Video:Vibrio vulnificus infection
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Description
Vibrio vulnificus infection is a species of Gram-negative, motile, curved rod-shaped (bacillus), pathogenic bacteria of the genus Vibrio. Present in marine environments such as estuaries, brackish ponds, or coastal areas, V. vulnificus is related to V. cholerae, the causative agent of cholera.[1][2] At least one strain of V. vulnificus is bioluminescent.[3]Infection with V. vulnificus leads to rapidly expanding cellulitis or sepsis.[4] It was first isolated as a source of disease in 1976.[5]Doxycycline 100 mg intravenously or orally may be used as treatment.[6]
Presentation 1
V. vulnificus is an extremely virulent bacterium that can cause three types of infections: acute gastroenteritis from eating raw or undercooked shellfish. V. vulnificus causes an infection often incurred after eating seafood, especially raw or undercooked oysters. Symptoms include vomiting, diarrhea, and abdominal pain.[7] [8]
Presentation 2
Necrotizing wound infections can occur in injured skin exposed to contaminated marine water. V. vulnificus bacteria can enter the body through open wounds when swimming or wading in infected waters, or by puncture wounds from the spines of fishes such as stingrays. People may develop a blistering dermatitis sometimes mistaken for pemphigus or pemphigoid.[2][8]
Presentation 3
Invasive sepsis can occur after eating raw or undercooked shellfish, especially oysters. V. vulnificus is 80 times more likely to spread into the bloodstream in people with compromised immune systems, especially those with chronic liver disease. [9][10] This severe infection may occur regardless of whether the infection began from contaminated food or an open wound.[10]
Complications
In terms of the complications an individual may develop we find the following:extremity gangrene, pneumonitis, Necrotizing fasciitis, Myonecrosis and Meningoencephalitis (rare).[8]
Cause
Vibrio vulnificus is a type of Gram-negative, motile, curved rod-shaped (vibrio) bacteria belonging to the genus Vibrio.[2]
Risk factors
In terms of risk factors that would place an individual at a higher possibility of infection we find:liver diseases, hemochromatosis, chronic kidney disease and diabetes.[8][6]
Mechanism
Like all gram negative bacteria, V. vulnificus has LPS . However, the LPS the bacteria produces isn't as efficient at triggering the immune system's release of tumor necrosis factor alpha and other cytokines that produce shock syndromes. The capsular proteins the bacteria express however, are capable of producing an immune response contributing to shock syndrome.[11]V. vulnificus produces a number of extracellular toxins such as metalloprotease VvpE, cytolysin/hemolysin VvhA, and the multifunctional autoprocessing repeats-in-toxins. While the VvhA and MARTX toxin are factors in the bacteria's virulence, in vivo studies in mice suggest that the MARTX toxin is more responsible for bacterial dissemination from the intestine to produce sepsis.[12][13]Growth of V. vulnificus is dependent on the amount of iron that is accessible to the bacteria.[14][15][16]
Diagnosis
In terms of the diagnosis of Vibrio vulnificus infection in an individual, the following is done:culture-independent diagnostic test and polymerase chain reaction.[17][8]
Differential diagnosis
As to the differential diagnosis of Vibrio vulnificus infection we find the following: Steven-Johnson syndrome, Toxic epidermal necrosis, Erythema multiforme and Aeromonas infection.[8]
Prevention
Among the preventive measures an individual can take are: don't eat raw or undercooked shellfish and if you have a wound avoid contact with seawater, brackish water, or raw shellfish.[18]
Treatment
In terms of management we find that the Centers for Disease Control and Prevention recommends combination therapy with intravenous ceftazidime with either ciprofloxacin or doxycycline.[8]
Prognosis
V. vulnificus is the most common cause of death due to seafood in the United States. Infection and mortality due to V. vulnificus causes over 95 percent of deaths in the United States that are known to have occurred due to ingested seafood. While V. vulnificus claims 95 percent of seafood related deaths, if treatment with tetracycline or other cephalosporin antibiotics is initiated at the onset of symptoms and is managed appropriately, patients will experience no long term effects.[19]
Epidemiology
V. vulnificus is commonly found in the Gulf of Mexico, where more than a dozen people have died from the infection since 1990. Most deaths at that time were occurring due to fulminant sepsis, either in the area of oyster harvest and ingestion, or in tourists returning home. [20] [8]
History
The pathogen was first isolated in 1976 from a series of blood culture samples submitted to the CDC in Atlanta.[21] It was described as a "lactose-positive vibrio".[21] It was subsequently given the name Beneckea vulnifica,[22] and finally Vibrio vulnificus by Farmer in 1979.[23]
References
- ↑ Oliver JD, Kaper J (2001). Vibrio species. pp. 263-300 In: Food Microbiology: Fundamentals and Frontiers. (Doyle MP et al., editors) (2nd ed.). ASM Press. ISBN 978-1-55581-117-4.
- ↑ 2.0 2.1 2.2 Oliver JD (2005). "Wound infections caused by Vibrio vulnificus and other marine bacteria". Epidemiol Infect. 133 (3): 383–91. doi:10.1017/S0950268805003894. PMC 2870261. PMID 15962544.
- ↑ ""Glowing" Seafood?"" (PDF). U.S Food And Drug Administration Seafood Products Research Center. Archived (PDF) from the original on 2020-11-27. Retrieved 2021-06-04.
- ↑ James, William D.; Berger, Timothy G. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
- ↑ Hollis, D G; Weaver, R E; Baker, C N; Thornsberry, C (April 1976). "Halophilic Vibrio species isolated from blood cultures". Journal of Clinical Microbiology. 3 (4): 425–431. doi:10.1128/jcm.3.4.425-431.1976. ISSN 0095-1137. Retrieved 1 March 2025.
- ↑ 6.0 6.1 Bross, Michael H.; Soch, Kathleen; Morales, Robert; Mitchell, Rayford B. (15 August 2007). "Vibrio vulnificus Infection: Diagnosis and Treatment". American Family Physician. 76 (4): 539–544. PMID 17853628. Archived from the original on 24 December 2024. Retrieved 13 February 2025.
- ↑ "Vibrio Species Causing Vibriosis". Centers for Disease Control. Archived from the original on June 16, 2017. Retrieved June 5, 2017.
- ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 Haftel, Anthony (2023). Vibrio vulnificus Infection. NIH-Stat Pearl. Retrieved 2 March 2025.
- ↑ "Vibrio vulnificus". NCBI Genome Project. Archived from the original on 2021-09-07. Retrieved 2005-09-01.
- ↑ 10.0 10.1 "Vibrio Species Causing Vibriosis - Questions and Answers". Centers for Disease Control. Archived from the original on June 7, 2017. Retrieved June 5, 2017.
- ↑ Powell, J. L.; Wright, A. C.; Wasserman, S. S.; Hone, D. M.; Morris, J. G. (September 1997). "Release of tumor necrosis factor alpha in response to Vibrio vulnificus capsular polysaccharide in in vivo and in vitro models". Infection and Immunity. 65 (9): 3713–3718. doi:10.1128/IAI.65.9.3713-3718.1997. ISSN 0019-9567. PMC 175529. PMID 9284142.
- ↑ Baker-Austin, Craig; Oliver, James D. (February 2018). "Vibrio vulnificus: new insights into a deadly opportunistic pathogen". Environmental Microbiology. 20 (2): 423–430. Bibcode:2018EnvMi..20..423B. doi:10.1111/1462-2920.13955. ISSN 1462-2920. PMID 29027375.
- ↑ Gavin, Hannah E.; Satchell, Karla J. F. (2019-02-23). "RRSP and RID Effector Domains Dominate the Virulence Impact of Vibrio vulnificus MARTX Toxin". The Journal of Infectious Diseases. 219 (6): 889–897. doi:10.1093/infdis/jiy590. ISSN 1537-6613. PMC 6386806. PMID 30289477.
- ↑ Brennt, C. E.; Wright, A. C.; Dutta, S. K.; Morris, J. G. (November 1991). "Growth of Vibrio vulnificus in serum from alcoholics: association with high transferrin iron saturation". The Journal of Infectious Diseases. 164 (5): 1030–1032. doi:10.1093/infdis/164.5.1030. ISSN 0022-1899. PMID 1940460.
- ↑ Kim, Choon-Mee; Park, Ra-Young; Choi, Mi-Hwa; Sun, Hui-Yu; Shin, Sung-Heui (2007-01-01). "Ferrophilic characteristics of Vibrio vulnificus and potential usefulness of iron chelation therapy". The Journal of Infectious Diseases. 195 (1): 90–98. doi:10.1086/509822. ISSN 0022-1899. PMID 17152012.
- ↑ Kim, Choon-Mee; Park, Yong-Jin; Shin, Sung-Heui (2007-11-15). "A widespread deferoxamine-mediated iron-uptake system in Vibrio vulnificus". The Journal of Infectious Diseases. 196 (10): 1537–1545. doi:10.1086/523108. ISSN 0022-1899. PMID 18008234.
- ↑ "Clinical Overview of Vibriosis". Vibrio Infection (Vibriosis). 16 May 2024. Archived from the original on 22 December 2024. Retrieved 5 February 2025.
- ↑ "Preventing Vibrio Infection". Vibrio Infection (Vibriosis). 16 May 2024. Archived from the original on 2 February 2025. Retrieved 8 February 2025.
- ↑ "Vibrio Vulnificus Infection: Background, Pathophysiology, Etiology". 2019-07-01. Archived from the original on 2021-04-16. Retrieved 2021-06-04.
{{cite journal}}: Cite journal requires|journal=(help) - ↑ Flynn, Dan (November 22, 2011). "Still Too Many Raw Oyster Deaths in Gulf States". Food Safety News. Archived from the original on October 9, 2016. Retrieved August 1, 2016.
- ↑ 21.0 21.1 Hollis DG, Weaver RE, Baker CN, Thornsberry C (April 1976). "Halophilic Vibrio species isolated from blood cultures". J. Clin. Microbiol. 3 (4): 425–31. doi:10.1128/jcm.3.4.425-431.1976. PMC 274318. PMID 1262454.
- ↑ Reichelt JL, Baumann P, Baumann L (October 1976). "Study of genetic relationships among marine species of the genera Beneckea and Photobacterium by means of in vitro DNA/DNA hybridization". Arch. Microbiol. 110 (1): 101–20. Bibcode:1976ArMic.110..101R. doi:10.1007/bf00416975. PMID 1015934. S2CID 23759213.
- ↑ Farmer JJ (October 1979). "Vibrio ("Beneckea") vulnificus, the bacterium associated with sepsis, septicaemia, and the sea". Lancet. 314 (8148): 903. doi:10.1016/S0140-6736(79)92715-6. PMID 90993. S2CID 34979437.