Vibrio vulnificus: Disease and Pathogenesis

Abstract

Vibrio vulnificus is an opportunistic human pathogen that is highly lethal and is responsible for the overwhelming majority of reported seafood-related deaths in the United States (30,117). This bacterium is a part of the natural flora of coastal marine environments worldwide and has been isolated from water, sediments, and a variety of seafood, including shrimp, fish, oysters, and clams (4,7,25,26,43,97,109,116,118,149,165). Consumption of seafood (primarily raw oysters) containing V. vulnificus can result in a severe, fulminant systemic infection. Characteristics of this disease include fever, chills, nausea, hypotensive septic shock, and the formation of secondary lesions on the extremities of patients (11,22,41,74,115,146). This primary septicemia is the most lethal infection caused by V. vulnificus, with an average mortality rate exceeding 50% (30, 41). A review of 459 U.S. cases reported by the FDA between 1992 and 2007 (J. D. Oliver, unpublished) revealed that 51.6% of the patients died. Interestingly, 85.6% of the cases were male; this aspect of the infection is discussed later in this review. Of 180 cases in 2002 to 2007 for which FDA data were available, 92.8% of patients had consumed raw oysters prior to the onset of symptoms and 95.3% had some preexisting disease(s). The latter are clearly associated with V. vulnificus infection, with liver diseases, such as cirrhosis or hepatitis, being the most common (116). In addition to septicemia, V. vulnificus can produce serious wound infections that typically result from exposure of open wounds to water harboring the bacterium (114). Wound infections are frequently contracted as a result of recreational swimming, fishing injuries, or seafood handling (7, 46). Like systemic disease, wound infections progress rapidly to cellulitis, ecchymoses, and bullae, which can progress to necrotizing fasciitis at the site of infection; however, the mortality rate for wound infections (ca. 25%) is lower than that for systemic disease (10,13,74). This organism possesses a wide array of virulence factors, including acid neutralization, capsular polysaccharide expression, iron acquisition, cytotoxicity, motility, and expression of proteins involved in attachment and adhesion. These factors likely require concerted expression for pathogenesis to take place and appear to be under the control of global regulators. Overall, V. vulnificus is a complex microorganism with physiological characteristics that contribute to its survival in the marine environment and in the human host.

pilF polymorphism-based real-time PCR to distinguish Vibrio vulnificus strains of human health relevance

“…The species is present in high numbers in filtering organisms, such as oysters, especially in warmer months (Oliver, 2006). V. vulnificus is a potent human pathogen, and is responsible for more than 95% of all seafood-related deaths (Jones and Oliver, 2009). Isolated incidents of V. vulnificus infections occur globally, with cases frequently reported in the U.S.A., Europe and the Far East (Dalsgaard et al, 1996;Chuang et al, 1992;Hlady and Klontz, 1996;Baker-Austin et al, 2010a).…”

Comparative analysis of proteins in the culture supernatants of human intestinal epithelial cells infected with the wild-type and rtxE mutant of Vibrio vulnificus

“…V. vulnificus infection disease is usually caused by the consumption of seafood containing V. vulnificus. V. vulnificus induces fever, septic shock, and the formation of secondary lesions, accompanied in many cases by the emergence of ulcer and edema in patients (1). The mortality of primary septicemia exceeds 50% in septic patients, and death may occur within 1-2 days after the initial signs of illness.…”

Virulence Characteristics of Sucrose-fermentingVibrio vulnificusStrains

“…

Vibrio vulnificus causes rapidly progressing fatal septicemia and necrotizing wound infections with a high mortality rate in susceptible individuals [1]. Accordingly, a rapid and appropriate diagnosis is essential for reducing the mortality of V. vulnificus infections.

…”

“…Their ability to utilize TBI appeared to be slightly lower compared to that of the M06-24/O strain. In the ferrophilic bacterium V. vulnificus, iron-uptake systems are the well-known virulence factors because its pathogenic potential is primarily determined by its ability to survive and multiply within the host where available iron is very low [1,11].…”