Vibrio metschnikovii bacteremia in a patient with cholecystitis

When Vibrios Take Flight: A Meta-Analysis of Pathogenic Vibrio Species in Wild and Domestic Birds

Of the over 100 species in the genus Vibrio, approximately twelve are associated with clinical disease, such as cholera and vibriosis. Crucially, eleven of those twelve, including Vibrio cholerae and Vibrio vulnificus, have been isolated from birds. Since 1965, pathogenic Vibrio species have been consistently isolated from aquatic and ground-foraging bird species, which has implications for public health, as well as the One Health paradigm defined as an ecology-inspired, integrative framework for the study of health and disease, inclusive of environmental, human, and animal health. In this meta-analysis, we identified 76 studies from the primary literature which report on or examine birds as hosts for pathogenic Vibrio species. We found that the burden of disease in birds was most commonly associated with V. cholerae, followed by V. metschnikovii and V. parahaemolyticus. Meta-analysis wide prevalence of our Vibrio pathogens varied from 19% for V. parahaemolyticus to 1% for V. mimicus. Wild and domestic birds were both affected, which may have implications for conservation, as well as agriculturally associated avian species. As pathogenic Vibrios become more abundant throughout the world as a result of warming estuaries and oceans, susceptible avian species should be continually monitored as potential reservoirs for these pathogens.

Vibrio metschnikovii isolated from cosmetic products as potential cause of skin infection

Cosmetics intended for human use should be free of microbes involving a potential health hazard. Different points in the cosmetic production process, from the choice of raw materials and the formulation itself to the final packaging, can be critical. The aim of this study is to present the first case of Vibrio metschnikovii isolated from cosmetics in Serbia, which caused signs of skin infection. Standard microbiological examination of the cosmetic sample, as well as skin swabs from the skin changes which appeared after applying the same cosmetics, were taken with final identification to the level of species applying matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry. Adequate management of hazard analysis and critical control points in cosmetic production is strongly recommended, which would guarantee microbiological safety of the final product.

Microbial Profiles of Retail Pacific Oysters (Crassostrea gigas) From Guangdong Province, China

Oysters are one of the main aquatic products sold in coastal areas worldwide and are popular among consumers because of their delicious taste and nutritional value. However, the microorganisms present in oysters may pose health risks to consumers. In this study, the microbial communities of Pacific oysters (Crassostrea gigas) collected from aquatic product markets in three cities (Guangzhou, Zhuhai, and Jiangmen) of Guangdong Province, China, where raw oysters are popular, were investigated. The plate counts of viable bacteria in oysters collected in the three cities were all approximately 2 log colony-forming units/g. High-throughput sequencing analysis of the V3–V4 region of the 16Sribosomal DNA gene showed a high level of microbial diversity in oysters, as evidenced by both alpha and beta diversity analysis. Proteobacteria, Bacteroidetes, and Firmicutes were the dominant phyla of the microorganisms present in these samples. A variety of pathogenic bacteria, including the fatal foodborne pathogen Vibrio vulnificus, were found, and Vibrio was the dominant genus. Additionally, the relationship between other microbial species and pathogenic microorganisms may be mostly symbiotic in oysters. These data provide insights into the microbial communities of retail oysters in the Guangdong region and indicate a considerable risk related to the consumption of raw oysters.

Vibrio metschnikovii: Current state of knowledge and discussion of recently identified clinical case

Vibrio metschnikovii is a widespread opportunistic pathogen that rarely causes disease in human. It caused graft infection in our case. It is important to differentiate it from another water-transmitted pathogens.

Vibriosis in Fish: A Review on Disease Development and Prevention

Current growth in aquaculture production is parallel with the increasing number of disease outbreaks, which negatively affect the production, profitability, and sustainability of the global aquaculture industry. Vibriosis is among the most common diseases leading to massive mortality of cultured shrimp, fish, and shellfish in Asia. High incidence of vibriosis can occur in hatchery and grow-out facilities, but juveniles are more susceptible to the disease. Various factors, particularly the source of fish, environmental factors (including water quality and farm management), and the virulence factors of Vibrio, influence the occurrence of the disease. Affected fish show weariness, with necrosis of skin and appendages, leading to body malformation, slow growth, internal organ liquefaction, blindness, muscle opacity, and mortality. A combination of control measures, particularly a disease-free source of fish, biosecurity of the farm, improved water quality, and other preventive measures (e.g., vaccination) might be able to control the infection. Although some control measures are expensive and less practical, vaccination is effective, relatively cheap, and easily implemented. In this review, the latest knowledge on the pathogenesis and control of vibriosis, including vaccination, is discussed.

Severe septic shock and cardiac arrest in a patient with Vibrio metschnikovii: a case report

INTRODUCTION

Vibrio metschnikovii is a very rare species and can be fatal to patients with massive comorbidity. Until now only eight other cases have been reported.

CASE PRESENTATION

This case report describes a 78-year-old Danish man who presented with fever, hypotension and unconsciousness and he developed cardiac arrest. Vibrio metschnikovii was identified in all his blood samples and effective antibiotics were initiated.

CONCLUSIONS

The human sources are believed to include shrimps, birds, water, sewage and seafood. We report the first case of Vibrio metschnikovii from a Nordic country and the report shows that even though isolation of Vibrio metschnikovii from human clinical samples is very rare, it still infects humans and may be fatal, despite sufficient treatment.

Vibrio zhuhaiensis sp. nov., isolated from a Japanese prawn (Marsupenaeus japonicus)

A Gram-negative, oxidase-positive, facultatively anaerobic bacterium, designated strain E20121, was isolated from the digestive tract of a Japanese prawn (Marsupenaeus japonicus) collected from the coastal sea water area of Zhuhai, Guangdong province, China. The new isolate was determined to be closely related to Vibrio ponticus DSM 16217(T), having 97.6 % 16S rRNA gene sequence similarity. Phylogenetic analysis based on recA, pyrH and rpoA also showed low levels of sequence similarities (72.6-96.6 %) with all species of the genus Vibrio. A multigene phylogenetic tree using concatenated sequences of the four genes (16S rRNA, rpoA, recA and pyrH) clearly showed that the new isolate is different from the currently known Vibrio species. DNA-DNA hybridization experiments revealed similarity values below 70 % with the closest related species V. ponticus DSM 16217(T). Several phenotypic traits enabled the differentiation of strain E20121 from the closest phylogenetic neighbours. The DNA G+C content of strain E20121 was determined to be 47.6 mol % and the major fatty acid components identified were C16:1ω7c and/or C16:1ω6c (39.8 %), C18:1ω7c (13.6 %) and C16:0 (9.6 %). Based on genotypic, phenotypic, chemotaxonomic, phylogenetic and DNA-DNA hybridization analyses, strain E20121 is proposed to represent a novel species of the genus Vibrio for which the name Vibrio zhuhaiensis sp. nov. is proposed. The type strain is E20121(T)(=DSM 25602(T) = CCTCC AB 2011174(T)).

Vibrio harveyi sepsis in a child with cancer

A paediatric oncology patient presented with central line sepsis caused by Vibrio harveyi, a gram negative bioluminescent marine bacterium known to be pathogenic to fish and marine invertebrates, after swimming in the sea.

Vibrio metschnikovii, a rare cause of wound infection

We report the first case of a postoperative wound infection caused by Vibrio metschnikovii on the lower right leg of a patient after saphenectomy. Compared to the healing of an uninfected site, that of the right leg was delayed, and a cure was achieved by intensified wound care. Several swabs taken from the infected site grew a gram-negative rod in pure culture that was identified as V. metschnikovii by the VITEK 2 system. The source of the infection was not detected; however, the absence of putative risk factors (exposure to water or shellfish or an episode of diarrhea), the profession of the patient (butcher), and the isolation of V. metschnikovii in a variety of farm animals (chicken, cattle, swine, and horses) suggest that infections caused by V. metschnikovii may be regarded as zoonotic.

Vibrio metschnikovii among diarrheal patients during cholera epidemic in Recife Brazil

Although known since the last century, Vibrio metschnikovii was only appropriately described and recognized as a new species within the genus Vibrio in 1978. Rarely is the organism linked to human disease. Only once has V. metschnikovii been incriminated as responsible for human diarrhea, and affecting an old woman who suffered from diabetes and had a hepatoma. During the first two years of the present cholera epidemic, which reached Recife in March, 1992, we screened for vibrio nearly 4000 diarrheal fecal specimens submitted to a private clinical laboratory for detection of enteropathogenic microorganisms. Now, we report six cases of diarrhea associated with V. metschnikovii affecting individuals not suffering of any apparent underlying systemic illness.

Mixed bacteremia with Vibrio metschnikovii in an 83-year-old female patient

An 83-year-old woman suddenly fell ill and was admitted to the hospital on suspicion of a heart attack. After admission she developed high fever, chills and malaise. Vibrio metshnikovii and Staphylococcus hominis were isolated from 2 separately obtained blood cultures. One of the cultures also yielded Escherichia coli. The patient's condition improved rapidly after treatment with ampicillin intravenously. To our knowledge, this is the fourth reported case of V. metschnikovii bacteremia in humans.

Severe human infections caused by Vibrio metschnikovii

Vibrio metschnikovii is largely distributed in the aquatic environment; human infections are rarely observed. A fatal case of septicemia in a patient with liver cirrhosis, renal insufficiency, and diabetes is described. A second case in a 82-year-old woman with septicemia, respiratory problems, and infected leg lesions is reported; she was successfully treated.

The human pathogenic vibrios--a public health update with environmental perspectives

Pathogenic Vibrio species are naturally-occurring bacteria in freshwater and saline aquatic environments. Counts of free-living bacteria in water are generally less than required to induce disease. Increases in number of organisms towards an infective dose can occur as water temperatures rise seasonally followed by growth and concentration of bacteria on higher animals, such as chitinous plankton, or accumulation by shellfish and seafood. Pathogenic Vibrio species must elaborate a series of virulence factors to elicit disease in humans. Activities which predispose diarrhoeal and extraintestinal infections include ingestion of seafood and shellfish and occupational or recreational exposure to natural aquatic environments, especially those above 20 degrees C. Travel to areas endemic for diseases due to pathogenic Vibrio species may be associated with infections. Host risk factors strongly associated with infections are lack of gastric acid and liver disorders. Involvement of pathogenic Vibrio species in cases of diarrhoea should be suspected especially if infection is associated with ingestion of seafood or shellfish, raw or undercooked, in the previous 72 h. Vibrio species should be suspected in any acute infection associated with wounds sustained or exposed in the marine or estuarine environment. Laboratories serving coastal areas where infection due to pathogenic Vibrio species are most likely to occur should consider routine use of TCBS agar and other detection regimens for culture of Vibrio species from faeces, blood and samples from wound and ear infections.

Effects of divalent cations and saccharides on Vibrio metschnikovii cytolysin-induced hemolysis of rabbit erythrocytes

Divalent cations and polysaccharides such as inulin and dextran reversibly inhibited hemolysis of rabbit erythrocytes caused by Vibrio metschnikovii cytolysin. On the basis of the 50% inhibitory doses, the cations were divided into two groups, group I (Cd2+, Cu2+, Ni2+, Sn2+, and Zn2+) and group II (Ba2+, Ca2+, Co2+, Mg2+, Mn2+, and Sr2+). Neither divalent cations nor polysaccharides interfered with the binding of toxins to the erythrocyte membrane. Group I cations disturbed tetramer formation of cytolysin on the cytolysin-lysed erythrocyte membrane, although group II cations and dextran did not affect the process. Erythrocytes treated with cytolysin in the presence of group II cations or dextran lysed after transfer to toxin- and inhibitor (group II cations or dextran)-free buffer at both 37 and 4 degrees C. However, erythrocytes treated in the presence of group I cations lysed at 37 degrees C but not at 4 degrees C, indicating that group I cations block the temperature-dependent lesion (tetramer)-forming step subsequent to the binding of cytolysin to the erythrocytes. The cytolysin-treated erythrocytes swelled in a colloid osmotic manner, and the swelling was preceded by the binding and the lesion-forming steps. It is also suggested that the lysis of the erythrocytes proceeds in a temperature-independent manner and that the cytolysin does not bind to the erythrocytes at 4 degrees C. These findings suggest that the sequence of V. metschnikovii cytolysin-induced hemolysis is defined by three steps: (i) a temperature-dependent binding step, (ii) a temperature-dependent lesion-forming step, and (iii) a temperature-independent lysis step.

Characterization of Vibrio metschnikovii and Vibrio gazogenes by DNA-DNA hybridization and phenotype

Vibrio metschnikovii and Vibrio gazogenes are two new Vibrio species that have been little studied. Thirteen strains of V. metschnikovii were highly related to the type strain, NCTC 8443, by DNA-DNA hybridization. Relatedness values were 83 to 90% at 60 degrees C and 75 to 84% at the more stringent 75 degrees C. Divergence values ranged from 0.7 to 1.9. Strains of V. metschnikovii were oxidase negative and did not reduce nitrate to nitrite. The other phenotypic characteristics agreed with published data. Twenty-three strains of V. gazogenes were isolated from salt marshes and marshy areas on the coast of North and South Carolina. A new medium, marine agar supplemented with an additional 2.5% agar, reduced the problem of swarming by marine Vibrio species and enhanced the isolation of V. gazogenes and other organisms. By DNA-DNA hybridization, 22 of 23 strains were 76% or more related to the type strain of V. gazogenes, ATCC 29988. However, four DNA hybridization subgroups were defined on the basis of divergence values and/or phenotype. Strains of DNA group 1 were more highly related to each other, and this group contained the type strain and six other strains. Strains of DNA group 2 were more highly related to each other, and this group contained reference strain ATCC 43942 and 14 other strains. Strains of DNA group 1 did not ferment melibiose or D-sorbitol (one strain was sorbitol positive), but strains of DNA group 2 fermented both sugars. A revised phenotypic description of V. gazogenes based on 24 strains was written on the basis of reactions (within 2 days of incubation) at 25 degrees C in media supplemented with Na+, K+, and Mg2+. Positive results (100% positive unless indicated) included motility; gas production during fermentation (96% at 2 days, 100% at 3 to 7 days); growth in nutrient broth with the addition of 1% NaCl (88%), 2% NaCl, 3.5% NaCl, 6% NaCl, 8% NaCl, and 10% NaCl (92%); dry red or orange colonies on marine agar; and fermentation of L-arabinose, cellobiose, D-galactose (88%), D-glucose, lactose (88%), maltose, D-mannitol (96%), D-mannose, salicin, sucrose, trehalose, and D-xylose. Negative results included oxidase; nitrate reduction to nitrite (4% positive); indole production; lysine decarboxylase; ornithine decarboxylase; arginine dihydrolase; swarming; growth on TCBS agar; growth in nutrient broth with 0% NaCl, 0.1% NaCl, 0.2% NaCl, 0.3% NaCl, and 0.4% NaCl (8% positive); and fermentation of adonitol, D-arabitol, dulcitol, erythritol, D-galacturonate, i-inositol, alpha-methyl-D-glucoside, raffinose, and L-rhamnose. Variable results were found for the Voges-Proskauer reaction (62% positive), growth in nutrient broth plus 0.5% NaCl (29%) and 12% NaCL (42%), and fermentation of melibiose (71%) and D-sorbitol (71%).

Current perspectives on the epidemiology and pathogenesis of clinically significant Vibrio spp

Recent taxonomic advances have now implicated several different Vibrio species as human pathogens. While the most common clinical presentation of Vibrio infection continues to be gastroenteritis, an increasing number of extraintestinal infections are being reported, particularly in immunocompromised individuals. Detection of Vibrio infections requires a good clinical history and the use of appropriate isolation and identification procedures by the laboratory to confirm illnesses attributed to Vibrio species. Except for Vibrio cholerae O1 and Vibrio parahaemolyticus, there is little direct evidence linking the production of a myriad of cell-associated or extracellular factors produced by each species with human disease and pathogenesis. Many questions regarding pathogenic Vibrio species remain unanswered, including their frequency and distribution in environmental specimens (water, shellfish), infective doses, virulence potential of individual isolates, and markers associated with such strains.

[Species of the genus Vibrio associated with marine products from Arachon Bay]

The distribution of Vibrio species in water and seafood collected from Arcachon Bay (located in the southwest of France) was studied. All invertebrate animals collected were associated with one or more Vibrio species. Eighty strains corresponding to 14 species were precisely identified. The identification of strains with V. parahaemolyticus was checked by DNA/DNA hybridization. The most frequently recovered species were V. alginolyticus, V. parahaemolyticus (non-haemolytic strains), V. harveyi and V. metschnikovii. The three V. cholerae non-O1 strains isolated from water and crab did not produce immunologically detectable cholera toxin and had no DNA fragment hybridizing with a cholera-toxin-gene-specific probe. It is suggested that the sanitary surveillance of seafood in France should include the precise characterization of potentially pathogenic Vibrio species.

Purification and characterization of Vibrio metschnikovii cytolysin

An extracellular cytolysin produced by Vibrio metschnikovii was purified by acid precipitation, phenyl-Sepharose CL-4B chromatography, and rechromatography on a phenyl-Sepharose CL-4B column and high-performance liquid chromatography on a Mono Q (anion-exchange) column. The purified cytolysin had a molecular weight of 50,000 and an isoelectric point of 5.1. It was inactivated by heating at 60 degrees C for 5 min and was inhibited by Zn2+, Cu2+, and high concentrations of cholesterol. Lysis of calf erythrocytes by cytolysin was temperature dependent and occurred only above 18 degrees C. Moreover, no lysis was observed at high concentrations of erythrocytes, suggesting that the cytolysin lyses erythrocytes by a multihit mechanism. This cytolysin had no immunological cross-reactivities with hemolysins from other Vibrio species tested, indicating that it is a new cytolysin. V. metschnikovii cytolysin lysed erythrocytes from several animal species (calf, rabbit, guinea pig, mouse, human, sheep, chicken, and horse) and cultured cells (Vero and Chinese hamster ovary), caused fluid accumulation in the intestines of infant mice, and increased vascular permeability in rabbit skin.

Bacteriology of the marine environment: implications for clinical therapy

Ocean water and tissue samples were obtained from a variety of sources with phylogenetic and geographic diversity. Purified bacterial colonies were isolated and identification procedures were performed. A total of 67 isolates were recovered. Thirty-eight isolates belonged to the genus Vibrio and included six species. Twenty-four non-fermentative bacteria and four Gram-positive isolates were recovered. Antibiotic susceptibility testing showed that while the non-fermentative marine bacteria generally were susceptible to the antibiotics tested, marine Vibrio species were relatively resistant to a wide variety of antimicrobials. Antibiotics effective against all species included imipenem, trimethoprim/sulfamethoxazole, and chloramphenicol. Further recommendations for treatment are based on sensitivity in culture. Some isolates failed to grow in the medium used for susceptibility testing. Because commercial test kits may not yield accurate identifications of bacteria, the acquisition of antimicrobial susceptibility data gains added importance.

Rapid microimmunodiffusion method with species-specific antiserum raised to purified antigen for identification of Vibrio vulnificus

An antigen common to Vibrio vulnificus strains, designated VVA, was purified by ammonium sulfate precipitation, gel filtration, ion-exchange column chromatography, and preparative gel electrophoresis. The molecular weight of VVA was 64,000 when estimated by gel filtration and 40,000 when measured by denaturing polyacrylamide gel electrophoresis. Antiserum prepared against purified VVA (anti-VVA serum) did not agglutinate whole cells of V. vulnificus. Therefore, VVA was considered a possible internal antigen. By using anti-VVA serum, a microimmunodiffusion method was designed to detect the antigen VVA in bacterial cell lysates prepared from a single colony. This simple method allowed the specific identification of V. vulnificus as soon as 10 h after antigen preparation and therefore can be a useful tool in the identification of V. vulnificus from environmental or clinical specimens. VVA was not detected as a line of complete identity in some 20 other Vibrio species or in 7 other bacterial genera. VVA was present in all 63 isolates of V. vulnificus obtained from clinical and nonclinical sources.

Wound infections caused by Vibrio vulnificus, a marine vibrio, in inland areas of the United States

Vibrio vulnificus is a halophilic marine vibrio which may produce infection in wounds exposed to seawater or raw shellfish. The Centers for Disease Control has received two isolates from wounds exposed to inland waters, a New Mexico creek and an Oklahoma reservoir. Halophilic organisms were recovered from both the creek and the reservoir, and the water in both sites was found to be brackish. Both clinical isolates of V. vulnificus grew in salt concentrations as low as those found in the creek and reservoir. These cases illustrate the potential for pathogenic halophilic Vibrio species to live in brackish inland waters and produce infections in patients living in inland areas of the United States.

Bacterial flora of marine penetrating injuries

Bacteriologic and clinical features of 28 cases of traumatic marine injuries are described. The most common bacterial isolates were normal skin bacteria, Staphylococcus aureus and, in 11% of cases, Vibrio alginolyticus. All injuries responded to local wound care, and only half received antibiotic therapy.

Identification of Vibrio hollisae sp. nov. from patients with diarrhea

The name Vibrio hollisae (synonym = Special Bacteriology group EF-13) is proposed for a new group of 16 strains that occurred in stool cultures of patients with diarrhea. V. hollisae is a small gram-negative rod, which is motile with a single polar flagellum. No lateral or peritrichous flagella were observed, even when it was grown on a solid medium. Sodium chloride is required for growth, so V. hollisae is a halophilic vibrio. Strains were positive (36 degrees C, 24 or 48 h) for oxidase (Kovacs), indole production, nitrate reduction to nitrite, and fermentation of D-glucose (acid, no gas), L-arabinose, D-galactose, and D-mannose. Strains were negative for the following tests often used in enteric bacteriology: lipase (corn oil); deoxyribonuclease; gelatinase; methyl red; Voges-Proskauer; utilization of citrate, acetate, and malonate; L-lysine decarboxylase (Møllers); L-ornithine decarboxylase (Møllers); L-arginine dihydrolase (Møllers); growth in KCN medium; and acid production from D-adonitol, D-arabitol, cellobiose, dulcitol, erythritol, glycerol (25% delayed positive at 7 days), i-(myo)-inositol, lactose, maltose, D-mannitol, melibiose, alpha-methyl-D-glucoside, mucate, raffinose, L-rhamnose, salicin, D-sorbitol, sucrose, trehalose, and D-xylose. None of the strains was motile (semisolid medium) at 36 degrees C at 48 h, but by 7 days 88% were motile. The strains did not grow within 2 days when plated on thiosulfate-citrate-bile salts-sucrose (TCBS) agar or MacConkey agar, but they grew on sheep blood agar and marine agar. By DNA-DNA hybridization (75 degrees C, hydroxyapatite with (32)P), V. hollisae was only 0 to 4% related to 21 named species in Vibrio and Photobacterium. The type strain is designated ATCC 33564, which has a mean guanineplus-cytosine content in DNA of 50 mol%. With the disk diffusion method V. hollisae had relatively large zones of inhibition around penicillin, ampicillin, carbenicillin, cephalothin, colistin, polymyxin B, streptomycin, kanamycin, gentamicin, tetracycline, chloramphenicol, and sulfadiazine. Future studies should focus on the isolation of this new vibrio and its ecology and relationship to human diseases.