Clinical and ecological characteristics of Vibrio vulnificus in the Northeastern United States

Tilton, Richard C.; Ryan, Raymond

doi:10.1016/0732-8893(87)90094-0

Cited by 57 publications

(35 citation statements)

References 16 publications

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“…The most remarkable parameters that change in the course of the infection process should be temperature and salinity (osmolarity). The optimal temperature and salinity of estuaries that give the highest isolation rate for V. vulnificus have been reported to be about 25°C (35,53) and over 23‰ (50), respectively. When V. vulnificus was cultured at a salinity of 2.5%, it produced the hemolysin poorly.…”

Section: Discussionmentioning

confidence: 99%

Vibrio vulnificus Has the Transmembrane Transcription Activator ToxRS Stimulating the Expression of the Hemolysin Gene vvhA

et al. 2000

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In an attempt to dissect the virulence regulatory mechanism in Vibrio vulnificus, we tried to identify the V. cholerae transmembrane virulence regulator toxRS (toxRS Vc ) homologs in V. vulnificus. By comparing the sequences of toxRS of V. cholerae and V. parahaemolyticus (toxRS Vp ), we designed a degenerate primer set targeting well-conserved sequences. Using the PCR product as an authentic probe for Southern blot hybridization, a 1.6-kb BglII-HindIII fragment and a 1. Vibrio vulnificus is a halophilic estuarine bacterium that causes fatal septicemia and necrotizing wound infections. Primary septicemia occurs following ingestion of raw seafood contaminated with V. vulnificus. V. vulnificus preferentially affects persons with underlying hepatic diseases, a heavy alcohol drinking habit, and other immunocompromised conditions. Primary septicemia shows a rapidly progressing and fulminant course, which results in a high mortality rate of over 50% despite aggressive antimicrobial and supportive shock therapies (38,39,48).The optimal natural habitat of V. vulnificus is an estuary. The bacterium normally flourishes in estuarine seawater, shellfish, and plankton during warm months (8,35,50,54). V. vulnificus is concentrated in oysters and probably in other shellfish as well (21, 49). V. vulnificus opportunistically causes primary septicemia when contaminated shellfish is eaten raw by susceptible patients. This opportunist should experience a very dramatic change in environmental parameters during the infection process. Successful infection by pathogenic bacteria, in general, is established by coordinate expression of various virulence factors in vivo. Expression of virulence factors is controlled by environmental cues. Pathogenic bacteria possess elegant regulatory systems that sense and react to fluctuations in environmental parameters such as temperature, osmolarity, pH, iron concentration, CO 2 concentration, etc. (12, 27).Many pathogens employ novel signal transduction systems in regulating the virulence gene expression (12). Toxigenic V. cholerae has the toxRS system for that purpose (30). The genes toxR and toxS are clustered in an operon and encode transmembrane proteins ToxR and ToxS, respectively (10,29,32). ToxR regulates expression of multiple V. cholerae virulence factors such as the cholera toxin (ctx), toxin-coregulated pilus (tcp), and accessory colonization factor (acf) genes (9, 47). The activity of ToxR is further enhanced by ToxS, which interacts with the former protein in the periplasmic space and is thought to stabilize it (10, 36). The toxRS system seems to play universally important roles in the survival and host-microorganism interaction of Vibrio species. V. parahaemolyticus and V. fischeri also have homologs of the V. cholerae toxRS (toxRS Vc ) system (25,43). In the present study, we identified the toxRS homolog in V. vulnificus and showed the functional homology of ToxRS Vv with ToxRS Vc . We also observed that ToxR Vv regulates the production of hemolysin, the most potent exotoxin produced ...

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Section: Discussionmentioning

confidence: 99%

Vibrio vulnificus Has the Transmembrane Transcription Activator ToxRS Stimulating the Expression of the Hemolysin Gene vvhA

et al. 2000

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“…Biomarkers of liver function and disease do not correlate with release of cytokines in response to V. vulnificus. Liver disease, particularly in the context of chronic alcohol use, has been shown to be associated with increased susceptibility to infection by V. vulnificus from raw oysters (14,17,43). However, not all individuals with liver disease are equally susceptible, nor is liver disease the only condition that predisposes an individual to infection.…”

mentioning

confidence: 99%

Inflammatory Cytokine Response to Vibrio vulnificus Elicited by Peripheral Blood Mononuclear Cells from Chronic Alcohol Users Is Associated with Biomarkers of Cellular Oxidative Stress

et al. 2003

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Vibrio vulnificus is the leading cause of death in the United States associated with the consumption of raw seafood, particularly oysters. In epidemiological studies, primary septicemia and inflammation-mediated septic shock caused by V. vulnificus is strongly associated with liver disease, often in the context of chronic alcohol abuse. The present study was undertaken to determine whether clinical biomarkers of liver function or cellular oxidative stress are associated with peripheral blood mononuclear cell inflammatory cytokine responses to V. vulnificus. Levels of interleukin-1␤ (IL-1␤), IL-6, IL-8, and tumor necrosis factor alpha elicited in response to V. vulnificus and measured in cell supernatants were not associated with the liver biomarkers aspartate aminotransferase (AST) or alanine aminotransferase (ALT) or the AST/ALT ratio. Vibrio vulnificus is a gram-negative bacterium found commonly in marine and estuarine environments. In the United States, it predominates in the warm waters of the Gulf and Atlantic Coasts (25, 27, 28). Despite not being a notifiable disease, each year there are 20 to 50 reported cases of V. vulnificus primary septicemia in the United States, occurring most often following the consumption of naturally contaminated raw oysters (2, 14). V. vulnificus also has the ability to cause gastroenteritis, which is generally self-limiting, and wound infections in otherwise healthy individuals (17, 32). Primary septicemia is seen almost exclusively in people with an underlying condition affecting their immune system. In epidemiological studies, primary septicemia caused by V. vulnificus is most often associated with preexisting liver disease, although other conditions, such as diabetes mellitus, hemochromatosis, immunodeficiency, or malignancy, may also increase susceptibility to this organism (2,14,17,24,41). The impairment of iron metabolism and resultant iron overload associated with many of these conditions is thought to support increased V. vulnificus growth and reduced immune clearance (1, 15, 16). Primary septicemia caused by V. vulnificus appears to follow a classical septic shock pathway, including an overwhelming inflammatory cytokine response followed by multiorgan failure and death. Presently, there is no effective treatment for V. vulnificus once someone has developed primary septicemia, and death usually ensues. It should be noted that V. vulnificus has many similarities with other gram-negative, encapsulated, opportunistic bacterial pathogens and likely exploits similar host susceptibility pathways that could be targeted for intervention.To date, the majority of V. vulnificus studies have focused on the bacterial factors involved in disease (41). Therefore, while much is now known about some of the bacterial factors involved in the disease process, little is understood about host cellular factors leading to susceptibility. It has been previously shown that V. vulnificus has the ability to elicit inflammationassociated cytokines from primary human cells in vitro and from animals...

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“…Extensive work has been done on the natural incidence and survivability of vibrios in the aquatic environment (34,68,74,93,191,197), and the picture that emerges is a fascinating one of seasonal growth and decline coupled to special ecologic relationships with higher copepods and other plankton. The vibrios may also be required for a balanced ecosystem in the marine environment, and their association with higher organisms may provide a beneficial effect on salt retention by copepods and other organisms which play vital roles in the food chain (35).…”

Section: Environmental Studies Ecologymentioning

confidence: 99%

Current perspectives on the epidemiology and pathogenesis of clinically significant Vibrio spp

et al. 1988

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Recent taxonomic advances have now implicated several different Vibrio species as human pathogens. While the most common clinical presentation of Vibrio infection continues to be gastroenteritis, an increasing number of extraintestinal infections are being reported, particularly in immunocompromised individuals. Detection of Vibrio infections requires a good clinical history and the use of appropriate isolation and identification procedures by the laboratory to confirm illnesses attributed to Vibrio species. Except for Vibrio cholerae O1 and Vibrio parahaemolyticus, there is little direct evidence linking the production of a myriad of cell-associated or extracellular factors produced by each species with human disease and pathogenesis. Many questions regarding pathogenic Vibrio species remain unanswered, including their frequency and distribution in environmental specimens (water, shellfish), infective doses, virulence potential of individual isolates, and markers associated with such strains.

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Clinical and ecological characteristics of Vibrio vulnificus in the Northeastern United States

Cited by 57 publications

References 16 publications

Vibrio vulnificus Has the Transmembrane Transcription Activator ToxRS Stimulating the Expression of the Hemolysin Gene vvhA

Vibrio vulnificus Has the Transmembrane Transcription Activator ToxRS Stimulating the Expression of the Hemolysin Gene vvhA

Inflammatory Cytokine Response to Vibrio vulnificus Elicited by Peripheral Blood Mononuclear Cells from Chronic Alcohol Users Is Associated with Biomarkers of Cellular Oxidative Stress

Current perspectives on the epidemiology and pathogenesis of clinically significant Vibrio spp

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