Vibrio vulnificus is found naturally in brackish coastal waters but can be greatly concentrated by filter-feeding organisms such as shellfish. Numerous experiments in which exogenous V. vulnificus cells are added to oysters in an attempt to measure uptake and depuration have been performed. In nearly all cases, results have shown that laboratory-grown bacteria are rapidly taken up by the oysters but ultimately eliminated, while naturally present Vibrio populations in oysters are resistant to depuration. In this study, oysters harvested during winter months, with low culturable Vibrio concentrations, were incubated in aquaria supplemented with strains of V. vulnificus that were either genotypically or phenotypically distinct from the background bacteria. These exogenous cells were eliminated from the oysters, as previously seen, but other vibrios already inhabiting the oysters responded to the V. vulnificus inoculum by rapidly increasing in number and maintaining a large stable population. The presence of such an oyster-adapted Vibrio population would be expected to prevent colonization by exogenous V. vulnificus cells, thus explaining the rapid depuration of these added bacteria.
Vibrio vulnificus
Ostreidae
Vibrio Infections
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Vibrio species, normal inhabitants of the sea and of shellfish harvested from marine or brackish waters, have been established as the causative agents of serious human infections. An investigation to isolate and identity Vibrio species in oysters collected from eight Louisiana commercial oyster beds was conducted. A selection of 127 vibrio isolates and 46 reference strains, including all known Vibrio species, were subjected to a bacteriological identification scheme of 46 parameters. When the data from the wild strains and the reference strains were analyzed by the numerical taxonomy program, TAXAN Version 3.0, six major phena were evident. Four of the phena contained Vibrio parahaemolyticus, Vibrio vulnificus, Vibrio cholerae, Vibrio mimicus, Vibrio furnissii, and Vibrio Group 521. Genetic relatedness studies showed one of the other phena to be composed of isolates of Vibrio damsela. The remaining major phenon appears to be a previously undescribed Vibrio group. Because of the severity and rapidity of the disease process in Vibrio vulnificus infections and because of the high mortality rates associated with these infections, a rapid serological method for V. vulnificus identification was developed. Species-specific anti-V. vulnificus flagellar (H) monoclonal antibody coagglutination reagents were sent to laboratories throughout the United States and Canada to be assessed for specificity. One of the user laboratories reported that fifteen Vibrio strains, isolated from Eastern seaboard oysters, agglutinated in these reagents but did not conform to established V. vulnificus bacteriological profiles. These findings suggested that the reagents may not be species-specific. DNA from representative oyster isolates which produced agglutination reactions were examined for thermal denaturation midpoint temperature, mol% G + C content, and DNA-DNA reassociation with DNA from V. vulnificus biogroups 1 and 2. High percentages of relative reassociation with V. vulnificus reference strains indicate that the H coagglutination reagents exhibit a high degree of specificity for V. vulnificus isolates, even those showing aberrant phenotypic characteristics.
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Eastern oyster
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All Vibrio vulnificus strains tested (four clinical isolates and eight environmental isolates) hemolyzed human erythrocytes. In contrast to findings with Vibrio parahaemolyticus, in which hemolytic activity correlates with isolation from clinical specimens, results from the present study suggest that hemolysis is not usefull in differentiating V. vulnificus strains.
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Vibrio Infections
Isolation
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ABSTRACT Filter feeding shellfish can concentrate pathogenic bacteria, including Vibrio vulnificus and Vibrio parahaemolyticus , as much as 100-fold from the overlying water. These shellfish, especially clams and oysters, are often consumed raw, providing a route of entry for concentrated doses of pathogenic bacteria into the human body. The numbers of foodborne infections with these microbes are increasing, and a better understanding of the conditions that might trigger elevated concentrations of these bacteria in seafood is needed. In addition, if bacterial concentrations in water are correlated with those in shellfish, then sampling regimens could be simplified, as water samples can be more rapidly and easily obtained. After sampling of oysters and clams, either simultaneously or separately, for over 2 years, it was concluded that while Vibrio concentrations in oysters and water were related, this was not the case for levels in clams and water. When clams and oysters were collected simultaneously from the same site, the clams were found to have lower Vibrio levels than the oysters. Furthermore, the environmental parameters that were correlated with levels of Vibrio spp. in oysters and water were found to be quite different from those that were correlated with levels of Vibrio spp. in clams. IMPORTANCE This study shows that clams are a potential source of infection in North Carolina, especially for V. parahaemolyticus . These findings also highlight the need for clam-specific environmental research to develop accurate Vibrio abundance models and to broaden the ecological understanding of clam- Vibrio interactions. This is especially relevant as foodborne Vibrio infections from clams are being reported.
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Ostreidae
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ABSTRACT Vibrio vulnificus is an estuarine bacterium that is capable of causing a rapidly fatal infection in humans. A randomly amplified polymorphic DNA (RAPD) PCR protocol was developed for use in detecting V. vulnificus , as well as other members of the genus Vibrio . The resulting RAPD profiles were analyzed by using RFLPScan software. This RAPD method clearly differentiated between members of the genus Vibrio and between isolates of V. vulnificus . Each V. vulnificus strain produced a unique band pattern, indicating that the members of this species are genetically quite heterogeneous. All of the vibrios were found to have amplification products whose sizes were within four common molecular weight ranges, while the V. vulnificus strains had an additional two molecular weight range bands in common. All of the V. vulnificus strains isolated from clinical specimens produced an additional band that was only occasionally found in environmental strains; this suggests that, as is the case with the Kanagawa hemolysin of Vibrio parahaemolyticus , the presence of this band may be correlated with the ability of a strain to produce an infection in humans. In addition, band pattern differences were observed between encapsulated and nonencapsulated isogenic morphotypes of the same strain of V. vulnificus .
Vibrio vulnificus
Vibrio Infections
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Hemolysin
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Vibrio vulnificus is associated with infection acquired during contact with sea water or with seafood, and is seldom suspected by physicians in noncoastal states. The ease of transportation of fresh raw seafood has facilitated this organism's capacity to produce disease in geographic areas in which it was previously unseen. We have reported a case of fatal Vibrio vulnificus sepsis acquired from ingestion of fresh oysters in the inland United States.
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Vibrio Infections
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Vibrio vulnificus
Vibrio Infections
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Vibrio spp. is naturally found in sea water and estuary. Taiwan is located in subtropical area and surrounded by ocean, which is suitable for growth of Vibrio spp. National Quarantine Service (one of the antecedents of Taiwan Centers for Disease Control) proceeded an investigation from 1991 to 1998 and revealed that Vibrio cholerae existed in all coastal harbors, including pathogenic (non-O1, non-139) and non-pathogenic serotypes (O1). Vibrio parahaemolyticus was also noted. Extensive environmental investigation of these pathogens is necessary in order to update the database established a decade ago. In this study, samples were collected from 17 harbors located in northern, central, southern and eastern Taiwan areas. From 204 collected samples, 476 Vibrio spp. were isolated. In which, Vibrio parahaemolyticus was the most commonly found strain (181 strains, 38%), followed by Vibrio alginolyticus (154 strains, 32.4%), Vibrio vulnificus (94 strains, 19.7%), Vibrio metschnikovii (21 strains, 4.4%), Vibrio fluvialis (18 strains, 3.8%) and Aeromonas sobria (7 strains, 1.5%). No Vibrio cholerae was isolated. The results indicated that the isolation rate of Vibrio parahaemolyticus and Vibrio vulnificus was higher than 10 years ago. On the contrary, the Vibrio cholerae used to have high isolation rate was not found in this investigation. There was no statistical difference in isolation of each Vibrio spp. in all areas. However, there was statistical difference in the isolation of Vibrio parahaemolyticus, Vibrio vulnificus and Vibrio metschnikovii in different seasons. Furthermore, statistical difference was also noted in isolation of Vibrio vulnificus comparing temperature and salinity. We recommend authorities of public health, environmental protection and fishery should monitor the environmental risk of Vibrio spp. in coastal areas around Taiwan regularly, and general public should be informed on the related information. Moreover, database of environmental, clinical bacterial strains, bacterial gene mapping and drug resistance should be established and compared with related data from overseas. This investigation updated environmental monitoring data and also provided a reference for disease prevention and food hygiene policy.
Vibrio vulnificus
Vibrio Infections
Vibrio alginolyticus
Isolation
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Vibrio vulnificus
Vibrio Infections
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