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Vibrio vulnificus

January 31, 2023

Vibrio vulnificus 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.[3][4] At least one strain of V. vulnificus is bioluminescent.[5]

Vibrio vulnificus
False-color SEM image of Vibrio vulnificus
Scientific classification
Domain: Bacteria
Phylum: Pseudomonadota
Class: Gammaproteobacteria
Order: Vibrionales
Family: Vibrionaceae
Genus: Vibrio
Species:
V. vulnificus
Binomial name
Vibrio vulnificus
(Reichelt et al. 1976)[1]
Farmer 1979[2]
Synonyms
  • Beneckea vulnifica

Infection with V. vulnificus leads to rapidly expanding cellulitis or sepsis.[6]: 279  It was first isolated as a source of disease in 1976.[7]

Signs and symptoms

Vibrio 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. It does not alter the appearance, taste, or odor of oysters.[8] Symptoms include vomiting, diarrhea, and abdominal pain.
  • 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,[4] or by puncture wounds from the spines of fishes such as stingrays. People may develop a blistering dermatitis sometimes mistaken for pemphigus or pemphigoid.
  • 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. When this happens, severe symptoms including blistering skin lesions and septic shock can sometimes lead to death.[9][10] This severe infection may occur regardless of whether the infection began from contaminated food or an open wound.[10]

Among healthy people, ingestion of V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In someone with a compromised immune system, particularly those with chronic liver disease, it can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock), and blistering skin lesions. While men have been shown to be more at risk from this infection than women, co-morbidities such as alcoholic cirrhosis and diseases affecting the endocrine system (diabetes, rheumatoid arthritis, etc.) put a person far more at risk to develop infection from V. vulnificus. [11]

Pathogenesis

Capsule: V. vulnificus has a capsule, made of polysaccharides, and is thought to protect against phagocytosis.[12] The capsule also aids the bacteria in escaping opsonization.[13] Different strains of the bacteria are capable of shifting through the unencapsulated and encapsulated forms. Mouse models have shown that the unencapsulated forms are avirulent. These same strains however, are shown to have a higher predisposition to shift to the virulent encapsulated form when taken up by oysters.[14]

Endotoxin: Like all gram negative bacteria, V. vulnificus has LPS (lipopolysaccharide as the major component of its outer membrane). However, the LPS the bacteria produces isn't as efficient at triggering the immune system's release of tumor necrosis factor (TNF) 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.[15]

Exotoxin: V. vulnificus produces a number of extracellular toxins such as metalloprotease VvpE, cytolysin/hemolysin VvhA, and the multifunctional autoprocessing repeats-in-toxins (MARTX) toxin. 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.[16][17]

Iron: Growth of V. vulnificus is dependent on the amount of iron that is accessible to the bacteria.[18][19][20] The observed association of the infection with liver disease (associated with increased serum iron) might be due to the capability of more virulent strains to capture iron bound to transferrin.[12]

Strains

The most harmful strains of V. vulnificus documented have been observed in three different forms. The first is in an anti-phagocytic polysaccharide capsule that protects the bacteria. By encapsulating the bacteria, phagocytosis and opsonization are not able to occur, thus allowing the bacteria to continue throughout the organism it is in. The second way that V. vulnificus has been most harmful is with some of the toxins that it creates. These toxins are not part of the infection that V. vulnificus causes but instead they are part of a secondary infection in the GI tract that most certainly will lead to systemic infection. Lastly, V. vulnificus has been seen to cause more harm in patients who have higher levels of iron.[11]

Treatment

Vibrio vulnificus wound infections have a mortality rate around 25%. In people in whom the infection worsens into sepsis, typically following ingestion, the mortality rate rises to 50%. The majority of these people die within the first 48 hours of infection. The optimal treatment is not known, but in one retrospective study of 93 people in Taiwan, use of a third-generation cephalosporin and a tetracycline (e.g., ceftriaxone and doxycycline, respectively) was associated with an improved outcome.[21] Prospective clinical trials are needed to confirm this finding, but in vitro data support the suggestion that this combination is synergistic against V. vulnificus. Likewise, the American Medical Association and the Centers for Disease Control and Prevention (CDC) recommend treating the person with a quinolone or intravenous doxycycline with ceftazidime. The first successful documented treatment of fulminant V. vulnificus sepsis was in 1995. Treatment was ceftazidime and intravenous (IV) ciprofloxacin and IV doxycycline, which proved successful. Prevention of secondary infections from respiratory failure and acute renal failure is crucial. Key to the diagnosis and treatment were the early recognition of bullae in an immunocompromised person with liver cirrhosis and oyster ingestion within the previous 48 hours, and the request by the physician for STAT Gram staining and blood cultures for V. vulnificus.[22]

Vibrio vulnificus often causes large, disfiguring ulcers that require extensive debridement or even amputation.[citation needed]

Prognosis

Vibrio vulnificus is the most common cause of death due to seafood in the United States, causing over 95% of deaths that are known to have occurred due to ingested seafood. If treatment with tetracycline or other cephalosporin antibiotics is initiated at the onset of symptoms and the full course followed, patients generally experience no long term effects.[23]

The worst prognosis is in those people arriving at hospital in a state of shock. Total mortality in treated people (ingestion and wound) is around 33%.[21]

People especially vulnerable are those with liver disease (especially cirrhosis and hepatitis) or immunocompromised states (some kinds of cancer, bone marrow suppression, HIV, diabetes, etc.). With these cases, V. vulnificus usually enters the bloodstream, where it may cause fever and chills, septic shock (with sharply decreased blood pressure), and blistering skin lesions.[24] About half of those who contract blood infections die.

Vibrio vulnificus infections also disproportionately affect males; 85% of those developing endotoxic shock from the bacteria are male. Females having had an oophorectomy experienced increased mortality rates, as estrogen has been shown experimentally to have a protective effect against V. vulnificus.[25]

Epidemiology

Further information: Effects of global warming on oceans

Vibrio vulnificus is commonly found in the Gulf of Mexico, where more than a dozen people have died from the infection since 1990.[26] 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. Lack of disease recognition, and also of the risk factors, presentation, and cause, were and are major obstacles to good outcome and recovery.[citation needed]

After the successful treatment of the first person, the Florida Department of Health was able to trace the origin of the outbreak to Apalachicola Bay oysters and their harvesting in water prone to excessive growth of the organism. This contamination was due to warmth of the water and change in freshwater dilution because of a change in flow of the Chattahoochee River into the Apalachicola River, and in turn into Apalachicola Bay. A similar situation occurred after Hurricane Katrina in New Orleans.[citation needed]

Further treatment research

While the treatment for V. vulnificus can be as straightforward as making the rapid choice of appropriate antibiotics, there have been cases in which the genes mutated, thus rendering antibiotics ineffective. While looking for an answer to this problem, researchers found that one way to stop the infection from spreading is to again mutate the bacteria. This mutation happens on the flagellum of the bacteria. When injected with flgC and flgE (two genes in the flagella that cause the mutation), the flagellum no longer function properly. When unable to move normally, the bacteria is no longer able to spread toxins through the body, thus decreasing the effect that V. vulnificus has on the body systemically.[27]

History

The pathogen was first isolated in 1976 from a series of blood culture samples submitted to the CDC in Atlanta.[7] It was described as a "lactose-positive vibrio".[7] It was subsequently given the initial name, Beneckea vulnifica,[1] and finally, Vibrio vulnificus, by J. J. Farmer in 1979.[2]

Increasing seasonal temperatures and decreasing coastal salinity levels seem to favor a greater concentration of Vibrio within filter-feeding shellfish of the U.S. Atlantic seaboard and the Gulf of Mexico, especially oysters (Crassostrea virginica). Scientists have frequently demonstrated the presence of V. vulnificus in the gut of oysters and other shellfish and in the intestines of fish that inhabit oyster reefs. The vast majority of people who develop sepsis from V. vulnificus became ill after they ate raw oysters; most of these cases have been men.[28]

In 2005, health officials clearly identified strains of V. vulnificus infections among evacuees from New Orleans due to the flooding there caused by Hurricane Katrina.[29]

In 2015, in Florida, eight cases of V. vulnificus infection with two resulting in death were reported.[30]

In 2022 following Hurricane Ian, Lee County, Florida saw a sharp rise in infections and deaths from V. vulnificus. By October 18, 2022, four deaths and 29 illnesses had been recorded since landfall of the hurricane in late September.[31][32]

Natural transformation

Natural transformation is a bacterial adaptation for DNA transfer between individual cells. V. vulnificus was found to become naturally transformable during growth on chitin in the form of crab shells.[33] The ability to now carry out transformation experiments in the laboratory should facilitate molecular genetic analysis of this opportunistic pathogen.[citation needed]

References

  1. ^ a b 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. doi:10.1007/bf00416975. PMID 1015934. S2CID 23759213.
  2. ^ a b 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.
  3. ^ 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.
  4. ^ a b 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.
  5. ^ ""Glowing" Seafood?"" (PDF). U.S. Food And Drug Administration Seafood Products Research Center.
  6. ^ James, William D.; Berger, Timothy G. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
  7. ^ a b c 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.
  8. ^ "Vibrio Species Causing Vibriosis". Centers for Disease Control. Retrieved June 5, 2017.
  9. ^ "Vibrio vulnificus". NCBI Genome Project. Retrieved 2005-09-01.
  10. ^ a b "Vibrio Species Causing Vibriosis - Questions and Answers". Centers for Disease Control. Retrieved June 5, 2017.
  11. ^ a b "UpToDate". www.uptodate.com. Retrieved 2019-06-21.
  12. ^ a b Oxford handbook of Infect Dis and Microbiol, 2009
  13. ^ Wright, A. C.; Simpson, L. M.; Oliver, J. D.; Morris, J. G. (June 1990). "Phenotypic evaluation of acapsular transposon mutants of Vibrio vulnificus". Infection and Immunity. 58 (6): 1769–1773. doi:10.1128/IAI.58.6.1769-1773.1990. ISSN 0019-9567. PMC 258721. PMID 2160432.
  14. ^ Srivastava, Milan; Tucker, Matthew S.; Gulig, Paul A.; Wright, Anita C. (August 2009). "Phase variation, capsular polysaccharide, pilus and flagella contribute to uptake of Vibrio vulnificus by the Eastern oyster ( Crassostrea virginica )". Environmental Microbiology. 11 (8): 1934–1944. doi:10.1111/j.1462-2920.2009.01916.x. PMID 19689704.
  15. ^ 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.
  16. ^ Baker-Austin, Craig; Oliver, James D. (February 2018). "Vibrio vulnificus: new insights into a deadly opportunistic pathogen". Environmental Microbiology. 20 (2): 423–430. doi:10.1111/1462-2920.13955. ISSN 1462-2920. PMID 29027375.
  17. ^ 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.
  18. ^ 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.
  19. ^ 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.
  20. ^ 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.
  21. ^ a b Liu JW, Lee IK, Tang HJ, et al. (2006). "Prognostic factors and antibiotics in Vibrio vulnificus septicemia". Archives of Internal Medicine. 166 (19): 2117–23. doi:10.1001/archinte.166.19.2117. PMID 17060542.
  22. ^ (PDF). issc.org. Archived from the original (PDF) on 21 July 2016. Retrieved August 1, 2016.
  23. ^ "Vibrio Vulnificus Infection: Background, Pathophysiology, Etiology". Medscape. 2019-07-01. Retrieved 19 October 2022.
  24. ^ Oliver JD, Kaper J (2005). Vibrio vulnificus. In: Oceans and Health: Pathogens in the Marine Environment. (Belken SS, Colwell RR, editors) (2nd ed.). Springer Science. ISBN 978-0-387-23708-4.
  25. ^ Merkel SM, Alexander S, Zufall E, Oliver JD, Huet-Hudson YM (2001). "Essential Role for Estrogen in Protection against Vibrio vulnificus-Induced Endotoxic Shock". Infection and Immunity. 69 (10): 6119–22. doi:10.1128/IAI.69.10.6119-6122.2001. PMC 98741. PMID 11553550.
  26. ^ Flynn, Dan (November 22, 2011). "Still Too Many Raw Oyster Deaths in Gulf States". Food Safety News. Retrieved August 1, 2016.
  27. ^ Oliver, James D.; Jones, Melissa K. (2009-05-01). "Vibrio vulnificus: Disease and Pathogenesis". Infection and Immunity. 77 (5): 1723–1733. doi:10.1128/IAI.01046-08. ISSN 0019-9567. PMC 2681776. PMID 19255188.
  28. ^ Diaz, James H. (May 2014). "Skin and Soft Tissue Infections Following Marine Injuries and Exposures in Travelers". Journal of Travel Medicine. 21 (3): 207–213. doi:10.1111/jtm.12115. ISSN 1195-1982. PMID 24628985.
  29. ^ Gold, Scott (September 6, 2005). "Newest Peril from Flooding Is Disease". Los Angeles Times.
  30. ^ Katy Galimberti (June 18, 2015). "Flesh-Eating Bacteria Kills Two in Florida as Water Temperatures Rise". msn.com. Retrieved August 1, 2016.
  31. ^ Matza, Max (2022-10-19). "Florida flesh-eating illness cases spike after Hurricane Ian". BBC News. Retrieved 2022-10-18.
  32. ^ Melissa Montoya; Amy Oshier (October 14, 2022). "Michigan man dies from bacteria while helping in Ian recovery". Wink News, Fort Meyers Broadcasting Company. Retrieved 21 October 2022.
  33. ^ Gulig PA, Tucker MS, Thiaville PC, Joseph JL, Brown RN (2009). "USER friendly cloning coupled with chitin-based natural transformation enables rapid mutagenesis of Vibrio vulnificus". Appl. Environ. Microbiol. 75 (15): 4936–49. Bibcode:2009ApEnM..75.4936G. doi:10.1128/AEM.02564-08. PMC 2725515. PMID 19502446.

External links

  • Large and detailed article on V. vulnificus at Todar's Online Textbook of Bacteriology
  • CNN video on vibrio vulnificus
  • Type strain of Vibrio vulnificus at BacDive - the Bacterial Diversity Metadatabase

January 31, 2023
vibrio, vulnificus, species, gram, negative, motile, curved, shaped, bacillus, pathogenic, bacteria, genus, vibrio, present, marine, environments, such, estuaries, brackish, ponds, coastal, areas, vulnificus, related, cholerae, causative, agent, cholera, least. Vibrio vulnificus 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 3 4 At least one strain of V vulnificus is bioluminescent 5 Vibrio vulnificusFalse color SEM image of Vibrio vulnificusScientific classificationDomain BacteriaPhylum PseudomonadotaClass GammaproteobacteriaOrder VibrionalesFamily VibrionaceaeGenus VibrioSpecies V vulnificusBinomial nameVibrio vulnificus Reichelt et al 1976 1 Farmer 1979 2 SynonymsBeneckea vulnificaInfection with V vulnificus leads to rapidly expanding cellulitis or sepsis 6 279 It was first isolated as a source of disease in 1976 7 Contents 1 Signs and symptoms 2 Pathogenesis 3 Strains 4 Treatment 5 Prognosis 6 Epidemiology 7 Further treatment research 8 History 9 Natural transformation 10 References 11 External linksSigns and symptoms EditVibrio 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 It does not alter the appearance taste or odor of oysters 8 Symptoms include vomiting diarrhea and abdominal pain 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 4 or by puncture wounds from the spines of fishes such as stingrays People may develop a blistering dermatitis sometimes mistaken for pemphigus or pemphigoid 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 When this happens severe symptoms including blistering skin lesions and septic shock can sometimes lead to death 9 10 This severe infection may occur regardless of whether the infection began from contaminated food or an open wound 10 Among healthy people ingestion of V vulnificus can cause vomiting diarrhea and abdominal pain In someone with a compromised immune system particularly those with chronic liver disease it can infect the bloodstream causing a severe and life threatening illness characterized by fever and chills decreased blood pressure septic shock and blistering skin lesions While men have been shown to be more at risk from this infection than women co morbidities such as alcoholic cirrhosis and diseases affecting the endocrine system diabetes rheumatoid arthritis etc put a person far more at risk to develop infection from V vulnificus 11 Pathogenesis EditCapsule V vulnificus has a capsule made of polysaccharides and is thought to protect against phagocytosis 12 The capsule also aids the bacteria in escaping opsonization 13 Different strains of the bacteria are capable of shifting through the unencapsulated and encapsulated forms Mouse models have shown that the unencapsulated forms are avirulent These same strains however are shown to have a higher predisposition to shift to the virulent encapsulated form when taken up by oysters 14 Endotoxin Like all gram negative bacteria V vulnificus has LPS lipopolysaccharide as the major component of its outer membrane However the LPS the bacteria produces isn t as efficient at triggering the immune system s release of tumor necrosis factor TNF 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 15 Exotoxin V vulnificus produces a number of extracellular toxins such as metalloprotease VvpE cytolysin hemolysin VvhA and the multifunctional autoprocessing repeats in toxins MARTX toxin 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 16 17 Iron Growth of V vulnificus is dependent on the amount of iron that is accessible to the bacteria 18 19 20 The observed association of the infection with liver disease associated with increased serum iron might be due to the capability of more virulent strains to capture iron bound to transferrin 12 Strains EditThe most harmful strains of V vulnificus documented have been observed in three different forms The first is in an anti phagocytic polysaccharide capsule that protects the bacteria By encapsulating the bacteria phagocytosis and opsonization are not able to occur thus allowing the bacteria to continue throughout the organism it is in The second way that V vulnificus has been most harmful is with some of the toxins that it creates These toxins are not part of the infection that V vulnificus causes but instead they are part of a secondary infection in the GI tract that most certainly will lead to systemic infection Lastly V vulnificus has been seen to cause more harm in patients who have higher levels of iron 11 Treatment EditVibrio vulnificus wound infections have a mortality rate around 25 In people in whom the infection worsens into sepsis typically following ingestion the mortality rate rises to 50 The majority of these people die within the first 48 hours of infection The optimal treatment is not known but in one retrospective study of 93 people in Taiwan use of a third generation cephalosporin and a tetracycline e g ceftriaxone and doxycycline respectively was associated with an improved outcome 21 Prospective clinical trials are needed to confirm this finding but in vitro data support the suggestion that this combination is synergistic against V vulnificus Likewise the American Medical Association and the Centers for Disease Control and Prevention CDC recommend treating the person with a quinolone or intravenous doxycycline with ceftazidime The first successful documented treatment of fulminant V vulnificus sepsis was in 1995 Treatment was ceftazidime and intravenous IV ciprofloxacin and IV doxycycline which proved successful Prevention of secondary infections from respiratory failure and acute renal failure is crucial Key to the diagnosis and treatment were the early recognition of bullae in an immunocompromised person with liver cirrhosis and oyster ingestion within the previous 48 hours and the request by the physician for STAT Gram staining and blood cultures for V vulnificus 22 Vibrio vulnificus often causes large disfiguring ulcers that require extensive debridement or even amputation citation needed Prognosis EditVibrio vulnificus is the most common cause of death due to seafood in the United States causing over 95 of deaths that are known to have occurred due to ingested seafood If treatment with tetracycline or other cephalosporin antibiotics is initiated at the onset of symptoms and the full course followed patients generally experience no long term effects 23 The worst prognosis is in those people arriving at hospital in a state of shock Total mortality in treated people ingestion and wound is around 33 21 People especially vulnerable are those with liver disease especially cirrhosis and hepatitis or immunocompromised states some kinds of cancer bone marrow suppression HIV diabetes etc With these cases V vulnificus usually enters the bloodstream where it may cause fever and chills septic shock with sharply decreased blood pressure and blistering skin lesions 24 About half of those who contract blood infections die Vibrio vulnificus infections also disproportionately affect males 85 of those developing endotoxic shock from the bacteria are male Females having had an oophorectomy experienced increased mortality rates as estrogen has been shown experimentally to have a protective effect against V vulnificus 25 Epidemiology EditFurther information Effects of global warming on oceans Vibrio vulnificus is commonly found in the Gulf of Mexico where more than a dozen people have died from the infection since 1990 26 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 Lack of disease recognition and also of the risk factors presentation and cause were and are major obstacles to good outcome and recovery citation needed After the successful treatment of the first person the Florida Department of Health was able to trace the origin of the outbreak to Apalachicola Bay oysters and their harvesting in water prone to excessive growth of the organism This contamination was due to warmth of the water and change in freshwater dilution because of a change in flow of the Chattahoochee River into the Apalachicola River and in turn into Apalachicola Bay A similar situation occurred after Hurricane Katrina in New Orleans citation needed Further treatment research EditWhile the treatment for V vulnificus can be as straightforward as making the rapid choice of appropriate antibiotics there have been cases in which the genes mutated thus rendering antibiotics ineffective While looking for an answer to this problem researchers found that one way to stop the infection from spreading is to again mutate the bacteria This mutation happens on the flagellum of the bacteria When injected with flgC and flgE two genes in the flagella that cause the mutation the flagellum no longer function properly When unable to move normally the bacteria is no longer able to spread toxins through the body thus decreasing the effect that V vulnificus has on the body systemically 27 History EditThe pathogen was first isolated in 1976 from a series of blood culture samples submitted to the CDC in Atlanta 7 It was described as a lactose positive vibrio 7 It was subsequently given the initial name Beneckea vulnifica 1 and finally Vibrio vulnificus by J J Farmer in 1979 2 Increasing seasonal temperatures and decreasing coastal salinity levels seem to favor a greater concentration of Vibrio within filter feeding shellfish of the U S Atlantic seaboard and the Gulf of Mexico especially oysters Crassostrea virginica Scientists have frequently demonstrated the presence of V vulnificus in the gut of oysters and other shellfish and in the intestines of fish that inhabit oyster reefs The vast majority of people who develop sepsis from V vulnificus became ill after they ate raw oysters most of these cases have been men 28 In 2005 health officials clearly identified strains of V vulnificus infections among evacuees from New Orleans due to the flooding there caused by Hurricane Katrina 29 In 2015 in Florida eight cases of V vulnificus infection with two resulting in death were reported 30 In 2022 following Hurricane Ian Lee County Florida saw a sharp rise in infections and deaths from V vulnificus By October 18 2022 four deaths and 29 illnesses had been recorded since landfall of the hurricane in late September 31 32 Natural transformation EditNatural transformation is a bacterial adaptation for DNA transfer between individual cells V vulnificus was found to become naturally transformable during growth on chitin in the form of crab shells 33 The ability to now carry out transformation experiments in the laboratory should facilitate molecular genetic analysis of this opportunistic pathogen citation needed References Edit a b 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 doi 10 1007 bf00416975 PMID 1015934 S2CID 23759213 a b 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 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 a b 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 James William D Berger Timothy G 2006 Andrews Diseases of the Skin Clinical Dermatology Saunders Elsevier ISBN 978 0 7216 2921 6 a b c 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 Vibrio Species Causing Vibriosis Centers for Disease Control Retrieved June 5 2017 Vibrio vulnificus NCBI Genome Project Retrieved 2005 09 01 a b Vibrio Species Causing Vibriosis Questions and Answers Centers for Disease Control Retrieved June 5 2017 a b UpToDate www uptodate com Retrieved 2019 06 21 a b Oxford handbook of Infect Dis and Microbiol 2009 Wright A C Simpson L M Oliver J D Morris J G June 1990 Phenotypic evaluation of acapsular transposon mutants of Vibrio vulnificus Infection and Immunity 58 6 1769 1773 doi 10 1128 IAI 58 6 1769 1773 1990 ISSN 0019 9567 PMC 258721 PMID 2160432 Srivastava Milan Tucker Matthew S Gulig Paul A Wright Anita C August 2009 Phase variation capsular polysaccharide pilus and flagella contribute to uptake of Vibrio vulnificus by the Eastern oyster Crassostrea virginica Environmental Microbiology 11 8 1934 1944 doi 10 1111 j 1462 2920 2009 01916 x PMID 19689704 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 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 a b Liu JW Lee IK Tang HJ et al 2006 Prognostic factors and antibiotics in Vibrio vulnificus septicemia Archives of Internal Medicine 166 19 2117 23 doi 10 1001 archinte 166 19 2117 PMID 17060542 Vibrio vulnificus fact sheet PDF issc org Archived from the original PDF on 21 July 2016 Retrieved August 1 2016 Vibrio Vulnificus Infection Background Pathophysiology Etiology Medscape 2019 07 01 Retrieved 19 October 2022 Oliver JD Kaper J 2005 Vibrio vulnificus In Oceans and Health Pathogens in the Marine Environment Belken SS Colwell RR editors 2nd ed Springer Science ISBN 978 0 387 23708 4 Merkel SM Alexander S Zufall E Oliver JD Huet Hudson YM 2001 Essential Role for Estrogen in Protection against Vibrio vulnificus Induced Endotoxic Shock Infection and Immunity 69 10 6119 22 doi 10 1128 IAI 69 10 6119 6122 2001 PMC 98741 PMID 11553550 Flynn Dan November 22 2011 Still Too Many Raw Oyster Deaths in Gulf States Food Safety News Retrieved August 1 2016 Oliver James D Jones Melissa K 2009 05 01 Vibrio vulnificus Disease and Pathogenesis Infection and Immunity 77 5 1723 1733 doi 10 1128 IAI 01046 08 ISSN 0019 9567 PMC 2681776 PMID 19255188 Diaz James H May 2014 Skin and Soft Tissue Infections Following Marine Injuries and Exposures in Travelers Journal of Travel Medicine 21 3 207 213 doi 10 1111 jtm 12115 ISSN 1195 1982 PMID 24628985 Gold Scott September 6 2005 Newest Peril from Flooding Is Disease Los Angeles Times Katy Galimberti June 18 2015 Flesh Eating Bacteria Kills Two in Florida as Water Temperatures Rise msn com Retrieved August 1 2016 Matza Max 2022 10 19 Florida flesh eating illness cases spike after Hurricane Ian BBC News Retrieved 2022 10 18 Melissa Montoya Amy Oshier October 14 2022 Michigan man dies from bacteria while helping in Ian recovery Wink News Fort Meyers Broadcasting Company Retrieved 21 October 2022 Gulig PA Tucker MS Thiaville PC Joseph JL Brown RN 2009 USER friendly cloning coupled with chitin based natural transformation enables rapid mutagenesis of Vibrio vulnificus Appl Environ Microbiol 75 15 4936 49 Bibcode 2009ApEnM 75 4936G doi 10 1128 AEM 02564 08 PMC 2725515 PMID 19502446 External links EditLarge and detailed article on V vulnificus at Todar s Online Textbook of Bacteriology CNN video on vibrio vulnificus Type strain of Vibrio vulnificus at BacDive the Bacterial Diversity Metadatabase Retrieved from https en wikipedia org w index php title Vibrio vulnificus amp oldid 1127726508, wikipedia, wiki, book, books, library,

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