Vibrio vulnificus

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Vibrio vulnificus
Scanning electron microscope image of Vibrio vulnificus

Scanning electron microscope image of Vibrio vulnificus

Systematics
Department : Proteobacteria
Class : Gammaproteobacteria
Order : Vibrional
Family : Vibrionaceae
Genre : Vibrionen ( Vibrio )
Type : Vibrio vulnificus
Scientific name
Vibrio vulnificus
( Reichelt et al. 1979)
Farmer 1980

Vibrio vulnificus is a type of gram-negative , curved rod bacteria of the genus Vibrio . They are found in marine environments such as estuaries , brackish pools, or coastal areas. V. vulnificus is closely related to V. cholerae , the cause of cholera . Infection with V. vulnificus leads to rapidly expanding cellulitis or sepsis .

Clinical features

Vibrio vulnificus causes an infection that can be caused by eating seafood , especially oysters . The bacteria can also enter the body through open wounds (including fresh, ie not yet fully healed tattoos ) when swimming or wading in contaminated waters or through stab wounds through the thorns of fish such as the tilapia .

Symptoms include vomiting, diarrhea , abdominal pain and blisters throwing dermatitis , sometimes mistaken for pemphigus vulgaris or pemphigus is held.

In people with weakened immune systems such as chronic liver disease, a cut infected with Vibrio bacteria can quickly worsen and spread to the bloodstream . Serious symptoms and death can occur.

treatment

Vibrio vulnificus infections have a mortality rate of around 25%. If the infection develops into sepsis , the fatality rate increases up to 50%, with most deaths occurring within the first 48 hours after infection. The optimal treatment is unknown, but a retrospective study of 93 patients in Taiwan found that the use of a third-generation cephalosporin with tetracyclines (e.g. ceftriaxone or doxycycline ) was associated with better treatment outcome. Prospective clinical studies have yet to confirm this finding, but in vitro data support the assumption that this combination acts synergistically against Vibrio vulnificus .

Vibrio vulnificus often causes large, disfiguring growths that require major surgery ( debridement ) or even amputation .

forecast

The worst prognosis is for those patients who arrive at the hospital in shock . The total mortality of treated patients is 33%.

Patients with immune deficiencies ( cancer , bone marrow suppression, HIV , diabetes , etc.) are particularly susceptible . In these cases, V. vulnificus usually enters the bloodstream where it can cause fever and chills, or even septic shock with drastically reduced blood pressure and blistering skin lesions. According to the Centers for Disease Control and Prevention , about half of those who contract a blood infection die.

Vibrio vulnificus infections affect men more than average; 85% of those who experience endotoxin shock from the bacteria are male. Women with oophorectomy have increased mortality rates because estrogen is believed to be protective against V. vulnificus .

Occur

Health officials have clearly identified strains of V. vulnificus infection in people evacuated from New Orleans because of the Hurricane Katrina flooding . According to a study, the German Baltic Sea coast is one of the most endangered areas due to its low salt content and increasing warming. In the summer of 2019, the death of a 90-year-old woman who was infected while bathing in the Baltic Sea caused a sensation.

Individual evidence

  1. ↑ Oliver JD, Kaper J: Vibrio species. pp. 263-300 In: Food Microbiology: Fundamentals and Frontiers. (Doyle MP et al., Editors) , 2nd. Edition, ASM Press, 2001, ISBN 1555811175 .
  2. ↑ a b Oliver JD: Wound infections caused by Vibrio vulnificus and other marine bacteria . In: Epidemiol Infect . 133, No. 3, 2005, pp. 383-91. doi : 10.1017 / S0950268805003894 . PMID 15962544 .
  3. ↑ James, William D .; Berger, Timothy G .; et al .: Andrews' Diseases of the Skin: Clinical Dermatology . Saunders Elsevier, 2006, ISBN 0-7216-2921-0 .
  4. ↑ Irene Berres: 31-year-old goes swimming with a fresh tattoo - and dies. In: Spiegel Online. June 2, 2017. Retrieved June 3, 2017 .
  5. ↑ Vibrio vulnificus . In: NCBI Genome Project . Retrieved September 1, 2005.
  6. ↑ a b Liu JW, Lee IK, Tang HJ, et al. : Prognostic factors and antibiotics in Vibrio vulnificus septicemia . In: Arch Intern Med . 166, No. 19, 2006, pp. 2117-23. PMID 17060542 .
  7. ↑ Oliver JD, Kaper J: Vibrio vulnificus. In: Oceans and Health: Pathogens in the Marine Environment. (Belken SS, Colwell RR, editors) , 2nd edition, Springer Science, 2005, ISBN 0387237089 .
  8. ↑ Merkel SM, Alexander S, Zufall E, Oliver JD, Huet-Hudson YM: Essential Role for Estrogen in Protection against Vibrio vulnificus -Induced Endotoxic Shock . In: Infection and Immunity . 69, No. 10, 2001, pp. 6119-22. doi : 10.1128 / IAI.69.10.6119-6122.2001 . PMID 11553550 .
  9. ^ Scott Gold: Newest Peril from Flooding Is Disease , Los Angeles Times. September 6, 2005. 
  10. ↑ Vibrio vulnificus: Cholera can come to Germany via the Baltic Sea. In: welt.de . July 23, 2012, accessed October 7, 2018 .
  11. ↑ Frank Thadeusz: Bacteria in lakes and in the sea: "As with the great white shark". In: Spiegel Online . August 16, 2019, accessed May 15, 2020 .

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