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Modified Dakin's solution for cutaneous vibrio infections.

Vibrio species, specifically Vibrio vulnificus, are known to be endemic to warm saltwater environments. As a human pathogen they are capable of causing severe, progressive, necrotizing infections. The lesions are bullous in nature and often require wide surgical debridement due to the aggressiveness of this organism. The literature supports prophylactic antibiotic therapy for those with preexisting hepatic dysfunction or immunocompromise. The authors routinely implement prophylactic antibiotic coverage with doxycycline 100 mg every 12 hours for vibrio in patients with wounds exposed to or acquired in saltwater. In addition, they institute topical therapy with 0.025% sodium hypochlorite solution (modified Dakin's), based on their in vitro study of vibrio sensitivity to antimicrobials. Over the past 2 years, the authors have treated 10 patients with this protocol for cutaneous vibrio infections confirmed by quantitative cultures. None of these patients experienced progression of infection requiring operative debridement-contrary to the aggressive nature of this organism documented in other reports.

Adolescent↗

An unusual vibrio infection.

Nonclassical vibrio infections are being better diagnosed because of awareness of them; many of the newer vibrio infections are being better recognized because of more selective culture methods. These infections pose a risk to individuals who play and work in warm coastal waters as well as to those who eat raw or partially cooked seafood.

Adult↗

The ability of two different Vibrio spp. bacteriophages to infect Vibrio harveyi, Vibrio cholerae and Vibrio mimicus.

AIMS: To determine the host range of the Vibrio harveyi myovirus-like bacteriophage (VHML) and the cholera toxin conversion bacteriophage (CTX Phi) within a range of Vibrio cholerae and V. mimicus and V. harveyi, V. cholerae and V. mimicus isolates respectively. METHODS AND RESULTS: Three V. harveyi, eight V. cholerae and five V. mimicus isolates were incubated with VHML and CTX Phi. Polymerase chain reaction (PCR) was used to determine the presence of VHML and CTX Phi in infected isolates. We demonstrated that it was possible to infect one isolate of V. cholerae (isolate ACM #2773/ATCC #14035) with VHML. This isolate successfully incorporated VHML into its genome as evident by positive PCR amplification of the sequence coding part of the tail sheath of VHML. Attempts to infect all other V. cholerae and V. mimicus isolates with VHML were unsuccessful. Attempts to infect V. cholerae non-01, V. harveyi and V. mimicus isolates with CTX Phi were unsuccessful. CONCLUSIONS: Bacteriophage infection is limited by bacteriophage-exclusion systems operating within bacterial strains and these systems appear to be highly selective. One system may allow the co-existence of one bacteriophage while excluding another. VHML appears to have a narrow host range which may be related to a common receptor protein in such strains. The lack of the vibrio pathogenicity island bacteriophage (VPI Phi) in the isolates used in this study may explain why infections with CTX Phi were unsuccessful. SIGNIFICANCE AND IMPACT OF THE STUDY: The current study has demonstrated that Vibrio spp. bacteriophages may infect other Vibrio spp.

Bacteriophages↗

Immunization with bacterial antigens: Vibrio infections.

Within the genus Vibrio, the species causing the most economically important diseases in marine culture are Vibrio anguillarum, V. ordalii, V. salmonicida and V. vulnificus biotype 2. For these bacterial fish pathogens host range, clinical importance, virulence mechanisms, the antigenic variants relevant to vaccination, the existence of genetic intraspecific diversity and the available vaccines including commercial or domestically produced will be described. Among the 10 serotypes described in V. anguillarum, only serotypes O1, O2 and O3 have been associated with mortality in a great variety of farmed and feral fish worldwide. Whereas serotype O1 is a very homogeneous group from the biochemical, serological and genetic stand-point, within serotype O2 and O3 two antigenic entities have been detected. Moreover these two serotypes present a remarkable genetic heterogeneity. However, many of the available commercial vibriosis vaccines include in their formulations only V. anguillarum serotype O1 in combination with V. ordalii (formerly V. anguillarum biotype 2). In addition no commercial vaccine provides information about the subgroup(s) used as representative of V. anguillarum O2. Recently, Vibrio species taxonomically related to V. anguillarum (VAR) have been isolated from diseased fishes. An extensive characterization of these VAR organisms allowed us to distribute them into at least seven O-serogroups. The inclusion of representative VAR strains in the vibriosis vaccines need to be discussed. V. ordalii, V. salmonicida and V. vulnificus are homogeneous species with respect to biochemical reactions, serology and degree of virulence, possess a narrow host range and seem to be restricted to some geographic areas. Although iron acquisition systems can be involved in the virulence mechanisms of these pathogens, only in V. anguillarum has it been clearly demonstrated that the ability to scavenge iron from the host is a crucial virulence determinant. The role of exotoxins and cell surface associated properties in the Vibrio infections remains to be elucidated.

Animals↗

Spectrum of Vibrio infections in a Gulf Coast community.

Infection with Vibrio species was diagnosed in 23 patients over a 10-year period in a Gulf Coast community. Species isolated were Vibrio vulnificus, V. cholerae, V. parahaemolyticus, and V. alginolyticus. Clinical presentations included diarrhea, wound infection, and bacteremia. Gastrointestinal tract infection was infrequently diagnosed, despite the routine use of stool culture media appropriate for vibrio isolation. Bacteremic infections were severe and occurred only in patients with underlying diseases. Wound infections were complicated by tissue necrosis and required surgical debridement. In patients with underlying diseases, soft tissue infections often progressed to fatal septicemias.

Adolescent↗

Isolation and characterization of a novel Schitoviridae phage VipHU7 that infects Vibrio parahaemolyticus.

In recent years, various bacteriophages that infect Vibrio spp. have been isolated and characterized. However, many characteristics concerning their infection mechanisms remain unknown. Here, we isolated and characterized a novel phage, VipHU7, that infects Vibrio parahaemolyticus. The morphology of VipHU7 was examined using transmission electron microscopy, which demonstrated that it has a short, noncontractile tail characteristic of podoviruses. VipHU7 formed clear plaques with halo zones on a bacterial lawn of V. parahaemolyticus MFS 1101, and host range analysis revealed that it had a limited host range. Analysis of the propagation and one-step growth curve of VipHU7 in liquid medium indicated that its replication rate increases in the presence of divalent cations, which did not affect its adsorption. Genome sequencing revealed that the VipHU7 genome is 76,454 bp long, with a 38.48% GC content and 112 predicted open reading frames. VipHU7 has a genomic structure similar to that of other Varunavirus phages that infect Vibrio spp. VIRIDIC analysis showed that the intergenomic similarity between VipHU7 and Vibrio phage BUCT194 was 83.7%, indicating that VipHU7 is a novel species belonging to the family Schitoviridae and genus Varunavirus.

Vibrio parahaemolyticus↗

Crayfish: a newly recognized vehicle for vibrio infections.

We conducted a 1-year case-control study of sporadic vibrio infections to identify risk factors related to consumption of seafood products in two coastal areas of Louisiana and Texas. Twenty-six persons with sporadic vibrio infections and 77 matched controls were enrolled. Multivariate analysis revealed that crayfish (P < 0.025) and raw oysters (P < 0.009) were independently associated with illness. Species-specific analysis revealed an association between consumption of cooked crayfish and Vibrio parahemolyticus infection (OR 9.24, P < 0.05). No crayfish consumption was reported by persons with V. vulnificus infection. Although crayfish had been suspected as a vehicle for foodborne disease, this is the first time to our knowledge that consumption of cooked crayfish has been demonstrated to be associated with vibrio infection.

Animals↗

Vibrio infections in Singapore.

Both symptomatic and asymptomatic Vibrio infections, caused by V cholerae, V parahaemolyticus and NAG vibrios, occurred in Singapore. V cholerae are introduced into the country from time to time, but the risk of transmission of infection in the community is negligible in the presence of a high standard of environmental sanitation and a well-established system of epidemiological surveillance. As cholera is probably transmitted through contaminated food, shellfish imported from cholera-endemic countries are regularly monitored for the presence of V cholerae. Vigilance has also been stepped up in the laboratory in view of the possibility of introduction of multiple-antibiotic resistant V cholerae strains into the country. V parahaemolyticus is one of the commonest causes of bacterial food poisoning in Singapore because of the preference of the local population to consume raw or partially cooked seafood. 78% of a variety of imported seafood were found to be contaminated with V parahaemolyticus. Infections caused by NAG vibrios are infrequent, and the mode of transmission has not been established.

Adolescent↗

Epidemiology and spectrum of Vibrio infections in a Chesapeake Bay community.

The clinical and epidemiologic features of vibrio infections occurring over 15 y in a hospital adjacent to the Chesapeake Bay were examined. Microbiologic techniques included the use of thiosulfate citrate bile salts sucrose (TCBS) medium on all stool specimens. Among 40 vibrio isolates from 32 patients, eight species were identified: V. parahaemolyticus (16), V. vulnificus (10), non-O1 V. cholerae (7), V. mimicus (3), V. hollisae (1), V. fluvialis (1), V. alginolyticus (1), and an unnamed halophilic vibrio. Sources included stool (13), wound (11), sputum (3), ear (3), bone (1), and gallbladder (1). While illnesses were diverse, they were relatively mild and self-limited with no mortality. The mild clinical spectrum and especially lack of mortality are in sharp contrast to the findings of previous reports. Even with the proximity to the bay and use of optimal isolation techniques, the demonstrated incidence of vibrio infections was low (1.6/100,000/y). The routine use of TCBS medium, which has been advocated for high-risk areas, was not cost-effective.

Adolescent↗

The epidemiology of Vibrio infections in Florida, 1981-1993.

The epidemiology of 690 Vibrio infections reported in Florida during 1981-1993 is described. Most infections resulted in one of three clinical syndromes: gastroenteritis (51%), wound infections (24%), or primary septicemia (17%). Case-fatality rates were 1% for gastroenteritis, 5% for wound infections, and 44% for primary septicemia. While gastroenteritis had little seasonal variation, 91% of primary septicemias and 86% of wound infections occurred from April through October, mostly due to the seasonality of Vibrio vulnificus and Vibrio parahaemolyticus infections. Infected wounds were largely a result of occupational activities around seawater. Some 68% of gastroenteritis cases and 83% of the primary septicemias were associated with raw oyster consumption. Preexisting liver disease was present in 48% of patients with primary septicemia and was associated with a fatal outcome in both wound infections (relative risk [RR], 28.3; 95% confidence interval [CI], 6.3-127.5; P < .0001) and primary septicemia (RR, 1.9; 95% CI, 1.2-3.1; P < .01).

Adolescent↗

Marine noncholera Vibrio infections in Florida.

In the past decade, there has been a dramatic increase in the number of reported cases of clinical illness from noncholera (marine) vibrio infections, leading to a greater recognition of this potentially lethal disease. The wide spectrum of pathogenicity of this organism is reflected in the six cases in this report, varying from simple gastroenteritis to focal necrotizing cellulitis to fatal septicemia. We have reviewed the fundamental clinical differences between Vibrio vulnificus and other noncholera vibrio infections. Physicians treating patients with a history of exposure to coastal waters and/or seafood should be aware of the clinical features and the potential for significant morbidity and mortality of associated Vibrio vulnificus infections.

Adult↗

Experimental studies on enteropathogenicity and pathogenesis of group 'F' vibrio infections.

Group 'F' vibrios are a recently recognised group of bacteria that have been isolated from cases of diarrhoea and a variety of sources in the environment. They have been shown to cause accumulation of fluid in rabbit gut loops. The enterotoxic factor was found to be heat-labile as evidenced by heat treatment, time course of fluid accumulation and negative suckling mouse assay. It was associated with cytotoxic factor(s). These organisms were seen to be lacking in invasive capacity. Prostaglandins and 5-hydroxytryptamine were found to play no role in causation of fluid outpouring into the loops but chlorpromazine was found to inhibit the fluid outpouring completely thereby indicating that the enterotoxin may act through mediation of cyclic AMP.

Animals↗

Vibrio infections in Kansas City.

In August 1989, the Kansas City Health Department declared vibrio infections a reportable disease. The authors present a report discussing cases of vibriosis reported between 1980 and 1989.

Adult↗

Vibrio infection associated with finning injury of the hand.

BACKGROUND: Penetrating injury by fish fins is common and often overlooked. Vibrio spp. are known worldwide for their virulence, quickly causing soft-tissue infection and lethal septicaemia. Vibrio infection following finning injury is rare, but can result in devastating complications in susceptible individuals. AIM: To elucidate the clinical significance of such injury. METHOD: Between July 2003 and September 2005, nine cases of Vibrio infection caused by finning injury to the hand were retrospectively reviewed. Clinical data, including skin presentations, treatment course and outcomes, were collected and reviewed. RESULTS: In our group of nine patients, seven had concurrent hepatoma, diabetes mellitus, cirrhosis, chronic renal insufficiency or the effects of long-term steroid use; three had wound infections manifested by cellulitis or tenosynovitis and six had life-threatening necrotising soft-tissue infections. Vibrio spp. were identified from the wound (n=4), blood (n=1), and both (n=4). Symptoms appeared within a few hours to 3 days after injury, with 50% of patients developing symptoms within 24h; three patients were hypotensive upon admission; one patient received antibiotic therapy only and eight required emergency fasciotomy. All patients survived and none required amputation. The mean hospital stay was 23.2 days. CONCLUSIONS: Vibrio infections after finning injury can produce bacteraemic necrotising soft tissue-infections, especially in individuals with a systemic illness. Health education should include a recommendation to wear protective gloves while handling fish. Early antibiotic and surgical treatment can avoid potentially life-threatening complications.

Adult↗

Halophilic Vibrio infections: a review.

Halophilic vibrios are gram-negative curved bacilli that requires high concentrations of salt for survival. They are usually found in marine environments and have a worldwide distribution. Infections caused by these organisms are usually associated with ingestion of raw shell fish or exposure of wounds to sea water. The clinical presentation and severity of this infections is wide ranging. The most common presentation is self-limiting gastroenteritis, but soft tissue infections and septicemia do occur and their morbidity and mortality is high specially in patients with liver disease. Early detection and initiation of treatment with tetracycline is of vital importance in soft tissue infections and septicemia since the progression of the infection may be extremely fast.

Humans↗

Non-cholera vibrio infections in the United States. Clinical, epidemiologic, and laboratory features.

Non-cholera vibrios are organisms that are biochemically indistinguishable from Vibrio cholerae but do not agglutinate in vibrio 0 group 1 antiserum. Since 1972 there has been a dramatic increase in the number of these organisms referred to the Center for Disease Control for identification. Clinical, epidemiologic, and laboratory data were analyzed for 26 of 28 patients with isolates identified between January 1972 and March 1975. Thirteen (50%) of the isolates were obtained from feces of patients who had an acute diarrheal illness; no other pathogens were isolated from their feces, and all patients survived. Four (15%) patients had non-cholera vibrios isolated from other gastrointestinal or biliary tract sites; none of these patients had acute illness definitely attributable to non-cholera vibrios. Nine (35%) patients had non-cholera vibrios isolated from other tissues and body fluids; four deaths occurred in this group. Patients with acute diarrhea frequently had a history of recent shellfish ingestion or foreign travel, whereas some patients with systemic non-cholera vibrio infection had a history of recent occupational or recreational exposure to salt water.

Adolescent↗