Genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021 / 中华预防医学杂志

Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.

Two cases of Vibrio vulnificus primary sepsis / 中华烧伤杂志

This article analyzed the medical records of two patients with Vibrio vulnificus primary sepsis who were admitted to the First Affiliated Hospital of Naval Medical University and reviewed the latest literature. On November 6, 2019, a 54-year-old male patient was admitted to the hospital. The patient's lower limbs were red, swollen, and painful with ecchymosis and hemorrhagic bullae after he ate freshwater products. The emergency fasciotomy was performed 3 h after admission, and the multiple organ failure occurred after operation. The patient was given up treatment 24 h after admission. On August 12, 2020, a 73-year-old male patient was admitted to the hospital. He was in shock state on admission and had hemorrhagic bullae on his right lower limb after he ate seafood. At 3 h post admission, he underwent emergency surgical exploration and amputation of right thigh. Six days later, he received negative pressure wound treatment on the stump. On the 13th day post admission, his families forgo the active treatment and he died 15 d after admission. The two cases were both failed to be diagnosed at the first time, and the disease progressed rapidly. Necrotizing fasciitis and multiple organ failure occurred. After the diagnosis was confirmed, timely fasciotomy and high amputation were performed respectively. The microbiological examinations both reported Vibrio vulnificus. Although the 2 cases were not cured successfully, the course of disease and some indexes of patient with early amputation were better than those of patients with fasciotomy. Vibrio vulnificus is widely distributed and frequently detected in fresh water products. The pathogenic pathway is fuzzy and complex, and it is easy to be misdiagnosed. It is necessary to establish the treatment process of Vibrio vulnificus sepsis. Early and aggressive surgical intervention should be carried out as soon as possible, fasciotomy and debridement should be thorough, and the patients with hemorrhagic bullae should be amputated early. Postoperative comprehensive measures are also important for improving the survival rate of patients.

Epidemiological and etiological characteristics of Vibrio parahaemolyticus strains causing foodborne disease outbreaks in Guangdong Province from 2017 to 2020 / 中华预防医学杂志

Objective: To study the epidemiological and pathogenic characteristics of Vibrio parahaemolyticus isolated from outbreaks cases in Guangdong Province, 2017-2020. Methods: Epidemiological characteristics of 87 outbreak events caused by Vibrio parahaemolyticus were analyzed. Strains were serotyped, and then analyzed by pulsed-field gel electrophoresis (PFGE). Results: The food-borne disease outbreak caused by Vibrio parahaemolyticus was found in 16 cities. 44.8% (39/87) and 37.9% (33/87) of the outbreaks occurred in hotels, restaurants and school canteens, respectively. Improper food processing and storage (40.2%, 35/87) and cross contamination caused by indiscriminate raw and cooked food (25.3%, 22/87) were the main causes of food-borne disease outbreaks of Vibrio parahaemolyticus. The main serotypes of patient derived strains were O3:K6 (87.5%) and O4:KUT (22.5%). The similarity value between O3:K6 type isolates was 65.5%-100.0%, and the PFGE pattern similarity value of O4:KUT type isolates was 66.5%-100.0%. Conclusion: Outbreaks caused by Vibrio parahaemolyticus are widely distributed in Guangdong province. It is necessary to strengthen the publicity and education on the correct handling of food in hotels, restaurants, schools, and unit canteens. O3:K6 and O4:KUT serotypes are the main serotypes of the outbreak. There is genetic diversity among the epidemic strains.

Diversidad molecular de variantes patogénicas de Vibrio parahaemolyticus en el Perú / Molecular diversity in pathogenic variants of vibrio parahaemolyticus in Peru

RESUMEN Con el objetivo de determinar la diversidad de variantes patogénicas de Vibrio parahaemolyticus en el Perú durante el periodo 1995-2017, se analizaron 102 genomas peruanos (97 clínicos y 5 ambientales) empleando el esquema de tipificación multilocus y BLASTn para la búsqueda de genes de virulencia. Se identificaron 15 tipos de secuencia diferentes, encontrándose que el genotipo ST3, perteneciente al clon pandémico, fue el más abundante, con 52% (n=53); seguido por el ST120, con 23,5% (n=24); y el complejo clonal CC345, con 11,8% (n=12). Un total de 89 cepas analizadas presentaron genes que codifican la isla de patogenicidad VpaI-7 (87,3%), mientras que 96 presentaron el gen tdh (94,1%), y 6, el trh (5,9%). Durante el periodo evaluado, se resalta la predominancia del ST3, causante de un importante brote en el pasado del Perú, además de otros genotipos patógenos que representan un riesgo latente en salud pública asociado al consumo de alimentos marinos.

ABSTRACT During the period from 1995 to 2017, in order to determine the diversity of Vibrio parahaemolyticus pathogenic variants in Peru, 102 Peruvian genomes (97 from a hospital setting and 5 from an out-of-hospital setting) were analyzed using the multilocus typification scheme and BLASTn in the search for virulence genes. Fifteen different sequence types were identified. It was found that the ST3 genotype, which is found in the pandemic clone, was the most abundant, with 52% (n=53); followed by ST120, with 23.5% (n=24); and the CC345 clonal complex, with 11.8% (n=12). A total of 89 analyzed strains presented genes encoding the pathogenicity island VpaI-7 (87.3%), while 96 presented the tdh gene (94.1%), and 6 the trh gene (5.9%). The ST3 genotype was the predominant one during the evaluated period, this genotype was the cause of a major outbreak in Peru's past history. Other pathogenic genotypes found represent a latent public health risk associated with seafood consumption.

Vibrio cholerae: doença, manifestações clínicas e microbiologia / Vibrio cholerae: disease, clinical manifestations and microbiology / Vibrio cholerae: enfermedad, manifestaciones clínicas y microbiologia

Justificativa e Objetivos: A cólera é uma doença infecciosa intestinal aguda causada pela toxina do Vibrio cholerae. A transmissão é oral-fecal e ocorre predominantemente em ambientes aquáticos contaminados. Pode ser fatal, mas é facilmente evitada e tratada. Associa-se a sua propagação com a falta de saneamento básico pois cresce exponencialmente nesses ambientes. O diagnóstico é clínico-epidemiológico, laboratorial com meios seletivos para o microrganismo e teste rápido, este último não é sensível e nem especifico. O tratamento é com sais de reidratação oral e antibioticoterapia, indica-se a suplementação com zinco. Existe vacinação para Vibrio cholerae, e essa é a melhor medida para o controle da doença. As pesquisas em cólera já não são mais frequentes, pois ela é considerada uma doença de países que não são desenvolvidos. Conclusão: Nesse contexto, ainda são necessárias pesquisas sobre sistemas de esgoto, monitorização de efluentes, vigilância da qualidade da água de abastecimento público e vigilância da qualidade de alimentos.(AU)

Background and Objectives: Cholera is an acute intestinal infectious disease caused by the toxin of Vibrio cholerae. Transmission is oral-fecal and occurs predominantly in contaminated aquatic environments. It can be fatal, but it is easily avoided and treated. Its propagation is associated with lack of basic sanitation because it grows exponentially in environments. The diagnosis is clinical-epidemiological, laboratory with selective media for the micro-organism and rapid test, the latter is not sensitive or specific. Treatment is with oral rehydration salts and antibiotic therapy, zinc supplementation is indicated. There is vaccination for Vibrio cholerae, and this is the best measure for the control of the disease. Conclusion: Cholera research is no longer frequent, as it is considered a disease of countries that are not developed. In this context, research is still needed on sewage systems, effluent monitoring, public water supply quality surveillance and food quality monitoring.(AU)

Justificación y objetivos: La cólera es una enfermedad infecciosa intestinal aguda causada por la toxina del Vibrio cholerae. La transmisión es oral-fecal y ocurre predominantemente en ambientes acuáticos contaminados. Puede ser fatal, pero es facilmente evitada y tratada. Se asocia su propagación con la falta de saneamiento básico pues crece exponencialmente en ambientes. El diagnóstico es clínico-epidemiológico, de laboratorio con medios selectivos para el microorganismo y la prueba rápida, este último no es sensible ni específico. El tratamiento es con sales de rehidratación oral y antibioticoterapia, se indica la suplementación con cinc. Hay vacunación para Vibrio cholerae, y esa es la mejor medida para el control de la enfermedad. Conclusión: Las investigaciones en cólera ya no son más frecuentes, ya que se considera una enfermedad de países que no se desarrollan. En este contexto todavía son necesarias investigaciones sobre sistemas de alcantarillado, monitorización de efluentes, vigilancia de la calidad del agua de abastecimiento público y vigilancia de la calidad de alimentos.(AU)

Early clinical manifestations of vibrio necrotising fasciitis

We present five patients with vibrio necrotising fasciitis, a lethal and disabling disease. Two of these patients had a history of exposure to either warm seawater or raw/live seafood, three had underlying chronic liver disease, and four presented with hypotension and fever. There were three deaths and four patients required intensive care unit stays. Among the two survivors, one had high morbidity. Only one patient met the criteria of Laboratory Risk Indicator for Necrotising Fasciitis score > 6. A clinician should suspect possible vibrio necrotising fasciitis if the following are present: contact with fresh seafood/warm seawater, a known history of chronic liver disease and pain that is out of proportion to cutaneous signs. All patients must be managed via intensive care in high dependency units. We recommend a two-step surgical protocol for patient management involving an initial local debridement, followed by a second-stage radical debridement and skin grafting.

Factores que inciden en la mortalidad del camarón marino en cooperativas del sector El Zompopero, Bahía de Jiquilisco, Usulután, El Salvador / Factors that affect the mortality of marine shrimp in cooperatives of El Zompopo area, Bahía de Jiquilisco, Usulután, El Salvador

El sector El Zompopero ubicado en la Bahía de Jiquilisco Usulután, es un núcleo productivo integrado por cinco cooperativas que se dedican al cultivo de camarón blanco de la especie Litopenaeus vannamei. Los miembros que integran las cooperativas son familias desmovilizadas de la guerra civil de El Salvador, a quienes se les repartieron tierras en esta zona costera como estrategia de reinserción a la vida productiva. Cuentan con un total de 21 estanques de tierra, que cubren un área de cultivo de 84.3 hectáreas y realizan tres ciclos de cultivo de camarón al año. Actualmente este sector productivo enfrenta serios problemas debido a la alta mortalidad que se registra en cada ciclo productivo. Por esta razón, la Escuela de Ciencias del Mar del Centro Regional MEGATEC La Unión realizó un proyecto de investigación aplicada para diagnosticar las principales causas que generan la mortalidad en los cultivos, así como el impacto económico y social que perciben las familias que se dedican a la producción de camarón. A través del diagnóstico se identificaron 5 causas externas y 15 internas que afectaron la producción en las granjas camaroneras en el año 2014. Las causas están asociadas al manejo del cultivo y a las condiciones de infraestructura de los estanques en las cooperativas

El Zompopero zone located in Jiquilisco Bay in Usulután, is a productive center formed by five farm cooperatives dedicated to the white shrimp farming, Litopenaeus vannamei species. The members forming the cooperatives are demobilized families from the civil conflict in El Salvador who were distributed lands in this coastal area as a reinsertion into productive life strategy. They currently have a total of 21 earth ponds with a farming area of 84.3 hectares that allow three shrimp farming cycles a year. At the moment, this productive area is facing serious problems due to the high mortality rate registered every productive cycle. Thy is why, the Marine Science School at the regional Centre MEGATEC in La Unión, implemented an applied research project to identify the main reasons causing farming mortality, as well as the economic and social impact in the families dedicated to shrimp farm production. The research identified 5 external causes and 15 internal ones that affected shrimp farm production in the year 2014. These causes are related to farming handling and to the conditions of the ponds infrastructure in the cooperatives.

The expression of heterologous MAM-7 in Lactobacillus rhamnosus reduces its intrinsic capacity to inhibit colonization of pathogen Vibrio parahaemolyticus in vitro

BACKGROUND: Vibrio parahaemolyticus (V. parahaemolyticus) is a Gram-negative, halophilic bacterium recognized as one of the most important foodborne pathogen. When ingested, V. parahaemolyticus causes a self-limiting illness (Vibriosis), characterized mainly by watery diarrhoea. Treatment is usually oral rehydration and/or antibiotics in complicated cases. Since 1996, the pathogenic and pandemic V. parahaemolyticus O3:K6 serotype has spread worldwide, increasing the reported number of vibriosis cases. Thus, the design of new strategies for pathogen control and illness prevention is necessary. Lactobacillus sp. grouped Gram positive innocuous bacteria, part of normal intestinal microbiota and usually used as oral vaccines for several diarrheic diseases. Recombinants strains of Lactobacillus (RL) expressing pathogen antigens can be used as part of an anti-adhesion strategy where RL block the pathogen union sites in host cells. Thus, we aimed to express MAM-7 V. parahaemolyticus adhesion protein in Lactobacillus sp. to generate an RL that prevents pathogen colonization RESULTS: We cloned the MAM-7 gene from V. parahaemolyticus RIMD 2210633 in Lactobacillus expression vectors. Recombinant strains (Lactobacillus rhamnosus pSEC-MAM7 and L. rhamnosus pCWA-MAM7) adhered to CaCo-2 cells and competed with the pathogen. However, the L. rhamnosus wild type strain showed the best capacity to inhibit pathogen colonization in vitro. In addition, LDH-assay showed that recombinant strains were cytotoxic compared with the wild type isogenic strain CONCLUSIONS: MAM-7 expression in lactobacilli reduces the intrinsic inhibitory capacity of L. rhamnosus against V. parahaemolyticus.

Utilização comparativa de enrofloxacino, probiótico (Lactobacilus plantarum) e propionato de sódio na larvicultura de camarão branco do pacífico / Comparative use of enrofloxacin, probiotic (Lactobacillus plantarum) and sodium propionate in pacific white shrimp larvae / Utilización comparativa de enrofloxacino, probiótico (Lactobacillus plantarum) y propionato de sodio en larvicultura de camarón blanco del pacífico

O objetivo do presente trabalho foi avaliar métodos de controle e tratamento de bacterioses na larvicultura de Litopenaeus vannamei, avaliando o uso contínuo de probiótico e o uso pontual de enrofloxacino 15mg.L-1 e propionato de sódio 0,5 mM.L-1 nos momentos de metamorfose sobre os, parâmetros zootécnicos e microbiológicos (larvas e da água). Foram utilizadas 16 unidades de 60L, povoadas na densidade de 325 náuplios.5L-1, divididos em três tratamentos: enrofloxacino, probiótico, propionato de sódio e controle. O enrofloxacino e o propionato foram ministrados em protozoea 3, misis 3 e pós-larva 4 e o probiótico foi ministrado na ração ao longo de todo o experimento. O probiótico aumentou as contagens de bactérias ácido-láticas em relação aos demais tratamentos na água de cultivo (p=0,00001) e em relação ao enrofloxacino e o proprionato nas larvas (p=0,0048). A água do tratamento com probiótico apresentou menor contagem de Vibrio spp. que o enrofloxacino (p=0,0011) e as larvas tratadas com probiótico apresentaram menor contagem de Vibrio spp. que o propionato (p=0,0158). Contudo, não foi observada diferença nos índices zootécnicos avaliados. Assim, os aditivos na dose utilizada não alteram parâmetros zootécnicos da larvicultura do camarão L. vannamei.

The purpose of this study was to assess control and treatment methods for bacterial diseases in Litopenaeus vannamei, evaluating the continuous use of probiotics and occasional use of 15mg-L-1 enrofloxacin and 0.5-mM.L-1 sodium propionate at the morphological change moments on the performance and microbiological parameters of larvae and water. A total of 16 60-L units were used, stocked with 325 nauplii/5L-1, divided into three treatments and one control. Enrofloxacin and propionate were administered into protozoea 3, misis 3 and 4, and post-larvae 4, while the probiotic was administered in the feed throughout the experiment. The probiotic increased the counts of lactic acid bacteria in relation to the other treatments in the culture water (p = 0.00001) and in relation to enrofloxacin and propionate in larvae (p = 0.0048). The treatment water with probiotic had lower counts of Vibrio ssp. than enrofloxacin (p = 0.0011) and larvae treated with probiotic showed lower counts of Vibrio ssp. that propionate (p = 0.0158). However, no difference was observed in the performance indexes assessed. Thus, it can be concluded that additives in the assessed doses did not influence the performance parameters of L. vannamei.

El objetivo del presente trabajo fue evaluar métodos de control y tratamiento de enfermedades bacterianas en larvicultura de Litopenaeus vannamei, evaluando el uso continuo de probiótico y el uso puntual de 15 mg.L-1 de enrofloxacino y 0,5 mM.L-1 de propionato de sodio en momentos de metamorfosis sobre los parámetros zootécnicos y microbiológicos (larvas y del agua). Se han utilizado 16 unidades de 60L, pobladas en la densidad de 325 nauplios.5L-1, divididos en tres tratamientos: enrofloxacino, probiótico, propionato de sodio y control. El enrofloxacino y el propionato fueron suministrados en protozoea 3, misis 3 y postlarva 4 y el probiótico suministrado en alimento durante el transcurso del experimento. El probiótico aumentó el contaje de bacterias ácido-lácticas en correlación a los demás tratamientos en agua de cultivo (p=0,0001) y las larvas en relación al enrofloxacino y el propionato en las larvas (p=0,0048). El agua del tratamiento con probiótico presentó menor contaje de Vibrio spp. que el enrofloxacino (p=0,0011) y las larvas tratadas con probiótico presentaron menor contaje de Vibrio spp. que el propionato (p=0,0158). Sin embargo, no se ha observado diferencia en los índices zootécnicos de larvicultura de camarón L. vannamei.

First isolation of Vibrio vulnificus causing sepsis in Santa Catarina, Brazil / Primeiro isolamento de Vibrio vulnificus causando sepse em Santa Catarina, Brasil

Vibrio vulnificus is a bacterium present in natural marine environments that causes infections in immunocompromised people. Sepsis in humans caused by this microorganism is usually accompanied by bullous skin lesions. In the present study we report a case of infection caused by this bacterium affecting a diabetic man, 74 years old, who fell overboard and hurt his leg. The identification of the V. vulnificus was made in the blood culture sample. This is the first report of isolation of V. vulnificus in Santa Catarina, Brazil, showing the dissemination of this bacterium in warm seawater over the world (AU)

Vibrio vulnificus é uma bactéria que se desenvolve em ambientes marinhos naturais e causa infecção em pessoas imunocomprometidas. Sepse em humanos causada por esse microrganismo é geralmente acompanhada por lesões bolhosas da pele. Relatamos um caso de infecção causada por esta bactéria que afetou um homem diabético, de 74 anos, que caiu ao mar e machucou a perna. A identificação do V. vulnificus foi feita na amostra de hemocultura. Este é o primeiro relato de isolamento de V. vulnificus em Santa Catarina, Brasil, elucidando a disseminação das bactérias de ambiente marítimo de água quente pelo mundo (AU)

The infection and molecular characteristics of Vibrio parahaemolyticus isolated from intestinal outpatient in two sentinel hospitals in Shanghai, 2010-2012 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze virulence genes and molecular characteristics of Vibrio parahaemolyticus isolated from sporadic cases with diarrhea in tow sentinel hospitals of Shanghai, 2010-2012.</p><p><b>METHODS</b>A total of 2 729 stool samples were collected from two surveillance sentinel hospitals in Shanghai 2010-2012. Vibrio parahaemolyticus strains were isolated and identified from diarrhea out patients using TCBS agar plates and biochemical reactions. Thermostable direct hemolysingene (tdh), thermostable-related hemolysin gene (trh), hemolysin gene (tlh) were detected by multiplex PCR method. Isolates were analyzed by PFGE and MLST. The PFGE profiles were analyzed using BioNumerics software.</p><p><b>RESULTS</b>A total of 30 clinical Vibrio parahaemolyticus strains isolated from 2 729 stool samples. The anually Vibrio parahaemolyticus isolation rate during 2010 to 2012 were 1.1%(11/973), 1.0%(11/1 120) and 1.3%(8/636) respectively. The PCR positive rates of virulence genes tlh, tdh and trh were 100%, 97% and 0 respectively. The Vibrio parahaemolyticus strains were divided into 13 PFGE types (P1-P13)and 3 ST types (ST-189, ST-799, ST-3). Among 13 PFGE types, P4 was the main PFGE type, accounting for 30%(9/30). P9, P10 were accounting for 12% (4/30) respectively, P1, P2, P12, P13 were accounting for 7%(2/30) respectively, the others types were 3%(1/30) respectively. MLST analysis results showed there are three ST types, ST3 was 84%(25/30), ST189 and ST799 were accounting for 13% (4/30) and 3% (1/30) respectively.</p><p><b>CONCLUSION</b>The infection rate of Vibrio parahaemolyticus was not very high from 2010-2012 in Shanghai, all strains were positive for tlh and negative for trh. ST3 was the major type of Vibrio parahaemolyticus.</p>

Analysis of molecular features of clinical Vibrio parahaemolyticus strains in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the phenetic and genetic features of clinical Vibrio parahaemolyticus strains from 2007-2009 in China.</p><p><b>METHODS</b>A total of 135 clinical Vibrio parahaemolyticus strains, isolated from Zhejiang, Jiangsu, Sichuan, Guangxi, Liaoning Provinces during 2007 to 2009, were selected for the research. The occurrence of virulence genes thermostable direct hemolysin (tdh) and TDH-related hemolysin (trh), species-specific genes thermolabile hemolysin (tlh), toxR, VPM and gyrB, the pandemic clone gene markers(GS-PCR, PGS-PCR, orf8 and HU-α) in 135 Vibrio parahaemolyticus strains was detected by PCR. The antimicrobial susceptibilities to eight antimicrobial agents of the experimental strains were determined by the broth microdilution method. All strains were serotyped and underwent the cluster analysis with pulsed-field gel electrophoreses.</p><p><b>RESULTS</b>The results of PCR methods claim that all experiment strains carry species-specific genes such as tlh, toxR, gyrB, VPM. Among clinical strains, 85.9% (116/135) carry tdh and/or trh. 85.2% (115/135) were positive for tdh, and 3.0% (4/135) were positive for trh; while 3 strains carried both.66.7% (90/135) , 80.7% (109/135) , 65.2% (88/135) , 66.7% (90/135) clinical strains carried the genes of GS-PCR, PGS-PCR, orf8, HU-α, respectively. The results of antibiotics susceptibility test showed that 8.1% (11/135) strains were resistant to at least one agent, including 9 strains were resistant to ampicillin, 2 strains were resistant to trimethoprim and sulphamethoxazole, and 1 strain were resistant to tetracycline. All clinical strains were sensitive to cefotaxime, ceftazidime, gentamicin, ciprofloxacin and chloromycetin.Serological analysis of the O and K antigens claimed that a total of 29 serotypes were identified for clinical strains, predominantly O3, O4 and O1 groups, accounting for 89.6% (121/135). O3: K6 was dominant serotype, accounting for 56.3% (76/135). The pandemic flora in China included O3: K6, O4: K68, O1: K36, O1: K25, O1: K5 and O3: K29 serotypes.Genomic DNAs of 135 clinical strains were digested with SfiI and NotI, the molecular size of PFGE restriction fragments used for analysis mainly ranged from 30-700 kb.When subjected to UPGMA clustering, 6 and 9 clusters were grouped by SfiI and NotI, and the minimal similarity was 52.6% and 58.7%, and pandemic flora were located in C groups and D group, respectively.</p><p><b>CONCLUSION</b>Most of Vibrio parahaemolyticus strains isolated from clinical sources in China were pathogenic. The pandemic clone, especially O3: K6 was prevalent. The GS-PCR and HU-α genes were reliable markers to identify the pandemic flora. The serotype by PFGE was reliable to distinguish the pandemic flora and the sporadic strains.</p>

Etiologic characteristics of Vibrio parahaemolyticus strains causing outbreaks and sporadic cases in Guangdong, 2013 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the serotypes, antimicrobial resistance, virulence genes and molecular characteristics of Vibrio parahaemolyticus isolated from outbreaks and sporadic cases in Guangdong, 2013.</p><p><b>METHODS</b>36 Vibrio parahaemolyticus strains isolated from outbreaks and 43 strains from sporadic cases were sero-typed and tested for antimicrobial resistance. PCR was used to detect for tdh(thermostable direct hemolysin gene), trh (tdh(-) related hemolysin gene), GS-PCR and orf8 genes. All the samples were analyzed by pulsed-field gel electrophoresis (PFGE).</p><p><b>RESULTS</b>36 isolates from outbreaks were all identified as O3 : K6, and among the 43 sporadic isolates, O3 : K6 (23, 53.49%) was the dominant serotype. Vibrio parahaemolyticus isolates showed high resistance rate to ampicillin (96.20%) and cefalotin (40.50%), but were high sensitive to cotrimoxazole (100%) and chloramphenicol (100%). 83.33% (30/36) outbreak isolates were resistant to multi-drugs but only 37.21% (16/43) of the sporadic isolates showed so. Results from virulence gene detection suggested that all the 36 outbreak isolates belonged to tdh(+) trh(-) strains, while 86.05% (37/43) of the sporadic isolates were tdh(+)trh(-) and 11.63% (5/43)were tdh(-)trh(+) . Only one tdh(+)trh(+) strain was found. All the outbreak isolates contained GS-PCR and/or orf8 genes, whereas among the sporadic isolates only 51.16% (22/43) of them carrying the similar genes. Results from PFGE analysis suggested that 79 isolates were discriminated into 3 clusters and 32 different PFGE patterns with the similarity value between 59.8% and 100.0%. Outbreak isolates seemed to gather in the same cluster, while the sporadic isolates spreading in all the three clusters.</p><p><b>CONCLUSION</b>O3 : K6 was the dominant serotype in Vibrio parahaemolyticus strains isolated in Guangdong, 2013. These strains showed high sensitivity to most antibiotics, but with multi-drug resistance. Positive rate of tdh gene was high, and most O3 : K6 strains contained GS-PCR and/or orf8 genes. PFGE analysis revealed genetic diversity was within the Vibrio parahaemolyticus strains in Guangdong.</p>

Vibrio vulnificus infection in Southern Brazil - Case report / Infecção por Vibrio vulnificus no sul do Brasil - Relato de caso

The genus Vibrio is a member of the family Vibrionaceae, and among their disease-causing species, Vibrio vulnificus, a lactose-positive gram-negative bacillus, is one of the most virulent pathogen of the noncholerae vibrios. We describe the case of a 39-year-old male patient, who was using immunosuppressive therapy, admitted to the hospital for liver transplantation. Twelve hours later, the patient presented high fever, myalgia, anuria and erythematous plaques on lower limbs, of rapid growth and proximal progression. The patient was treated with ceftriaxone, meropenem and oxacillin, however he expired within 30 hours. Blood cultures showed growth of a gram-negative bacillus, which was later identified as Vibrio vulnificus.

O gênero Vibrio é membro da família Vibrionaceae, e entre as espécies patogênicas, Vibrio vulnificus, bacilo gram negativo lactose positivo, tem sido frequentemente citado. Descrevemos o caso de um paciente masculino de 39 anos, em uso de medicação imunossupressora, admitido no hospital para transplante hepático. Doze horas após a internação, o paciente evoluiu com febre, mialgias, anúria e placas eritematosas em membros inferiores, com rápido crescimento e evolução proximal. O paciente foi tratado com ceftriaxona, meropenem e oxacilina sem melhora, evoluindo para óbito em 30 horas. Hemocultura mostrou crescimento de bacilo gram negativo posteriormente identificado como Vibrio vulnificus.

Accurate diagnosis and treatment of Vibrio vulnificus infection: a retrospective study of 12 cases

BACKGROUND AND AIMS: Vibrio vulnificus causes an infectious disease that has extremely poor convalescence and leads to necrotic fasciitis. In this study, we sought to define the characteristic epidemiology of V. vulnificus infection and clarify its diagnosis at the global level. METHODS: Over a period of 10 years, we investigated the appearance of symptoms, underlying conditions, treatment, and mortality in 12 patients (eight men, four women; >50 years old; average age, 66 years,) infected with V. vulnificus. RESULTS: The development of symptoms occurred primarily between June and September, a period during which seawater temperature rises and the prevalence of V. vulnificus increases. All patients had underlying diseases, and seven patients reported a history of consuming fresh fish and uncooked shellfish. The patients developed sepsis and fever with sharp pain in the limbs. Limb abnormalities were observed on visual examination. All patients underwent debridement; however, in the survival group, the involved limb was amputated early in 80% patients. The mortality rate was 58.3%. CONCLUSION: Recognition of the characteristic epidemiology and clinical features of this disease is important, and positive debridement should be performed on suspicion. When the illness reaches an advanced stage, however, amputation should be the immediate treatment of choice.

Sepsis por Vibrio vulnificus: reporte de dos casos en ciudades de altura en el Ecuador / Vibrio vulnificus sepsis: report of two cases in high altitude cities from Ecuador

La infección por Vibrio vulnifcus está generalmente relacionada con el contacto de heridas con agua de mar y el consumo de mariscos bivalvos. No se han publicado hasta la fecha casos causados por Vibrio vulnifcus en el Ecuador. Presentación de los casos Se describen dos casos de sepsis fatal. El primer caso fue un hombre de 69 años, residente en Ibarra (2220 m.s.n.m.), que tenía como enfermedad de base diabetes mellitus tipo 2, artritis reumatoide y hepatopatía. El segundo fue un hombre de 26 años, residente en Quito (2800 m.s.n.m.), con antecedente de anemia aplásica bajo tratamiento. Ambos pacientes ingresaron febriles y presentaron un deterioro rápidamente progresivo, sin respuesta al manejo de soporte y antibiótico-terapia en cuidados intensivos, falleciendo en menos de 48 horas posteriores a su ingreso. En los hemocultivos se identifcó la presencia de Vibrio vulnifcus. Conclusión El reporte de estos casos pone en alerta la presencia de esta bacteria como causa de sepsis en pacientes con factores de riesgo. El reconocimiento oportuno del cuadro clínico, el tratamiento de soporte, terapia antibiótica y un equipo multidisciplinario, son pilares fundamentales en el manejo de este tipo de infecciones.

Vibrio vulnifcus infection usually is related to the contact of wounds with seawater and bivalve shellfsh consumption. Non-cases has been published of this infection in Ecuador. Case Report Two cases of septic shock are described. The frst case was a man (69 years old) from Ibarra city (2220 m.s.l.) who had diabetes mellitus, rheumatoid arthritis and liver disease. The second case was a man (26 years old) resident in Quito city (2800 m.s.l.) with a history of treated aplastic anemia. Both patients were admitted febrile and showed a fast and progressive deterioration, without response to support management and antibiotic therapy in the intensive care unit. They died within 48 hours after admission. Blood cultures were positive for Vibrio vulnifcus. Conclusion The report of these cases must put on alert for the presence of this bacterium as a cause of sepsis in patients with risk factors. Early recognition of clinical data, the supportive management, antibiotic therapy and a multidisciplinary team are essentials for the outcome.

Molecular characterization of Vibrio parahaemolyticus collected from human infections in Shenzhen, between 2002 and 2008 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the occurrence and distribution of specific clones of pathogenic Vibrio parahaemolyticus(VP)isolated in Shenzhen and to assess the relationship between serotype O3:K6 and the globally distributed pandemic clone.</p><p><b>METHODS</b>A total of 1005 VPs isolated from diarrhea patients in 2002-2008 were sero-typed. Real-time PCR was used to detect the virulence genes tlh, toxR, tdh, trh and orf8 in 281 isolates from 68 different serotypes. The main serotypes were typed by pulsed field gel electrophoresis(PFGE). Strains with dominant serotypes and PFGE patterns were assayed by GS-PCR and toxRS sequencing for the identification of pandemic clone. Multilocus sequence typing(MLST)analysis was reserved for exemplary 41 O3 : K6 and O1 : K25 isolates.</p><p><b>RESULTS</b>Seventy-nine serotypes were observed among the 1005 isolates, including O3 : K6(57.9%), O4 : K8(8.16%), O1 : KUT(5.87%), O1 : K25(5.27%), O4 : K68(1.39%), O1 : K56(1.39%) and O9 : K44(0.99%). Most of the strains(99.36%)showed PCR positive to tlh, toxR, and tdh but eleven strains were tdh negative. MLST showed that all the 36 O3 : K6 isolates belonged to ST3 and all the 5 O4 : K8 strains were ST189. These results matched the description of the pandemic VP clone.</p><p><b>CONCLUSION</b>A recognizable burden of diarrheal illness caused by VP had been seen in Shenzhen. Results from serotyping indicated that although there existing a large variety of diversities, the dominant serotype appeared to be O3 : K6. VP isolates identified in Shenzhen mainly showed as tdh positive but trh negative, in consistent with the current pandemic O3 : K6 clone. The pandemic O3 : K6 clone did appear to co-exist with other clones of O3 : K6, as well as O4 : K8,O1 : K25. Potential outbreak of VP could be monitored through the laboratory-based surveillance programs, suggesting that the strategies related to prevention and control of VP should be prioritized in Shenzhen.</p>

In vitro and in vivo bactericidal activity of Vitex negundo leaf extract against diverse multidrug resistant enteric bacterial pathogens

OBJECTIVE@#To investigate in vitro and in vivo antibacterial potentials of Vitex negundo (V. negundo) leaf extracts against diverse enteric pathogens.@*METHODS@#Water and methanol extracts of V. negundo leaves were evaluated against enteric bacterial pathogens by using standard disc diffusion, viable bacterial cell count methods, determination of minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC).@*RESULTS@#Methanol extract of V. negundo leaves showed potent antibacterial activity (inhibition zone: 9.9-22.6 mm, MIC: 200-3200 μg/mL, MBC: 200-6400 μg/mL) against all the pathogenic enteric bacteria (Vibrio cholerae, Vibrio parahaemolyticus, Vibrio mimicus, Echerichia coli, Shigella spps., and Aeromonas spps) tested. Methanol extract of V. negundo leaves showed potent bactericidal activity both in vitro laboratory conditions (MBC, 200-400 μg/mL) and in the intestinal environment (Dose, 1-2 mg/mL) of infant mice against pathogenic Vibrio cholerae, the major causative agent of cholera. Furthermore, assays using the mice cholera model showed that V. negundo methanol extract can protect mice from Vibrio cholerae infection and significantly decrease the mortality rate (P<0.0001).@*CONCLUSIONS@#For the first time we showed that methanol extract of V. negundo leaves exhibited strong vibriocidal activity both in vitro and in vivo conditions. Therefore, it will be useful to identify and isolate the active compounds of this extract that could be a good alternative of antibiotics to treat cholera.

Effect of combined function of temperature and water activity on the growth of Vibrio harveyi

Vibrio harveyi is considered as a causative agent of the systemic disease, vibriosis, which occurs in many biological fields. The effects of temperatures (12.9-27.1 ºC) and water activity (NaCl% 0.6%-3.4%) on V. harveyi were investigated. The behavior and growth characteristics of V. harveyi was studied and modeled. Growth curves were fitted by using Gompertz and Baranyi models, and the Baranyi model showed a better fittness. Then, the maximum growth rates (µmax) and lag phase durations (LPD, λ) obtained from both Gompertz and Baranyi model were modeled as a combination function of temperature and water activity using the response surface and Arrhenius-Davey models for secondary model. The value of r², MSE, bias and accuracy factor suggest Baranyi model has better fitness than Gompertz model. Furthermore, validation of the developed models with independent data from ComBase also shown better interrelationship between observed and predicted growth parameter when using Baranyi model.

Peritonitis bacteriana espontánea asociada a bacteriemia por Vibrio cholerae no O1, no O139 / Spontaneous bacterial peritonitis associated with Vibrio cholerae non-O1, non-139 bacteremia

Vibrio cholerae is a Gram-negative bacilli with curved, comma shape that belongs to the family Vibrionaceae. The antigenic structure consists of a flagellar H antigen and a somatic O antigen (used to classify V cholerae in various serogroups). Serogroups 01 and 0139 have caused epidemics of cholera. Vibrio cholerae non-01 non-139 has been isolated from patients with bacteremia, acute secretory diarrhea, dysentery, abdominal pain, nausea, vomiting, fever and cellulitis. Invasive forms such as meningitis, spontaneous bacterial peritonitis (SBP) and encephalitis are uncommon. Immunosuppression and cirrhosis are risk factors for developing invasive disease. This case report describes a cirrhotic patient from Salta, Argentina, consulting for abdominal pain and fever. He was diagnosed with SBP and Vibrio cholerae non-01 non-139 bacteremia. He received antibiotic treatment with third generation cephalosporins for fourteen days with favorable clinical outcome.

Vibrio cholerae es un bacilo gramnegativo, curvo y móvil, perteneciente a la familia Vibrionaceae, que presenta antígenos flagelares H y somático O; este último permite clasificarlo en numerosos serogrupos. Los serogrupos O1 y O139 han causado epidemias de cólera. Vibrio cholerae serogrupo no O1, no O139 es no aglutinable con el antisuero específico y se manifiesta clínicamente como bacteriemias, diarrea acuosa, disentería, dolor abdominal, náuseas, vómitos, fiebre y celulitis. Raramente se describen formas invasoras tales como meningitis, peritonitis bacteriana espontánea (PBE) y cerebritis, entre otras. Dentro de los factores de riesgo para desarrollar enfermedad invasora se encuentran la inmunodepresión y la cirrosis hepática. Comunicamos el caso de un paciente procedente de la provincia de Salta, Argentina, con antecedentes de cirrosis hepática, que consulta por dolor abdominal y fiebre, en el que se diagnóstica PBE asociada a bacteriemia por Vibrio cholerae no 01, no 0139. Recibió tratamiento con cefalosporinas de tercera generación iv, por catorce días con una evolución clínica favorable.