A comprehensive review of Vibrio vulnificus: an important cause of severe sepsis and skin and soft-tissue infection

Abstract

Vibrio vulnificus is a halophilic Gram-negative bacillus found worldwide in warm coastal waters. The pathogen has the ability to cause primary sepsis in certain high-risk populations, including patients with chronic liver disease, immunodeficiency, iron storage disorders, end-stage renal disease, and diabetes mellitus. Most reported cases of primary sepsis in the USA are associated with the ingestion of raw or undercooked oysters harvested from the Gulf Coast. The mortality rate for patients with severe sepsis is high, exceeding 50% in most reported series. Other clinical presentations include wound infection and gastroenteritis. Mild to moderate wound infection and gastroenteritis may occur in patients without obvious risk factors. Severe wound infection is often characterized by necrotizing skin and soft-tissue infection, including fasciitis and gangrene. V. vulnificus possesses several virulence factors, including the ability to evade destruction by stomach acid, capsular polysaccharide, lipopolysaccharide, cytotoxins, pili, and flagellum. The preferred antimicrobial therapy is doxycycline in combination with ceftazidime and surgery for necrotizing soft-tissue infection.

Successful Treatment of a Case of Necrotizing Fasciitis due to <i>Vibrio vulnificus</i> in a Cold Climate in Japan

“…vulnificus is a Gram-negative bacillus that preferentially grows in warm coastal regions with a brackish zone. V. vulnificus infection develops in three modes: primary septicemia, wound, and gastrointestinal infections (1). Septicemia has a mortality rate of 50% or higher (2, 3).…”

“…Wound infection occurs upon injury in the ocean or exposure of a wound to seawater. V. vulnificus infection can progress to severe skin and soft tissue infections, including necrotizing fasciitis (1,12).…”

“…V. vulnificus infection is a highly lethal disease that causes serious skin and soft tissue infections and sepsis (1). Patients with weakened immune systems, particularly those with chronic hepatic disorders, diabetes, and alcoholism, are known to be at high risk of developing this infection (2)(3)(4).…”

“…Patients with weakened immune systems, particularly those with chronic hepatic disorders, diabetes, and alcoholism, are known to be at high risk of developing this infection (2)(3)(4). The infection develops via the following modes: primary septicemia, wounds, and gastrointestinal infections (1). The incidence of V. vulnificus infection shows seasonal and regional patterns because V. vulnificus grows in warm water temperatures around 20 and lower salinity at coastal regions (3,5,6).…”

The inhibitory effect of a non-yessotoxin-producing dinoflagellate, Lingulodinium polyedrum (Stein) Dodge, towards Vibrio vulnificus and Staphylococcus aureus

“…Vibrio vulnificus is a Gram-negative, oxidase-positive, facultative anaerobe. In warm coastal waters, it causes vomiting, diarrhea and abdominal pain, when raw or undercooked shellfish, especially oysters, are consumed (Strom & Paranjpye, 2000;Tortora Funke & Case, 2007;Horseman & Surani, 2011). It has become resistant to various antibiotics (Kim et al, 2011;Shaw et al, 2014).…”