Vibrio cholerae non-O1 bacteraemia: description of three cases in the Netherlands and a literature review

Abstract

Vibrio cholerae non-O1 serogroup (VCNO) bacteraemia is a severe condition with a high case-fatality rate. We report three cases diagnosed in the Netherlands, identified during a national microbiological congress, and provide a literature review on VCNO bacteraemia. A search strategy including synonyms for 'VCNO' and 'bacteraemia' was applied to PubMed, Medline, Web of Science and Embase databases. The three cases were reported in elderly male patients after fish consumption and/or surface water contact. The literature search yielded 82 case reports on 90 cases and six case series. Thirty case reports were from Asia (30/90; 33%), concerned males (67/90; 74%), and around one third (38/90; 42%) involved a history of alcohol abuse and/or liver cirrhosis The presenting symptom often was gastroenteritis (47/90; 52%) which occurred after seafood consumption in 32% of the cases (15/47).Aside from the most frequent symptom being fever, results of case series concurred with these findings. Published cases also included rare presentations e.g. endophthalmitis and neonatal meningitis. Based on the limited data available, cephalosporins seemed the most effective treatment. Although mainly reported in Asia, VCNO bacteraemia occurs worldwide. While some risk factors for VCNO were identified in this study, the source of infection remains often unclear. Clinical presentation may vary greatly and therefore a quick microbiological diagnosis is indispensable.

Application of three different methods to determine the prevalence, the abundance and the environmental drivers of culturableVibrio choleraein fresh and brackish bathing waters

“…; Engel et al . ). In the past two decades, Vibrio ‐associated infections have been significantly increasing in Europe and the United States of America (Newton et al .…”

“…Only strains belonging to serogroups O1 and O139 and possessing the virulence factors cholera toxin (ctx) and toxin coreglated pilus (tcp) are able to cause this devastating disease. Besides cholera, nontoxigenic V. cholerae strains (belonging to serogroups other than O1 and O139) are able to cause a variety of other infections such as gastroenteritis, ear, wound, blood or soft-tissue infections (Huhulescu et al 2007;Crowe et al 2016;Engel et al 2016). In the past two decades, Vibrio-associated infections have been significantly increasing in Europe and the United States of America (Newton et al 2012;Baker-Austin et al 2013;Le Roux et al 2015;Vezzulli et al 2016).…”

“…Especially in Northern Europe (Baltic Sea), infections of swimmers have been predominantly caused by V. cholerae nonO1/nonO139 (Baker-Austin et al 2016b). Some serious infections of swimmers due to V. cholerae nonO1/nonO139 have also been reported from other European countries (Stypulkowska-Misiurewicz et al 2006;Huhulescu et al 2007;Sterk et al 2015;Dobrovic et al 2016;Engel et al 2016;Hirk et al 2016;Maraki et al 2016). The observed increase in infection frequency has been linked to global warming and the significantly increased water temperatures observed in many aquatic environments (Baker-Austin et al 2016b;Vezzulli et al 2016).…”

A note from the editors: impact of anthropogenic changes to water on human pathogens

“…In conclusion, this special issue provides some insights into the importance of surveillance of pathogens in the water [19][20][21][22][23] and outbreaks or cases caused by waterborne pathogens [19,21,23]. Wider studies could help further refine criteria for assessing water treatment processes.…”

“…Cases had been prior exposed to fish and/or had contact with surface water. The Dutch study includes a review of the literature to identify sources and risk factors for bacteraemia [23].…”