Vibrio alginolyticus infections in Hawaii

Characteristic and Otopathogenic Analysis of a Vibrio alginolyticus Strain Responsible for Chronic Otitis Externa in China

Vibrio alginolyticus, a Gram-negative rod bacterium found in marine environments, is known to cause opportunistic infections in humans, including ear infections, which can be difficult to diagnose. We investigated the microbiological and otopathogenic characteristics of a V. alginolyticus strain isolated from an ear exudate specimen obtained from a patient with chronic otitis externa to provide a basis for the future diagnosis of V. alginolyticus-associated infections. The identification of V. alginolyticus was accomplished using a combination of matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS), classical biochemical identification methods, and the use of Vibrio-selective media and advanced molecular identification methodologies. Antimicrobial susceptibility testing revealed that the strain was resistant to ampicillin and sensitive to β-lactam, aminoglycosides, fluoroquinolones, and sulfonamide antibiotics. The potential otopathogenic effects of V. alginolyticus were determined through the performance of cell viability, cell apoptosis, and cell death assays in tympanic membrane (TM) keratinocytes and HEI-OC1 cells treated with V. alginolyticus-conditioned medium using cell-counting kit (CCK)-8 assay, a wound-healing migration assay, Annexin V/propidium iodide (PI) flow cytometric analysis, and terminal deoxynucleotidyl transferase deoxyuridine triphosphate (dUTP) nick-end labeling (TUNEL staining). The results indicated that the identified V. alginolyticus strain exerts cytotoxic effects on keratinocytes and HEI-OC1 cells by inhibiting cell proliferation and migration and inducing apoptosis and cell death. To evaluate the ototoxicity of V. alginolyticus, the cell density and morphological integrity of hair cells (HCs) and spiral ganglion neurons (SGNs) were analyzed after exposing cochlear organotypic explants to the bacterial supernatant, which revealed the pre-dominant susceptibility and vulnerability of HCs and SGNs in the basal cochlear region to the ototoxic insults exerted by V. alginolyticus. Our investigation highlights the challenges associated with the identification and characteristic analysis of the Vibrio strain isolated in this case and ultimately aims to increase the understanding and awareness of clinicians and microbiologists for the improved diagnosis of V. alginolyticus-associated ear infections and the recognition of its potential otopathogenic and ototoxic effects.

Vibrio alginolyticus infections in the USA, 1988-2012

Vibrio alginolyticus causes soft tissue and bloodstream infection; little systematically collected clinical and epidemiological information is available. In the USA, V. alginolyticus infections are reported to the Cholera and Other Vibrio Illness Surveillance system. Using data from 1988 to 2012, we categorised infections using specimen source and exposure history, analysed case characteristics, and calculated incidence rates using US Census Bureau data. Most (96%) of the 1331 V. alginolyticus infections were from coastal states. Infections of the skin and ear were most frequent (87%); ear infections occurred more commonly in children, lower extremity infections more commonly in older adults. Most (86%) infections involved water activity. Reported incidence of infections increased 12-fold over the study period, although the extent of diagnostic or surveillance bias is unclear. Prevention efforts should target waterborne transmission in coastal areas and provider education to promote more rapid diagnosis and prevent complications.

Purification, characterization and production optimization of a vibriocin produced by mangrove associated Vibrio parahaemolyticus

OBJECTIVE

To identify a potential bacterium which produces antimicrobial peptide (vibriocin), and its purification, characterization and production optimization. The bacteria subjected in the study were isolated from a highly competitive ecological niche of mangrove ecosystem.

METHODS

The bacterium was characterized by phenotype besides 16S rRNA gene sequence analysis. The antibacterial activity was recognised by using agar well diffusion method. The vibriocin was purified using ammonium sulphate precipitation, butanol extraction, gel filtration chromatography, ion-exchange chromatography and subsequently, by HPLC. Molecular weight of the substance identified in SDS-PAGE. Production optimization performed according to Taguchi's mathematical model using 6 different nutritional parameters as variables.

RESULTS

The objective bacterium was identified as Vibrio parahaemolyticus. The vibriocin showed 18 KDa of molecular mass with mono peptide in nature and highest activity against pathogenic Vibrio harveyi. The peptide act stable in a wide range of pH, temperature, UV radiation, solvents and chemicals utilized. An overall ∼20% of vibriocin production was improved, and was noticed that NaCl and agitation speed played a vital role in secretion of vibriocin.

CONCLUSION

The vibriocin identified here would be an effective alternative for chemically synthesized drugs for the management of Vibrio infections in mariculture industry.

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.

Vibrio vulnificus infection in Hawaii

A life-threatening Vibrio vulnificus infection occurred in a 52-year-old Korean woman with hepatic cirrhosis. Four days after ingesting raw crab, the patient presented to the hospital with nausea, vomiting, fever, hypotension, and hemorrhagic blistering of the left foot. Vibrio vulnificus was recovered from both her blood and a foot wound.

Occurrence and distribution of Vibrio spp., Listonella spp., and Clostridium botulinum in the Seto Inland Sea of Japan

The distribution of Vibrio species in samples of surface water, bottom water (water 2 m above the sediment), and sediment from the Seto Inland Sea was studied. A simple technique using a membrane filter and short preenrichment in alkaline peptone water was developed to resuscitate the injured cells, followed by plating them onto TCBS agar. In addition, a survey was conducted to determine the incidence of Clostridium botulinum in sediment samples. Large populations of heterotrophs were found in surface water, whereas large numbers of total vibrios were found in bottom water. In samples from various water sampling regions, high counts of all bacterial populations were found in the inner regions having little exchange of seawater when compared with those of the open region of the inland sea. In the identification of 463 isolates, 23 Vibrio spp. and 2 Listonella spp. were observed. V. harveyi was prevalent among the members of the Vibrio genus. Vibrio species were categorized into six groups; an estimated 20% of these species were in the so-called "pathogenic to humans" group. In addition, a significant proportion of this group was hemolytic and found in the Bisan Seto region. V. vulnificus, V. fluvialis, and V. cholerae non-O1 predominated in the constricted area of the inland sea, which is eutrophic as a result of riverine influence. It was concluded that salinity indirectly governs the distribution of total vibrios and analysis of variance revealed that all bacterial populations were distributed homogeneously and the variance values were found to be significant in some water sampling regions.(ABSTRACT TRUNCATED AT 250 WORDS)

Vibrio alginolyticus cellulitis following coral injury

Infections associated with marine activities, particularly work or recreation in salt water, present unique diagnostic challenges for the infectious disease practitioner. Those caused by halophilic, non-cholera Vibrio species are increasingly being recognized in clinical practice. They typically follow saltwater injuries, especially those associated with coral. Because these infections can be both severe and life-threatening, a consideration of halophilic Vibrio species in the differential diagnosis of marine-acquired infections is important. In this case report, we discuss the diagnosis and treatment of cellulitis in a patient with a Caribbean coral injury associated with Vibrio alginolyticus cellulitis.

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.

Vibrio alginolyticus bacteremia in an immunocompromised patient

Vibrio alginolyticus, an extremely halophilic member of this genus, was isolated from multiple sets of blood cultures drawn during a septic crisis of a patient with osteogenic sarcoma. No identifiable source of this infection could be determined.

Marine-acquired infections. Hazards of the ocean environment

Numerous pathogenic bacteria are found in seawater. They can cause several environmental infections, such as conjunctivitis, otitis externa, wound infections, pneumonia, and gastrointestinal illness. The incidence of some of these infections could be lowered if people took care to avoid eating undercooked seafood, swimming in brackish water, or sustaining lacerations in a marine environment. However, such infections will probably increase in frequency as more people visit ocean resorts. Prompt elimination of the infective agent, adequate wound care, and avoidance of reexposure can minimize the severity of the condition.

Bacteriology of the teeth from a great white shark: potential medical implications for shark bite victims

Bacteria were cultured for the first time from the teeth of a great white shark (Carcharodon carcharias). Isolates included Vibrio alginolyticus, Vibrio fluvialis, Vibrio parahaemolyticus, and other genera. All are common in the marine environment and some may be associated with wound infections in humans. Shark bite lacerations may serve as a source of these potentially infectious bacteria, particularly Vibrio spp., and should be treated immediately. Antibiotic susceptibility patterns are shown for representatives of Vibrio isolates and indicate that a variety of new agents may be appropriate chemotherapy for shark bite victims.

Vibrio hand infections: a case report and review of the literature

A case of Vibrio vulnificus infection of the hand is presented. The role of Vibrio species as primary pathogens in infections associated with exposure to a marine environment is discussed.

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.

Vibrio parahaemolyticus and related halophilic Vibrios

Approximately 30 years have elapsed since Dr. Fujino's original discovery that Vibrio parahaemolyticus (then termed Pasteurella parahemolytica) was the cause of "summer diarrhea" in Japan. Since that finding, V. parahaemolyticus has been established as a cause of gastroenteritis in numbers and places approaching global proportions. It has been isolated in marine and estuarine areas almost worldwide and despite its halophilic nature, V. parahaemolyticus has been isolated from saline-free waters. The relationship of this organism to the environment reveals a close association with other marine organisms especially copepods on which the Vibrios depend for survival in winter months and growth in summer months. There is a uniquely provocative disparity between human strains of V. parahaemolyticus which are Kanagawa phenomenon (KP) positive and the environmental strains which to a large extent are KP negative, the significance being that pathogenicity is measured according to the Kanagawa phenomenon (hemolytic activity) reaction. The hemolysin of the pathogenic strains is a thermostable, cardiotoxic protein, which thus far has not been implicated in the mechanism(s) which causes human gastroenteritis. The interest in this organism has been widened in recent years by the finding that similar organisms, V. alginolyticus, lactose positive vibrios and group F vibrios also cause serious disease in humans.

In vitro antibiotic sensitivity testing of Vibrio alginolyticus

V. alginolyticus from environmental sources of different geographical areas and some human pathogenic strains were investigated for their sensitivity to 29 different antimicrobial agents, using the agar diffusion method. All strains were sensitive to Gentamicin, Neomycin, Sulfaisodimidin, Sulfamethoxazole-Trimethoprim, Rifamycin, Nalidixan and Linco-Spectin and all except one to Trimethoprim, Tetracycline, Chloramphenicol, Nitrofurantoin and Tobramycin. Between 80 and 94% of tested strains were sensitive to Clindamycin, Cephalotin, Kanamycin, Tylosin and Spiramycin, while Ampicillin, Vancomycin and Novobiocin were effective to approximately 50%. A high percentage of resistance was found to Meticillin, Carbenicillin and Lincomycin. All strains were resistant to Penicillin and Fucidin. No variation in sensitivity pattern between environmental strains isolated from different areas was detected. Great correlation was found among environmental and human pathogenic strains, which could be helpful as guidance in therapy.

Vibrio alginolyticus infections in humans

Two clinical isolates of Vibrio alginolyticus from New Jersey are reported, one from a mixed stump infection and the other grown in pure culture from the conjunctival discharge of a man with conjunctivitis. The biochemical characteristics and antibiotic susceptibilities of these two isolates are presented. Human infections caused by V. alginolyticus are reviewed.

Halophilic, lactose-positive Vibrio in a case of fatal septicemia

A halophilic Vibrio species was isolated from blood cultures from a 59-year-old male with enteritis. The strain differed from Vibrio parahaemolyticus and Vibrio alginolyticus by its ability to ferment lactose, its production of beta-galactosidase, and its lower NaCl tolerance. A report of this infection and a description of the isolate is presented.

Disease caused by a marine Vibrio. Clinical characteristics and epidemiology

We studied the clinical characteristics and epidemiology of disease associated with a rare, unnamed halophilic lactose-fermenting Vibrio species in 39 persons from whom the organism had been isolated. Two distinct clinical presentations were seen. In the first, the illness began with septicemia, often within 24 hours after raw oysters had been eaten; 18 of 24 such patients had pre-existing hepatic disease, and 11 of the 24 died. In the second, there was a wound infection after exposure to seawater or an injury incurred during the handling of crabs; none of these persons had pre-existing hepatic disease, and one of 15 died. Most cases (85 per cent) occurred during relatively warm months (May to October) in men (90 per cent) 40 or more years of age (95 per cent). This Vibrio species is a pathogen and should be considered in the differential diagnosis of septicemia with secondary skin lesions and of wound infections after exposure to seawater.

Two strains of Vibrio species with unusual biochemical features isolated from ear tracts

A strain of vibrio cholerae Heiberg type II, not agglutinable with any of the eight antisera corresponding to Heiberg's groups, and a nonmotile, methyl red-positivs of chronic external otitis.

Experimental pathogenicity and mortality in ligated ileal loop studies of the newly reported halophilic lactose-positive Vibrio sp

Laboratory animals were challenged subcutaneously, intraperitoneally, and intravenously with the halophilic lactose-positive Vibrio. Intraperitoneal inocula of 10(8) organisms proved to be rapidly lethal in mice, rats, and hamsters. The 50% lethal doese in ICR strain mice was estimatd to be 8 X 10(5) live cells, injected intraperitoneally or subcutaneously. Subtaneous inocula in mice resulted in severe local infections, characterized by gross edema, and for those animals surviving longer than 48 h, tissue necrosis. Intravenous, intraperitoneal, and subcutaneous injections of 10(8) cells in mice resulted in death within 3 to 6 h. These animals rapidly developed Vibrio bacteremia after injections. V. parahaemolyticus, studied for comparative purposes, produced no morbidity or mortality when injected subcutaneously. Injections of live lactose-positive Vibrio into ligated ileal loops in rats and rabbits consistently proved to be lethal with a high-density bacteremia resulting.