Histopathology of Marine Vibrio Wound Infections

Beckman, Edwin N.; Leonard, George L.; Castillo, Luis E.; Genre, Charles F.; Pankey, George A.

doi:10.1093/ajcp/76.6.765

Cited by 31 publications

(13 citation statements)

References 9 publications

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“…Our histopathologic findings were consistent with the gross appearance, clinical progression, and results of cultures of the experimental lesions in the mice, as well as with results of previous studies in experimental animals (5,6,14,39,56) and with findings in human cases (3,27). The salient characteristics of the lesions were profound edema, presence of numerous bacteria, especially in perivascular regions, and necrosis of cells of all types within affected tissues.…”

Section: Discussionsupporting

confidence: 91%

“…One striking observation in histopathology was the propensity for all of the V. vulnificus strains to cause infection of the perivascular regions (Fig. 4), which is also noted in human disease (3). We speculate that when the bacteria increase vascular permeability, most likely by the action of secreted enzymes or toxins, nutrient-rich plasma becomes more available for the bacteria within the surrounding tissues.…”

Section: Discussionmentioning

confidence: 76%

“…Of equal importance, s.c. inoculation yielded at least a 350-fold difference in the virulence potential of our clinical versus environmental V. vulnificus strains. Most importantly, the host-pathogen interaction and damage to s.c. inoculated mice mimics damage observed in humans suffering from either postingestion sepsis or wound infection caused by V. vulnificus (3,4,27). It should be noted that even though the two primary diseases caused by V. vulnificus in humans, septicemia after ingestion and wound infection, utilize different routes of entry, both infections are significantly manifested in the skin (4).…”

Section: Discussionmentioning

confidence: 99%

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Pathogenesis of Infection by Clinical and Environmental Strains of Vibrio vulnificus in Iron-Dextran-Treated Mice

Starks¹,

Schoeb²,

Tamplin

et al. 2000

Infect Immun

106

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Vibrio vulnificus is an opportunistic pathogen that contaminates oysters harvested from the Gulf of Mexico. In humans with compromising conditions, especially excess levels of iron in plasma and tissues, consumption of contaminated seafood or exposure of wounds to contaminated water can lead to systemic infection and disfiguring skin infection with extremely high mortality. V. vulnificus-associated diseases are noted for the rapid replication of the bacteria in host tissues, with extensive tissue damage. In this study we examined the virulence attributes of three virulent clinical strains and three attenuated oyster or seawater isolates in mouse models of systemic disease. All six V. vulnificus strains caused identical skin lesions in subcutaneously (s.c.) inoculated iron dextran-treated mice in terms of numbers of recovered CFU and histopathology; however, the inocula required for identical frequency and magnitude of infection were at least 350-fold higher for the environmental strains. At lethal doses, all strains caused s.c. skin lesions with extensive edema, necrosis of proximate host cells, vasodilation, and as many as 10 8 CFU/g, especially in perivascular regions. These data suggest that the differences between these clinical and environmental strains may be related to growth in the host or susceptibility to host defenses. In non-iron dextran-treated mice, strains required 10 5 -fold-higher inocula to cause an identical disease process as with iron dextran treatment. These results demonstrate that s.c. inoculation of iron dextran-treated mice is a useful model for studying systemic disease caused by V. vulnificus.Vibrio vulnificus is a gram-negative, halophilic, marine bacterium that is the most common cause of seafood-related deaths in the United States (17, 18). Infection by V. vulnificus occurs through the consumption of raw oysters or contamination of wounds. Individuals with high levels of circulating iron, for example, people suffering from hemochromatosis or cirrhosis, are at highest risk for developing disease after contact with V. vulnificus (7,9,26,50). V. vulnificus causes a rapid and severe disease process resulting in extensive tissue damage. In fact, death can occur within 24 h after contact with the bacterium. Typically, individuals infected by V. vulnificus exhibit fever, chills, hypotension, and characteristic bullous skin lesions, which are rapidly progressive. The rapid nature of the disease process makes intervention difficult, yielding mortality rates of greater than 50% in septicemic individuals (17). Using pulsed-field gel electrophoresis, more than 100 strains of V. vulnificus have been identified in individual oysters (8). However, not all strains of V. vulnificus have equal ability to cause disease. Single strains of V. vulnificus were recovered from the blood of septicemic individuals who consumed oysters contaminated with numerous strains of V. vulnificus (19).Several putative virulence factors have been proposed for V. vulnificus, including metalloprotease, hemolysin-cytolysin...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pathogenesis of Infection by Clinical and Environmental Strains of Vibrio vulnificus in Iron-Dextran-Treated Mice

Starks¹,

Schoeb²,

Tamplin

et al. 2000

Infect Immun

106

View full text Add to dashboard Cite

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“…Patients exhibiting wound infections often experience painful swelling and redness in the infected area. In extreme cases, skin infections can lead to severe cellulitis, necrotizing fasciitis, and myositis requiring surgical debridement of infected tissue or amputation of the limb (2,6,22); sepsis can also follow skin infection. Therapeutic intervention is often difficult, since death from sepsis can occur in less than 24 h after contact with bacteria.…”

mentioning

confidence: 99%

Genotype Is Correlated with but Does Not Predict Virulence of Vibrio vulnificus Biotype 1 in Subcutaneously Inoculated, Iron Dextran-Treated Mice

et al. 2011

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Vibrio vulnificus is the leading cause of reported deaths from infections related to consumption of seafood in the United States. Affected predisposed individuals frequently die rapidly from sepsis. Otherwise healthy people can experience severe wound infection, which can lead to sepsis and death. A question is why, with so many people consuming contaminated raw oysters, the incidence of severe V. vulnificus disease is low. Molecular typing systems have shown associations of V. vulnificus genotypes and the environmental or clinical source of the strains, suggesting that different genotypes possess different virulence potentials. We examined 69 V. vulnificus biotype 1 strains that were genotyped by several methods and evaluated them for virulence in a subcutaneously inoculated iron dextran-treated mouse model. By examining the relationships between skin infection, systemic liver infection, and presumptive death (a decrease in body temperature), we determined that liver infection is predicated on severe skin infection and that death requires significant liver infection. Although most strains caused severe skin infection, not every strain caused systemic infection and death. Strains with polymorphisms at multiple loci (rrn, vcg, housekeeping genes, and repetitive DNA) designated profile 2 were more likely to cause lethal systemic infection with more severe indicators of virulence than were profile 1 strains with different polymorphisms at these loci. However, some profile 1 strains were lethal and some profile 2 strains did not cause systemic infection. Therefore, current genotyping schemes cannot strictly predict the virulence of V. vulnificus strains and further investigation is needed to identify virulence genes as markers of virulence.Vibrio vulnificus is a halophilic bacterium that is naturally present in estuarine waters and contaminates oysters and other shellfish. It is an opportunistic pathogen of humans that causes primary septicemia and wound infection in susceptible hosts and is the leading cause of reported seafood-related deaths due to infection in the United States (for a review, see reference 17). V. vulnificus strains are divided into three biotypes, with human disease caused predominantly by biotype 1 and disease of eels caused predominantly by biotype 2. Biotype 3 was recently isolated from wound infections in Israel and represents an emerging form of this species (3). Several factors have been definitively shown to contribute to virulence of V. vulnificus, including capsular polysaccharide (60), the ability to acquire iron (38, 45, 61), type IV pili (46), flagella (37, 47), RTX toxin (30, 35, 39), and others (17, 27). To date, no single factor has been identified that can distinguish between naturally occurring virulent and less virulent isolates of V. vulnificus.In susceptible humans, V. vulnificus causes a rapid, fulminating disease process resulting in extensive tissue damage (reviewed in reference 17). Primary septicemia is characterized by high fever, chills, hypotension, and septic shock. ...

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“…fin pricks of the skin or cuts sustained while shucking oysters), or immersion of a wound into the seawater where V. vulnificus occurs (Oliver, 1989). The wound does not need to be significant; several cases of persons who suffered ant bites on their legs or hands before or after contact with coastal waters developed wound infections that were fatal or resulted in limb amputation (Beckman et al, 1981;Howard et al, 1986;Howard & Lieb, 1988).…”

Section: Wound Infectionsmentioning

confidence: 99%

Vibrio vulnificus

Oliver

Oceans and Health: Pathogens in the Marine Environment

103

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Histopathology of Marine Vibrio Wound Infections

Cited by 31 publications

References 9 publications

Pathogenesis of Infection by Clinical and Environmental Strains of Vibrio vulnificus in Iron-Dextran-Treated Mice

Pathogenesis of Infection by Clinical and Environmental Strains of Vibrio vulnificus in Iron-Dextran-Treated Mice

Genotype Is Correlated with but Does Not Predict Virulence of Vibrio vulnificus Biotype 1 in Subcutaneously Inoculated, Iron Dextran-Treated Mice

Vibrio vulnificus

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